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North Staffordshire Joint Formulary
North Staffordshire Clinical Commissioning Group
Stoke-on-Trent Clinical Commissioning Group
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 Formulary Chapter 10: Musculoskeletal and joint diseases - Full Chapter
10.02  Expand sub section  Drugs used in neuromuscular disorders
Nusinersen (Spinraza )Black Triangle
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Formulary
Red
High Cost Medicine
NHS England

Restriction: In line with NICE Guidance only

 

 
Link  NICE TA588:Nusinersen for treating spinal muscular atrophy
   
10.02.01  Expand sub section  Drugs which enhance neuromuscular transmission
10.02.01  Expand sub section  Anticholinesterases
Neostigmine  
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Formulary
Amber

Neostigmine bromide 15mg tablets 
Neostigmine metilsulfate 2.5mg/1ml solution for injection ampoules (Hospital only)

 
Link  UKMI Q&A: Converting oral pyridostigmine or neostigmine dose to a parenteral neostigmine dose
   
Pyridostigmine bromide

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Formulary
Amber

Pyridostigmine bromide 60mg tablets

 
Link  UKMI Q&A: Converting oral pyridostigmine or neostigmine dose to a parenteral neostigmine dose
   
10.02.01  Expand sub section  Acetylcholine-release enhancers
Amifampridine (Firdapse)Black Triangle
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Formulary
Red
High Cost Medicine
NHS England

Amifampridine phosphate 10mg tablets

Restriction: In accordance with NHS England prescribing policy

 

Not routinely commissioned by NHS England for Lambert-Eaton myasthenic syndrome (LEMS) except by prior IFR approval.

 
   
Fampridine (Fampyra)
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Formulary
Red
High Cost Medicine
NHS England

Fampridine 10mg MR tablets

Restriction: In accordance with NHS England prescribing policy

 

Not routinely commissioned by NHS England for multiple sclerosis except by prior IFR approval

 
   
10.02.02  Expand sub section  Skeletal muscle relaxants to top
Baclofen 
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Formulary
Green

Baclofen 10mg tablets
Baclofen 5mg/5ml oral solution SF

 

Red Intrathecal Injection (Hospital only):
Baclofen 50mcg/ml solution for injection ampoules 
Baclofen 10mg/5ml solution for infusion ampoules
Baclofen 10mg/20ml solution for infusion ampoules

 

 

 
   
Dantrolene sodium  (Dantrium)
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Formulary
Amber

Dantrium®- Dantrolene sodium 25mg capsules
Dantrium®- Dantrolene sodium 100mg capsules

 
   
Diazepam 
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Formulary
Green

Diazepam 2mg tablets
Diazepam 5mg tablets
Diazepam 10mg tablets
Diazepam 2mg/5ml oral suspension
Diazepam 2mg/5ml oral solution SF

 

 

 
Controlled Drug Schedule 4 (CD Benz)
   
Tizanidine hydrochloride

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Formulary
Amber E

Tizanidine hydrochloride 2mg tablets
Tizanidine hydrochloride 4mg tablets - EXPENSIVE

Monitor liver function monthly for first 4 months and in those who develop unexplained nausea, anorexia or fatigue.

Link to the ESCA

 

 
   
10.02.02  Expand sub section  Nocturnal leg cramps
Quinine sulfate 
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Formulary
Green

Quinine sulfate 200mg tablets

In hospital, ONLY Quinine sulfate 300mg strength tablets is available

MHRA/CHM advice: reminder of dose-dependent QT-prolonging effects (November 2017)

 
   
 ....
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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