South East London Joint Medicines Formulary Formulary

	South East London Joint Medicines Formulary
	Guy's and St Thomas' NHS Foundation Trust Kings College Hospital NHS Foundation Trust Lewisham and Greenwich NHS Trust

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Formulary Chapter 10: Musculoskeletal and joint diseases - Full Chapter

Notes:

Where a formulary entry does not detail a medicine’s indications for use, the medicine can be assumed to be approved for all licensed indications.

Formulary approved "off-label" use is detailed separately.

Details...

10.01.01

Non-steroidal anti-inflammatory drugs

Acelofenac tabs

Formulary

Arthrotec^® tabs (diclofenac + misoprostol)

Formulary

Aspirin tabs (analgesia)

Formulary

Celecoxib capsules

Formulary

Diclofenac sodium e/c, m/r & disp tabs, suppositories

Formulary

Approved for all licensed indications, and the following off-label indication:

Stat rectal dose prior to ERCP for prevention of post-ERCP pancreatitis

MHRA Jun 2013: Diclofenac: new contraindications and warnings

Etoricoxib tabs

Formulary

Approved for:

Rheumatoid arthritis and ankylosing spondylitis

Restricted to use after a non-selective NSAID (e.g. naproxen), has failed to achieve symptom relief.

Refer to APC recommentation for further information (link below)

SE London APC recommendation: Etoricoxib 60mg and 90mg tablets for the symptomatic relief of symptoms in adults with ankylosing spondylitis and rheumatoid arthritis

Fenbufen tabs

Formulary

Flurbiprofen tabs

Formulary

Ibuprofen tabs, suspension

Formulary

Indometacin caps, m/r caps, suppositories

Formulary

Approved for licensed use, and the following off label indications:

Stat rectal dose prior to ERCP for prevention of post-ERCP pancreatitis

Chronic paroxysmal hemicrania

Ketoprofen caps

Formulary

Mefenamic acid caps, tabs

Formulary

In secondary care use on gynaecology advice only for:

dysmenorrhoea

Menorrhagia

Meloxicam tabs

Formulary

Nabumetone tabs, suspension

Restricted

For palliative care patients with pain relating to soft tissue, visceral or bone inflammation

Naproxen tabs

Formulary

Sulindac tabs

Formulary

Phenylbutazone tablets

Unlicensed

Restricted use

Ankylosing spondylitis

MHRA Guidance Jan 2015: Cox-2 selective inhibitors and non-steroidal anti-inflammatory drugs (NSAIDs): Cardiovascular safety

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Key

	Notes
	Section Title (top level)
	Section Title (sub level)
	First Choice item
	Non Formulary section
	Restricted Drug
	Unlicensed
	Display tracking information
	Link to adult BNF
	Link to SPCs
	Scottish Medicines Consortium

	Cytotoxic Drug
	Controlled Drug
	High Cost Medicine
	Cancer Drugs Fund
	NHS England
	Homecare
	CCG

Traffic Light Status Information

Status	Description
	Specialist or hospital prescribing only. The responsibility for prescribing, monitoring, dose adjustment and review should remain with the specialist or hospital. In very exceptional circumstances a specialist may discuss individual patient need for a RED drug to be prescribed by a GP and the GP should consider informing the Medicines Management team before a decision is made to prescribe for individual patients.
	Treatment can be initiated in primary care after a recommendation from an appropriate specialist
	Specialist initiation followed by maintenance prescribing in primary care
	Specialist initiation with ongoing monitoring required. After dose stabilisation GPs can be requested to take over prescribing responsibilities using the approved APC shared care documentation
	Specialist and non-specialist initiation
	Not recommended for prescribing