netFormulary South East London Joint Medicines Formulary NHS
Guy's and St Thomas' NHS Foundation Trust
Kings College Hospital NHS Foundation Trust
Lewisham and Greenwich NHS Trust
 Formulary Chapter 10: Musculoskeletal and joint diseases - Full Chapter
10.01.04  Expand sub section  Gout and cytotoxic-induced hyperuricaemia
10.01.04  Expand sub section  Acute attacks of gout
10.01.04  Expand sub section  Long-term control of gout
10.01.04  Expand sub section  Hyperuricaemia associated with cytotoxic drugs
Rasburicase injection

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High Cost Medicine
Anakinra injection

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Restricted Drug Restricted
High Cost Medicine
Approved off-label indication (consultant specialists only):
Polyarticular acute gout and multiple swollen joints where:
  • There have been recurrent acute flares of gout
  • There has been lack of response to, or contra-indications to NSAIDs, colchicine and steroids
    Dose = 100mg daily for 3 days

  • Link  SE London APC recommendation: anakinra for acute gout    
    Probenecid tabs

    Restricted Drug Unlicensed Approved for:
  • Prevention of nephrotoxicity associated with cidofovir
  • Prophylaxis of gout in cases resistant to allopurinol
    Probenecid tabs (penicillin augmentation in syphilis)

    Restricted Drug Unlicensed
    Approved for use in:
  • Late latent syphilis and neurosyphilis in conjuction with penicillin treatments (either amoxicillin or procaine pneicillin G) as per BASHH guidance. Dose = 500mg qds for duration of penicillin use
    note Notes First Choice Item First Choice item
    Section Title Section Title (top level) Non Formulary Item Non Formulary section
    Section Title Section Title (sub level)
    Cytotoxic Drug
    Cytotoxic Drug
    Restricted Drug
    Restricted Drug
    Controlled Drug
    Unlicensed Drug
    High Cost Medicine
    High Cost Medicine
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    Link to SPCs
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    Link to adult BNF
    Track Changes
    Display tracking information
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    Cancer Drugs Fund
    Cancer Drugs Fund


    Traffic Light Status Information

    Status Description
      Red   Specialist Prescribing only. The responsibility for prescribing, monitoring, dose adjustment and review should remain with the specialist. 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.   
      Amber 1   Treatment can be initiated in primary care after a recommendation from an appropriate specialist  
      Amber 2   Specialist initiation followed by maintenance prescribing in primary care  
      Amber 3   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  
      Green   Specialist and non-specialist initiation  
      Grey   Not recommended for prescribing