Lancashire and South Cumbria
Formulary
Formulary
10 Musculoskeletal and joint diseases
This chapter of the formulary is under continual development, please let the team know if you have any comments about the contents: mlcsu.lscformulary@nhs.net.
For more information about the formulary development process, please see: https://www.lancsmmg.nhs.uk/lancashire-and-south-cumbria-icb-formulary-development/
10-01-01 Non-steroidal anti-inflammatory drugs
Systemic as well as local effects of NSAIDs contribute to gastro–intestinal damage; taking oral formulations with milk or food, or using enteric-coated formulations, or changing the route of administration may only partially reduce symptoms such as dyspepsia.
| Ibuprofen |
|
First Choice
|
Tablets 200mg, 400mg, 600mg
|
 LSCMMG: Over the Counter Items that Should not be Routinely Prescribed in Primary Care Policy MHRA: High-dose ibuprofen (≥2400mg/day): small increase in cardiovascular risk |
|
Solution for infusion 400mg/100mL| Naproxen |
|
First Choice
|
Tablets 250mg, 500mg |
|
LSCMMG: Over the Counter Items that Should not be Routinely Prescribed in Primary Care Policy |
|
|
| Diclofenac |
|
Formulary
|
Tablets e/c 25mg, 50mg
|
|
MHRA: Diclofenac: new contraindications and warnings |
|
|
For short term use in breastfeeding mothers only.
Rheumatology initiation ONLY. When other NSAIDs have been shown to be clinically ineffective.| Etoricoxib |
|
Formulary
|
Tablets 30mg, 60mg, 90mg, 120mg |
|
MHRA: Etoricoxib (Arcoxia): revised dose recommendation for rheumatoid arthritis and ankylosing spondylitis |
|
| Diclofenac |
|
Formulary
|
Suppositories 12.5mg, 25mg, 50mg, 100mg Short-term use only. |
|
MHRA: Diclofenac: new contraindications and warnings |
|
Links
- LSCMMG: Inflammatory Bowel Disease: High Cost Drugs Commissioning Pathway
- LSCMMG: Over the Counter Items that Should not be Routinely Prescribed in Primary Care Policy
- LSCMMG: Over the Counter Items that Should not be Routinely Prescribed in Primary Care Policy
- LSCMMG: Primary Care Constipation Guidelines
- MHRA Drug Safety Update Oct 2016: Etoricoxib (Arcoxia): revised dose recommendation for rheumatoid arthritis and ankylosing spondylitis
- MHRA Drug Safety Update: Contraindications and warnings due to CV risk (2013)
- MHRA Drug Safety Update: Contraindications and warnings due to CV risk (2013)
- MHRA Drug Safety Update: Contraindications and warnings due to CV risk (2013)
- MHRA Drug Safety Update: Contraindications and warnings due to CV risk (2013)
- MHRA Drug Safety Update: Contraindications and warnings due to CV risk (2013)
- MHRA DSU April 2019: Belimumab (Benlysta): increased risk of serious psychiatric events seen in clinical trials
- MHRA: Antiepileptic drugs in pregnancy: updated advice following comprehensive safety review
- MHRA: Diclofenac: new contraindications and warnings
- MHRA: Diclofenac: new contraindications and warnings
- MHRA: Etoricoxib (Arcoxia): revised dose recommendation for rheumatoid arthritis and ankylosing spondylitis
- MHRA: High-dose ibuprofen (≥2400mg/day): small increase in cardiovascular risk
- MHRA: https://www.gov.uk/drug-safety-update/diclofenac-new-contraindications-and-warnings
- MHRA: Non-steroidal anti-inflammatory drugs (NSAIDs): cardiovascular risks
- MHRA: Non-steroidal anti-inflammatory drugs (NSAIDs): potential risks following prolonged use after 20 weeks of pregnancy
- NICE CG143:Fever in under 5s: assessment and initial management
- NICE CG147: Diverticular disease: diagnosis and management
- NICE CG184 Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management
- NICE CG61: Irritable bowel syndrome in adults: diagnosis and management
- NICE NG1: Gastro-oesophageal reflux disease: recognition, diagnosis and management in children and young people
- NICE TA397: Belimumab for treating active autoantibody-positive systemic lupus erythematosus
- NICE TA752:Belimumab for treating active autoantibody-positive systemic lupus erythematosus
- NICE TA806: Belimumab for treating lupus nephritis (terminated appraisal)
- NPC: Diclofenac and CV risk review (2010)
- NPC: Diclofenac and CV risk review (2010)
- NPC: Diclofenac and CV risk review (2010)
- NPC: Diclofenac and CV risk review (2010)
- NPC: Diclofenac and CV risk review (2010)
- NSAID review (UKmi 2013) - naproxen or ibuprofen preferred
- NSAID review (UKMi 2013) - Naproxen or ibuprofen preferred
- NSAID review (UKMi 2013) - Naproxen or ibuprofen preferred
- NSAID review (UKmi 2013) - Naproxen or ibuprofen preferred
- NSAID review (UKMi 2013) - Naproxen or ibuprofen preferred
- NSAID review (UKMi 2013) - Naproxen or ibuprofen preferred
- NSAID review (UKMi 2013) - Naproxen or ibuprofen preferred
- UKMI Q&A: Can breastfeeding mothers take ibuprofen?