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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
(Oral)
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First Choice
Green 1

Prescribing note: 1st line agent – preferred choice

 
Naproxen
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First Choice
Green 1

Prescribing note: 1st line agent

 
Celecoxib (Celebrex)
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Formulary
Green

Prescribe generically. See current guidance about the use of COX2 inhibitors. Please remember that COX2 inhibitors should not be used in patients with cardiovascular disease.

 
   
Diclofenac
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Formulary
Advice

Restricted: oral preparation not recommended for routine use. Please note: IM injection – maximum of 4 doses in 48 hours – see data sheet. Voltarol dispersible tablets are for patients who cannot swallow tablets.

See MHRA warning January 2015 and updated contra-indications – tablets not for new patients

 
   
Diclofenac with Misoprostol (Arthrotec 50 and 75)
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Restricted Drug Restricted
Advice

Not recommended for new patients

Restricted: Second line agent in patients with criteria to support the use of Misoprostol

 
   
Etodolac
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Formulary
Green 2

Note: Second line agent only

 
   
Indometacin
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Formulary
Green
 
   
Indometacin
(Indometacin mr)
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Formulary
Green
 
   
Ketoprofen
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Formulary
Green
 
   
Ketoprofen (Oruvail MR)
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Formulary
Green 2

Note: Second line agent only

 
   
Meloxicam
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Formulary
Green

See current guidance about the use of COX2 inhibitors. Please remember that COX2 inhibitors should not be used in patients with cardiovascular disease.

 
   
Nabumetone
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Restricted Drug Restricted
Amber

Restricted: For Consultant Rheumatologist use only

 
   
Piroxicam
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Restricted Drug Restricted
Advice

Restricted: Feldene Melts are available to patients whilst nil by mouth only. Once the patient is taking oral medication, an oral preparation should be used

 
   
Sulindac
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Restricted Drug Restricted

Restricted: Third line agent, for initiation by consultant rheumatologists only

 
   
10.01.01  Expand sub section  Aspirin
 ....
 Non Formulary Items
Aceclofenac

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Non Formulary
 
Acelofenac  (Preservex)

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Non Formulary
 
Acemetacin  (Emflex)

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Non Formulary
 
Azapropazone  (Rheumox)

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Non Formulary
 
Celecoxib  (Onsenal)

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Non Formulary
 
Dexibuprofen  (Seractil)

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Non Formulary
 
Dexketoprofen  (Keral)

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Non Formulary
 
Dicolfenac Sodium  (Diclomax Retard)

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Non Formulary
 
Dicolfenac Sodium  (Diclomax SR)

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Non Formulary
 
Dicolfenac Sodium  (Motifene 75mg)

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Non Formulary
 
Dicolfenac Sodium  (Voltarol 75 mg SR)

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Non Formulary
 
Dicolfenac Sodium  (Voltarol Radid)

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Non Formulary
 
Dicolfenac Sodium  (Voltarol Retard)

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Non Formulary
 
Etodolac  (Lodine SR)

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Non Formulary
 
Etoricoxib  (Arcoxia)

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Non Formulary
 
Fenbufen

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Non Formulary
 
Fenbufen  (Lederfen)

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Non Formulary
 
Fenoprofen  (Fenopron)

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Non Formulary
 
Flurbiprofen

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Non Formulary
 
Flurbiprofen  (Froben SR)

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Non Formulary
 
Flurbiprofen  (Froben)

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Non Formulary
 
Ibuprofen  (Brufen Retard)

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Non Formulary
 
Ibuprofen  (Brufen)

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Non Formulary
 
Ibuprofen  (Fenbid)

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Non Formulary
 
Ibuprofen and famotidine  (Duexis)

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Non Formulary
 
Ketoprofen  (Axorid®)

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Non Formulary
 
Ketoprofen  (Orudis)

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Non Formulary
 
Ketoprofen  (Oruvail)

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Non Formulary
 
Lumiracoxib  (Prexige)

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Non Formulary
 
Mefenamic Acid

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Non Formulary
Not Recomended / Black

If an NSAID is required for dysmenorrhoea or menorrhagia, consider the use of ibuprofen or naproxen which is first choice/alternative NSAID on formulary rather than mefenamic acid which is increasingly expensive and has no evidence of superiority over other NSAIDs 

 
Mefenamic Acid  (Ponstan)

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Non Formulary
 
Meloxicam  (Mobic)

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Non Formulary
 
Nabumetone  (Relifex)

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Non Formulary
 
Naproxen  (Naprosyn)

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Non Formulary
 
Naproxen  (Synflex)

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Non Formulary
 
Naproxen & esomeprazole  (Vimovo)

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Non Formulary
 
Naproxen with Misoprostol  (Napratec)

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Non Formulary
 
Piroxicam  (Brexidol)

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Non Formulary
 
Piroxicam  (Feldene)

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Non Formulary
 
Sulindac  (Clinoril)

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Non Formulary
 
Tenoxicam  (Mobiflex)

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Non Formulary
 
Tiaprofenic Acid

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Non Formulary
 
Tiaprofenic Acid  (Surgam)

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Non Formulary
 
  
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

Traffic Light Status Information

Status Description

Green

Suitable for use in primary care  

Amber

Specialist initiation. Shared care in place  

Red

Red do not use..  

Advice

Some formulations restricted  

Black

NICE "Do not do"  

Green 1

1st line option  

Green 2

2nd line option  

Green 3

3rd line option only  

Not Recomended / Black

Low Value Medicine not recommended for use - see NHSE guidelines  

OTC

This preparation should be bought over the counter for self-care  

Red Amber

Check product description for traffic light status  

Red Black

Low Value Medicine  

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