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/
10-01-03 Drugs affecting the immune response
| Azathioprine |
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Formulary
|
Tablets 25mg, 50mg |
 LSCMMG: Azathioprine and Mercaptopurine shared care guideline MHRA: Thiopurines and intrahepatic cholestasis of pregnancy |
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| Ciclosporin |
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Formulary
|
Capsules 25mg, 50mg, 100mg Patients should be stabilised on a particular brand of oral ciclosporin because switching between formulations without close monitoring may lead to clinically important changes in blood-ciclosporin concentration. |
|
LSCMMG: Ciclosporin shared care guideline |
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| Cyclophosphamide |
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Formulary
|
Tablets 50mg |
|
| Leflunomide |
|
Formulary
|
Tablets 10mg, 20mg |
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LSCMMG: Leflunomide shared care guideline |
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| Methotrexate |
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Formulary
|
Tablets 2.5mg Prefilled syringes and pens (various strengths) Methotrexate subcutaneous injection is supplied through a homecare arrangement in ELHT. |
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LSCMMG: Methotrexate shared care guideline MHRA: Methotrexate once-weekly for autoimmune diseases: new measures to reduce risk of fatal overdose due to inadvertent daily instead of weekly dosing MHRA: Methotrexate: advise patients to take precautions in the sun to avoid photosensitivity reactions |
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| Mycophenolate Mofetil |
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Formulary
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Tablets 500mg |
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LSCMMG: Shared care guideline: Mycophenolate Mofetil MHRA: Mycophenolate mofetil, mycophenolic acid: new pregnancy-prevention advice for women and men MHRA: Mycophenolate mofetil, mycophenolic acid: updated contraception advice for male patients |
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Links
- Baricitinib (Olumiant▼): risk of venous thromboembolism
- LSCMMG Shared Care Guideline - Azathioprine and mercaptopurine
- LSCMMG Shared Care Guideline - ciclosporin
- LSCMMG Shared Care Guideline - Leflunomide
- LSCMMG Shared Care Guideline - Methotrexate
- LSCMMG Shared Care Guideline - Methotrexate
- LSCMMG Shared Care Guideline - Methotrexate
- LSCMMG Shared care guideline - penicillamine
- LSCMMG Shared Care Guideline - sodium aurothiomalate (gold) injection
- LSCMMG Shared Care Guideline - Sulfasalazine
- LSCMMG: Azathioprine and Mercaptopurine shared care guideline
- LSCMMG: Ciclosporin shared care guideline
- LSCMMG: Hydroxychloroquine information sheet
- LSCMMG: Inflammatory Bowel Disease: High Cost Drugs Commissioning Pathway
- LSCMMG: Juvenile Idiopathic Arthritis in adult patients: Position statement for biological agents
- LSCMMG: Leflunomide shared care guideline
- LSCMMG: Methotrexate shared care guideline
- LSCMMG: Penicillamine shared care guideline
- LSCMMG: Primary Care Constipation Guidelines
- LSCMMG: Shared care guideline: Mycophenolate Mofetil
- LSCMMG: Sulfasalazine shared care guideline
- MHRA advice regarding risk of hepatotoxicity, haemotoxicity, infections, and birth defects
- MHRA Drug Safety Update Aug 2020: Baricitinib (Olumiant): increased risk of diverticulitis, particularly in patients with risk factors
- MHRA Drug Safety Update July 2019: Tocilizumab (RoActemra): rare risk of serious liver injury including cases requiring transplantation
- MHRA Drug Safety Update Mar 2020: Tofacitinib (Xeljanz): new measures to minimise risk of venous thromboembolism and of serious and fatal infections
- MHRA Drug safety Update March 2020: Baricitinib (Olumiant): risk of venous thromboembolism
- MHRA Drug Safety Update may 2019: Tofacitinib (Xeljanz): restriction of 10 mg twice-daily dose in patients at high risk of pulmonary embolism while safety review is ongoing
- MHRA Drug Safety Update Oct 2021: Tofacitinib (Xeljanz): new measures to minimise risk of major adverse cardiovascular events and malignancies
- 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: Apremilast (Otezla ▼): risk of suicidal thoughts and behaviour
- MHRA: Baricitinib (Olumiant▼): increased risk of diverticulitis, particularly in patients with risk factors
- MHRA: Belimumab (Benlysta▼): increased risk of serious psychiatric events seen in clinical trials
- MHRA: Hydroxychloroquine, chloroquine: increased risk of cardiovascular events when used with macrolide antibiotics; reminder of psychiatric reactions
- MHRA: Janus kinase (JAK) inhibitors: new measures to reduce risks of major cardiovascular events, malignancy, venous thromboembolism, serious infections and increased mortality
- MHRA: Janus kinase (JAK) inhibitors: new measures to reduce risks of major cardiovascular events, malignancy, venous thromboembolism, serious infections and increased mortality
- MHRA: Janus kinase (JAK) inhibitors: new measures to reduce risks of major cardiovascular events, malignancy, venous thromboembolism, serious infections and increased mortality
- MHRA: Janus kinase (JAK) inhibitors: new measures to reduce risks of major cardiovascular events, malignancy, venous thromboembolism, serious infections and increased mortality
- MHRA: Methotrexate once-weekly for autoimmune diseases: new measures to reduce risk of fatal overdose due to inadvertent daily instead of weekly dosing
- MHRA: Methotrexate: advise patients to take precautions in the sun to avoid photosensitivity reactions
- MHRA: Mycophenolate mofetil, mycophenolic acid: new pregnancy-prevention advice for women and men
- MHRA: Mycophenolate mofetil, mycophenolic acid: updated contraception advice for male patients
- MHRA: Rituximab: screen for hepatitis B virus before treatment
- MHRA: Thiopurines and intrahepatic cholestasis of pregnancy
- MHRA: Tocilizumab (RoActemra): rare risk of serious liver injury including cases requiring transplantation
- MHRA: Tofacitinib (Xeljanz▼): new measures to minimise risk of major adverse cardiovascular events and malignancies
- MHRA: Tofacitinib (Xeljanz▼): new measures to minimise risk of venous thromboembolism and of serious and fatal infections
- MHRA: Tofacitinib (Xeljanz▼): restriction of 10 mg twice-daily dose in patients at high risk of pulmonary embolism while safety review is ongoing
- MHRA: Tuberculosis riskscreen patients before starting treatment
- MHRA: Tuberculosis riskscreen patients before starting treatment
- MHRA: Tuberculosis riskscreen patients before starting treatment
- MHRA: Tuberculosis riskscreen patients before starting treatment
- MHRA: Tuberculosis riskscreen patients before starting treatment
- MHRA: Tumour necrosis factor alpha inhibitors
- MHRA: Tumour necrosis factor alpha inhibitors
- MHRA: Tumour necrosis factor alpha inhibitors
- MHRA: Tumour necrosis factor alpha inhibitors
- MHRA: Tumour necrosis factor alpha inhibitors
- MHRA: Ustekinumab (Stelara): risk of exfoliative dermatitis
- NHSE: Clinical commissioning policy: Etanercept and adalimumab for the treatment of deficiency of adenosine deaminase type 2 (aged 5 years and older) [2319]
- NHSE: Clinical commissioning policy: Etanercept and adalimumab for the treatment of deficiency of adenosine deaminase type 2 (aged 5 years and older) [2319]
- 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 NG191 COVID-19 rapid guideline: managing COVID-19
- NICE Q&A: Interaction between methotrexate and penicillins
- NICE TA 225: rheumatoid arthritis
- NICE TA 375 Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed
- NICE TA 375 Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed
- NICE TA103: Etanercept and efalizumab for the treatment of adults with psoriasis
- NICE TA143: Ankylosing spondylitis
- NICE TA143: Ankylosing spondylitis
- NICE TA143: Ankylosing spondylitis
- NICE TA167: Infliximab and adalimumab for the treatment of Crohn’s disease
- NICE TA195: Adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a TNF inhibitor
- NICE TA195: Adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a TNF inhibitor
- NICE TA195: After the failure of a TNF inhibitor
- NICE TA195: Rheumatoid arthritis - after failure of a TNF inhibitor
- NICE TA195: Rheumatoid arthritis (after failure of a TNF inhibitor)
- NICE TA195:Adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a TNF inhibitor
- NICE TA195:Adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a TNF inhibitor
- NICE TA195:Adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a TNF inhibitor
- NICE TA195:Adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a TNF inhibitor
- NICE TA199: Etanercept, infliximab and adalimumab for the treatment of psoriatic arthritis
- NICE TA199: Etanercept, infliximab and adalimumab for the treatment of psoriatic arthritis
- NICE TA199: Etanercept, infliximab and adalimumab for the treatment of psoriatic arthritis
- NICE TA199: Psoriatic arthritis
- NICE TA199: Psoriatic arthritis
- NICE TA199: Psoriatic arthritis
- NICE TA220: Golimumab for the treatment of psoriatic arthritis
- NICE TA220: psoriatic arthritis
- NICE TA225: Golimumab for the treatment of rheumatoid arthritis after the failure of previous disease-modifying anti-rheumatic drugs
- NICE TA233: ankylosing spondylitis
- NICE TA247: Tocilizumab for the treatment of rheumatoid arthritis
- NICE TA340: Ustekinumab for treating active psoriatic arthritis
- NICE TA373 Abatacept, adalimumab, etanercept and tocilizumab for treating juvenile idiopathic arthritis
- NICE TA373: Abatacept, adalimumab, etanercept and tocilizumab for treating juvenile idiopathic arthritis
- NICE TA373: Abatacept, adalimumab, etanercept and tocilizumab for treating juvenile idiopathic arthritis
- NICE TA373: Abatacept, adalimumab, etanercept and tocilizumab for treating juvenile idiopathic arthritis
- NICE TA373: Abatacept, adalimumab, etanercept and tocilizumab for treating juvenile idiopathic arthritis
- NICE TA373: Abatacept, adalimumab, etanercept and tocilizumab for treating juvenile idiopathic arthritis
- NICE TA373: Abatacept, adalimumab, etanercept and tocilizumab for treating juvenile idiopathic arthritis
- NICE TA373: Abatacept, adalimumab, etanercept and tocilizumab for treating juvenile idiopathic arthritis
- NICE TA375 Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed
- NICE TA375 Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed
- NICE TA375 Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed
- NICE TA375 Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed
- NICE TA375 Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed
- NICE TA375: Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed
- NICE TA375: Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed
- NICE TA375: Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed
- NICE TA375: Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed
- NICE TA375: Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed
- NICE TA375: Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed
- NICE TA375: Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed
- NICE TA383: TNF-alpha inhibitors for ankylosing spondylitis and non-radiographic axial spondyloarthritis
- NICE TA383: TNF-alpha inhibitors for ankylosing spondylitis and non-radiographic axial spondyloarthritis
- NICE TA383: TNF-alpha inhibitors for ankylosing spondylitis and non-radiographic axial spondyloarthritis
- NICE TA383: TNF-alpha inhibitors for ankylosing spondylitis and non-radiographic axial spondyloarthritis
- NICE TA383: TNF-alpha inhibitors for ankylosing spondylitis and non-radiographic axial spondyloarthritis
- NICE TA397: Belimumab for treating active autoantibody-positive systemic lupus erythematosus
- NICE TA407: Secukinumab for active ankylosing spondylitis after treatment with non-steroidal anti-inflammatory drugs or TNF-alpha inhibitors
- NICE TA415: Certolizumab pegol for treating rheumatoid arthritis after inadequate response to a TNF-alpha inhibitor
- NICE TA415: Certolizumab pegol for treating rheumatoid arthritis after inadequate response to a TNF-alpha inhibitor
- NICE TA433: Apremilast for treating active psoriatic arthritis
- NICE TA445: Certolizumab pegol and secukinumab for treating active psoriatic arthritis after inadequate response to DMARDs
- NICE TA445: Certolizumab pegol and secukinumab for treating active psoriatic arthritis after inadequate response to DMARDs
- NICE TA445: Certolizumab pegol and secukinumab for treating active psoriatic arthritis after inadequate response to DMARDs
- NICE TA466: Baricitinib for moderate to severe rheumatoid arthritis
- NICE TA466: Baricitinib for moderate to severe rheumatoid arthritis
- NICE TA480 Tofacitinib for moderate to severe rheumatoid arthritis
- NICE TA480: Tofacitinib for moderate to severe rheumatoid arthritis
- NICE TA485: Sarilumab for moderate to severe rheumatoid arthritis
- NICE TA485: Sarilumab for moderate to severe rheumatoid arthritis
- NICE TA497: Golimumab for treating non-radiographic axial spondyloarthritis
- NICE TA497: Golimumab for treating non-radiographic axial spondyloarthritis
- NICE TA518: Tocilizumab for treating giant cell arteritis
- NICE TA518: Tocilizumab for treating giant cell arteritis
- NICE TA537: Ixekizumab for treating active psoriatic arthritis after inadequate response to DMARDs
- NICE TA543: Tofacitinib for treating active psoriatic arthritis after inadequate response to DMARDs
- NICE TA543: Tofacitinib for treating active psoriatic arthritis after inadequate response to DMARDs
- NICE TA547: Tofacitinib for moderately to severely active ulcerative colitis
- NICE TA574: Certolizumab pegol for treating moderate to severe plaque psoriasis
- NICE TA575: Tildrakizumab for treating moderate to severe plaque psoriasis
- NICE TA596:Risankizumab for treating moderate to severe plaque psoriasis
- NICE TA665: Upadacitinib for treating severe rheumatoid arthritis
- NICE TA665: Upadacitinib for treating severe rheumatoid arthritis
- NICE TA676: Filgotinib for treating moderate to severe rheumatoid arthritis
- NICE TA676; Filgotinib for treating moderate to severe rheumatoid arthritis
- NICE TA681: Baricitinib for treating moderate to severe atopic dermatitis
- NICE TA685: Anakinra for treating Stills disease
- NICE TA685:Anakinra for treating Stills disease
- NICE TA711: Guselkumab for treating active psoriatic arthritis after inadequate response to DMARDs
- NICE TA715: Adalimumab, etanercept, infliximab and abatacept for treating moderate rheumatoid arthritis after conventional DMARDs have failed
- NICE TA715: Adalimumab, etanercept, infliximab and abatacept for treating moderate rheumatoid arthritis after conventional DMARDs have failed
- NICE TA715: Adalimumab, etanercept, infliximab and abatacept for treating moderate rheumatoid arthritis after conventional DMARDs have failed
- NICE TA715: Adalimumab, etanercept, infliximab and abatacept for treating moderate rheumatoid arthritis after conventional DMARDs have failed
- NICE TA715: Adalimumab, etanercept, infliximab and abatacept for treating moderate rheumatoid arthritis after conventional DMARDs have failed
- NICE TA715: Adalimumab, etanercept, infliximab and abatacept for treating moderate rheumatoid arthritis after conventional DMARDs have failed
- NICE TA715: Adalimumab, etanercept, infliximab and abatacept for treating moderate rheumatoid arthritis after conventional DMARDs have failed
- NICE TA715: Adalimumab, etanercept, infliximab and abatacept for treating moderate rheumatoid arthritis after conventional DMARDs have failed
- NICE TA718: Ixekizumab for treating axial spondyloarthritis
- NICE TA719: Secukinumab for treating non-radiographic axial spondyloarthritis
- NICE TA735: Tofacitinib for treating juvenile idiopathic arthritis
- NICE TA735: Tofacitinib for treating juvenile idiopathic arthritis
- NICE TA744: Upadacitinib for treating moderate rheumatoid arthritis
- NICE TA744: Upadacitinib for treating moderate rheumatoid arthritis
- NICE TA752:Belimumab for treating active autoantibody-positive systemic lupus erythematosus
- NICE TA752:Belimumab for treating active autoantibody-positive systemic lupus erythematosus
- NICE TA768: Upadacitinib for treating active psoriatic arthritis after inadequate response to DMARDs
- NICE TA768: Upadacitinib for treating active psoriatic arthritis after inadequate response to DMARDs
- NICE TA792: Filgotinib for treating moderately to severely active ulcerative colitis
- NICE TA803: Risankizumab for treating active psoriatic arthritis after inadequate response to DMARDs
- NICE TA803: Risankizumab for treating active psoriatic arthritis after inadequate response to DMARDs
- NICE TA806: Belimumab for treating lupus nephritis (terminated appraisal)
- NICE TA806: Belimumab for treating lupus nephritis (terminated appraisal)
- NICE TA814 : Abrocitinib, tralokinumab or upadacitinib for treating moderate to severe atopic dermatitis
- NICE TA815: Guselkumab for treating active psoriatic arthritis after inadequate response to DMARDs
- NICE TA815: Guselkumab for treating active psoriatic arthritis after inadequate response to DMARDs
- NICE TA829: Upadacitinib for treating active ankylosing spondylitis
- NICE TA829: Upadacitinib for treating active ankylosing spondylitis
- NICE TA829: Upadacitinib for treating active ankylosing spondylitis
- NICE TA861 Upadacitinib for treating active non-radiographic axial spondyloarthritis
- NICE TA861: Upadacitinib for treating active non-radiographic axial spondyloarthritis
- NICE TA878 Casirivimab plus imdevimab, nirmatrelvir plus ritonavir, sotrovimab and tocilizumab for treating COVID-19
- NICE TA888: Risankizumab for previously treated moderately to severely active Crohn’s disease
- NICE TA916: Bimekizumab for treating active psoriatic arthritis
- NICE TA916: Bimekizumab for treating active psoriatic arthritis
- NICE TA918: Bimekizumab for treating axial spondyloarthritis
- NICE TA918:Bimekizumab for treating axial spondyloarthritis
- NICE TA920: Tofacitinib for treating active ankolysing spondylitis
- NICE TA920: Tofacitinib for treating active ankylosing spondylitis
- NICE TA982: Baricitinib for treating juvenile idiopathic arthritis in people 2 years and over (terminated appraisal)
- NICETA195: Adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a TNF inhibitor
- Policy for prescribing and supply of methotrexate to inpatients
- UKMI Q and A: Can mothers breast feed while taking azathioprine?
- UKMI Q&A: Methotrexate and alcohol guidance