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 Formulary Chapter 10: Musculoskeletal and joint diseases - Full Chapter
10.01.03  Expand sub section  Drugs which suppress the rheumatic disease process
10.01.03  Expand sub section  Gold
10.01.03  Expand sub section  Penicillamine
10.01.03  Expand sub section  Antimalarials
10.01.03  Expand sub section  Drugs affecting the immune response to top
10.01.03  Expand sub section  Cytokine modulators
Abatacept (Orencia)
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Restricted Drug Restricted
Red
Intravenous infusion 250mg vial
Injection 125mg pre-filled syringe 
   
Adalimumab (Humira)
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Restricted Drug Restricted
Green
Subcut injection 40mg prefilled syringe
  • Alternate week dosing increased to weekly if necessary
  • On recommendation from specialist consultant  
  • Link  NICE TA195: Rheumatoid arthritis - drugs for treatment after failure of a TNF inhibitor
       
    Anakinra (Kineret)
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    Restricted Drug Restricted
    Red
    Prefilled syringe 100mg (subcut)
  • Daily dose 
  •    
    Certolizumab Pegol (Cimzia)
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    Restricted Drug Restricted
  • For use in line with NICE guidance 
  • Link  NICE TA186: Rheumatoid arthritis - certolizumab pegol
    Link  NICE TA445: Certolizumab pegol and secukinumab for treating active psoriatic arthritis after inadequate response to DMARDs
    Link  TA375: Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed
       
    Etanercept (Enbrel)
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    Restricted Drug Restricted
    Green
    Subcut injection 25mg and 50mg
  • On recommendation from specialist consultant  
  • Link  NICE TA195: Rheumatoid arthritis - drugs for treatment after failure of a TNF inhibitor
    Link  NICE TA199: Psoriatic arthritis - etanercept, infliximab and adalimumab
    Link  NICE TA35: Arthritis (juvenile idiopathic) - etanercept
       
    Golimumab (Simponi)
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    Restricted Drug Restricted  
    Link  NICE TA220: Psoriatic arthritis - golimumab
    Link  NICE TA225: Rheumatoid arthritis - golimumab
    Link  NICE TA233: Ankylosing spondylitis - golimumab
       
    Infliximab (Remicade)
    (rheumatology)
    View adult BNF View SPC online View childrens BNF  Track Changes
    Restricted Drug Restricted
    Red
     
    Link  NICE TA195: Rheumatoid arthritis - drugs for treatment after failure of a TNF inhibitor
    Link  NICE TA199: Psoriatic arthritis - etanercept, infliximab and adalimumab
       
    Rituximab (rheumatology) (MabThera)
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    Restricted Drug Restricted
    Red
     
    Link  NICE TA195: Rheumatoid arthritis - drugs for treatment after failure of a TNF inhibitor
       
    Secukinumab (Cosentyx)
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    Restricted Drug Restricted
    Red
    For use in line with NICE guidance for treatment of:
  • Psoriatic arthritis
  • Ankylosing spondylitis
    For use in plaque psoriasis, see section 13.5.3 
  • Link  NICE TA407: Secukinumab for active ankylosing spondylitis after treatment with non-steroidal anti-inflammatory drugs or TNF-alpha inhibitors
    Link  NICE TA445: Certolizumab pegol and secukinumab for treating active psoriatic arthritis after inadequate response to DMARDs
       
    Tocilizumab (RoActemra)
    View adult BNF View SPC online View childrens BNF  Track Changes
    Restricted Drug Restricted
    Red
     
    Link  NICE TA198: Rheumatoid arthritis - tocilizumab
       
    Tofacitinib (Xelijang)
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    Restricted Drug Restricted
    Red
  • Restricted for treatment of rheumatoid arthritis through patient access scheme

  • NICE TA currently in development. Due Jan 2018 
  •    
    Ustekinumab
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    Restricted Drug Restricted  
       
    10.01.03  Expand sub section  Sulfasalazine
     ....
    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

    Amber

    Medicines suitable to be prescribed in primary care after Specialist* recommendation or initiation. A supporting prescribing guideline may be requested which must have been agreed by the relevant secondary care trust D&TC(s). *Specialist is defined as a clinician who has undertaken an appropriate formal qualification or recognised training programme within the described area of practice.   

    Amber 1

    Medicines that should be initiated by a specialist and prescribed by primary care prescribers only under a shared care protocol, once the patient has been stabilised. Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. The shared care protocol must have been agreed by the relevant secondary care trust Drugs and Therapeutics Committee(s) (D&TC) * All drugs awaiting the production or approval of a shared care guideline default to RED   

    Cancer Drug Fund

    Cancer Drug Fund   

    Green

    Medicines suitable for routine use and can be prescribed within primary care within their licensed indication, in accordance with nationally recognised formularies, for example the BNF, BNF for Children, Medicines for Children or Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.  

    Green Specialist Initiation

    These drugs should be initiated only by a hospital or specialist clinician (GPSi) but there is no requirement for additional monitoring over the general requirements for all medicines. Some may require short or medium specialist monitoring of efficacy or dose titration before transferring in Primary care. The GP should have all the information they require to support continued prescribing.   

    Green Specialist Recomendation

      

    Grey

    Grey - Medicines, which the Drug & therapeutics Committee has actively reviewed and does not recommend for use at present following a review of clinical and/or cost effective data. Grey (assessment in progress) - will be reviewed at a future D&T meeting. Grey (awaiting submission) - The D&T are awaiting a submission from an appropriate practitioner. If you wish to make a submission for this medicine to be added to the formulary please email drug.information@bthft.nhs.uk .   

    Non Formulary

    Not recommended for prescribing as initial therapy, but can be continued if patient already stable on treatment   

    Red

    Medicines which should normally be prescribed by specialists only. ** For patients already receiving prescriptions in primary care - continue. No new patients to receive prescriptions in primary care   

    RED ULM

    Unlicensed Medication  

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