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North Staffordshire Joint Formulary
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Stoke-on-Trent Clinical Commissioning Group
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 Formulary Chapter 10: Musculoskeletal and joint diseases - Full Chapter
10.01.01  Expand sub section  Non-steroidal anti-inflammatory drugs
Ibuprofen 
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First Choice
Green

1st line NSAID

Ibuprofen 200mg tablets
Ibuprofen 400mg tablets
Ibuprofen 100mg/5ml oral suspension
Ibuprofen 100mg/5ml oral suspension SF

 
Diclofenac 
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Formulary
Red

Diclofenac 25mg E/C tablet
Diclofenac 50mg E/C tablet
Diclofenac 50mg tablet
Diclofenac 75mg MR tablet and capsule
Diclofenac 100mg MR tablet and capsule
Diclofenac 12.5mg suppositories
Diclofenac 25mg suppositories
Diclofenac 50mg suppositories
Diclofenac 100mg suppositories
Diclofenac 75mg/3ml solution for injection ampoules

Diclofenac is now contraindicated in those with: ischaemic heart disease; peripheral arterial disease; cerebrovascular disease; or established congestive heart failure (New York Heart Association [NYHA] classification II-IV). Naproxen and ibuprofen are preferred when NSAIDs are indicated. 

 
Link  MHRA Guidance on Diclofenac
   
Diclofenac 
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Formulary
Green

Diclofenac 25mg E/C tablet
Diclofenac 50mg E/C tablet
Diclofenac 50mg tablet
Diclofenac 75mg MR tablet and capsule
Diclofenac 100mg MR tablet and capsule
Diclofenac 12.5mg suppositories
Diclofenac 25mg suppositories
Diclofenac 50mg suppositories
Diclofenac 100mg suppositories
Diclofenac 75mg/3ml solution for injection ampoules

 

Paediatrics only

 
Link  Medicines For Children: Diclofenac for pain and inflammation
   
Indometacin 
(Indomethacin)
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Formulary
Green

Indometacin 25mg capsules
Indometacin 50mg capsules

 

If an NSAID is needed, use ibuprofen (1200mg a day or less) or naproxen (1000mg a day or less)

 

 

 
   
Meloxicam 
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Formulary
Green

Meloxicam 7.5mg tablets
Meloxicam 15mg tablets

 

If an NSAID is needed, use ibuprofen (1200mg a day or less) or naproxen (1000mg a day or less)

 
   
Nabumetone 
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Formulary
Green

Nabumetone 500mg tablets

 

If an NSAID is needed, use ibuprofen (1200mg a day or less) or naproxen (1000mg a day or less).

 
   
Naproxen 
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Formulary
Green

Naproxen 250mg tablets
Naproxen 500mg tablets

Standard release preparations only

 

 
   
Celecoxib 
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Formulary
Green

Celecoxib 100mg capsules
Celecoxib 200mg capsules

 

If an NSAID is needed, use ibuprofen (1200mg a day or less) or naproxen (1000mg a day or less)

MHRA Advice: COX-2 NSAIDs have a higher cardiovascular risk profile

 
Link  MHRA Guidance on cardiovascular safety of Cox-2 inhibitors
   
 ....
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG
Blueteq
High Cost Drug Approval System

Traffic Light Status Information

Status Description

Red

Medicines that can only be prescribed within Secondary Care. Examples of medicines which fall into this category are: Certain new medicines and new indications for older medicines where there is at present no experience of use in Primary Care. Medicines or dressings not available or prescribable in Primary Care. Where a medicine has been classified as Amber E, but an approved shared-care guideline is not yet available   

Amber

Medicines which can be prescribed within Secondary Care, but are only suitable for prescribing in Primary Care after specialist referral. There is no need for approved shared care guidelines for medicines in this category. This replaces Amber 2 on the North Staffs Formulary.   

Amber E

Medicines which can be prescribed within Secondary Care, but are only considered suitable for prescribing in Primary Care under an approved shared-care agreement (ESCA) or Rationale for Initiation, Continuation and Discontinuation (RICaD). This replaces Amber 1 on the North Staffs Formulary  

Green

Medicines which can be prescribed in either Primary or Secondary Care.  

Grey

These medicines have been reviewed by the New Medicines Committee and the Area Prescribing Committee and found not to be suitable for inclusion in the Joint Formulary. Inadequate or weak evidence for efficacy No clearly defined local need Lack of long term safety data No perceived benefit over established formulary alternatives Prescribers can consider these medicines where formulary alternatives are unsuitable, ineffective or not tolerated.  

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