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NHS Herefordshire Clinical Commissioning Group
Wye Valley NHS Trust
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 Formulary Chapter 10: Musculoskeletal and joint diseases - Full Chapter
10.02  Expand sub section  Drugs used in neuromuscular disorders
10.02.01  Expand sub section  Drugs which enhance neuromuscular transmission
10.02.01  Expand sub section  Anticholinesterases
Edrophonium Chloride
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Restricted Drug Restricted
Amber

Unlicensed product.

Restricted for the diagnosis of myasthenia gravis.

 
   
Neostigmine
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Formulary
Green
 
   
Pyridostigmine Bromide (Mestinon)
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Formulary
Green
 
   
10.02.01  Expand sub section  Immunosuppressant therapy
10.02.01  Expand sub section  Acetylcholine-release enhancers to top
Amifampridine (Firdapse)
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Restricted Drug Restricted
Red
High Cost Medicine
NHS England
 
   
10.02.02  Expand sub section  Skeletal muscle relaxants
Baclofen
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Formulary
Green
 
   
Dantrolene
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Formulary
Green
 
   
Diazepam
(muscle relaxant)
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Formulary
Green 2

Diazepam should not routinely be added to NSAIDs for the treatment of acute lower back pain.

10mg tablets should NOT be prescribed (make up the dose with 2mg and 5mg)

 
   
Tizanidine
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Restricted Drug Restricted
Amber

Restricted: Consultant Neurologist only

 
   
10.02.02  Expand sub section  Other muscle relaxants
10.02.02  Expand sub section  Nocturnal leg cramps
Quinine
(cramps)
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Formulary
Green

The BNF recommends a trial discontinuation with long-term use of quinine sulfate.
Treatment should be interrupted at intervals of 3 months to assess the need for further treatment.
 

 
   
 ....
 Non Formulary Items
Ataluren  (Translarna)

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Non Formulary
High Cost Medicine
 
Baclofen  (Lioresal)

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Non Formulary
 
Controlled Drug  Cannabis extract  (Sativex)

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Non Formulary

Not recommended by NICE - see Herefordshire LPT

 

 
Carisoprodol  (Carisoma)

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Non Formulary
 
Distigmine Bromide

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Non Formulary
 
Methocarbamol  (Robaxin)

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Non Formulary
 
Nusinersen  (Spinraza)

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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
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Link to adult BNF
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Link to children's BNF
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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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