Lancashire and South Cumbria
Formulary
 
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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

Ibuprofen
First Choice

Tablets 200mg, 400mg, 600mg
M/R tablets 800mg
Liquid 100mg/5mL

Red Solution for infusion 400mg/100mL

Link  LSCMMG: Over the Counter Items that Should not be Routinely Prescribed in Primary Care Policy

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Naproxen
First Choice

Tablets 250mg, 500mg
Effervescent tablets 250mg

Evidence suggests that naproxen is aassociated with a lower cardiovascular risk than COX-2 inhibitors, diclofenac or high dose ibuprofen.
naproxen is the preferred option for patients requiring long-term treatment with a more potent NSAID than ibuprofen


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Celecoxib Celebrex®
Formulary
Capsules 100mg & 200mg

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Etoricoxib Arcoxia®
Formulary

Tablets 60mg, 90mg, 120mg

Rheumatology initiation only

Link  MHRA: Etoricoxib (Arcoxia): revised dose recommendation for rheumatoid arthritis and ankylosing spondylitis

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Indometacin
Formulary
Capsules 25mg
M/R capsules 75mg
Suppositories 100mg

Indometacin is usually only recommended for gout

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Meloxicam
Formulary
Tablets 7.5mg, 15mg

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Phenylbutazone
Formulary
Tablets 100mg
Consultant rheumatologist only.
Reserved for ankylosing spondylitis not responsive to other NSAIDs

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Diclofenac
Formulary

Suppositories 12.5mg, 25mg, 50mg, 100mg

For short term treatment of post-op pain, renal colic and lithotripsy only

Link  MHRA: Diclofenac: new contraindications and warnings

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Diclofenac
Formulary

Tablets e/c 25mg, 50mg
Dispersible tablets 50mg
 
Restricted ItemFor short term use in breastfeeding mothers only

Link  MHRA: Diclofenac: new contraindications and warnings

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Diclofenac Akis®
Formulary

Restricted ItemFor short term treatment of post-op pain (Akis®)
 

Injection 75mg/1mL

Morecambe bay only

Link  MHRA: https://www.gov.uk/drug-safety-update/diclofenac-new-contraindications-and-warnings

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