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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
Apremilast (Otezla« )
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Formulary
Red
Tablets 
Link  NICE TA433: Apremilast for treating active psoriatic arthritis
   
Cytotoxic Drug Azathioprine
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Amber
Tablets 
   
Baricitinib (Olumiant«)
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Red
High Cost Medicine

Tablets

 
Link  NICE TA466: Baricitinib for moderate to severe rheumatoid arthritis
   
Ciclosporin
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Amber
Capsules

Prescribe by brand
 
   
Cytotoxic Drug Cyclophosphamide
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Red
Tablets
Injection 
   
Leflunomide
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Amber
Tablets

Restricted Item Specialist Initiation Only 
   
Cytotoxic Drug Methotrexate
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Amber
Tablets
Pre-filled injection pen (supplied to patients via homecare arrangements)

Restricted ItemáSpecialist initiation only

WEEKLY dosing
 
Link  NPSA Alert, June 2006: Improving compliance with oral methotrexate guidelines
   
Mycophenolate
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Formulary
Amber
Tablets
Capsules


unlicensedunlicensed indication (rheumatoid arthritis).  
Link  MHRA Safety Alert: Contraception advice for male patients
Link  MHRA Safety Update: Pregnancy prevention advice
   
Tofacitinib (Xeljanz)
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Red
High Cost Medicine
BlueTeq

Tablets

 
Link  NICE TA480: Tofacitinib for moderate to severe rheumatoid arthritis
   
10.01.03  Expand sub section  Biologics
10.01.03  Expand sub section  Sulfasalazine
 ....
 Non Formulary Items
Anakinra

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Non Formulary
Red
 
  
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

Amber

Drugs designated amber are suitable for shared care arrangements under a shared care protocol. Prescribing may be transferred from secondary to primary care once the patient is stabilised and agreed shared care arrangements have been established. Alternatively primary care may initiate under the supervision of secondary care if this option is given in the shared care document. It is recommended that shared care arrangements should be drawn up following local discussion and agreement by prescribing parties.   

Black

These products have been reviewed by the GM Joint Formulary Group and have been deemed not suitable for prescribing for adults in primary or secondary care within Greater Manchester. These decisions have been made on the basis of safety, efficacy and cost-effectiveness of the products.  

Green

Not used   

Green 1

Drugs designated green1 are suitable for initiation and ongoing prescribing within primary care.   

Green 2

Drugs designated green2 can be initiated by primary care following written or verbal advice from a specialist and then be subsequently safely prescribed in primary care with little or no monitoring required.  

Green 3

Drugs designated green3 are suitable for on-going prescribing within primary care after specialist initiation and an initial review (unless specified) in secondary care. Little or no monitoring is required.  

Grey

Not suitable for routine prescribing but may be suitable for a defined patient population. Whilst prescribers should think very carefully before prescribing or recommending any of the products on the grey list, there may be exceptional instances when the use of one of these products is necessary for a particular patient.   

Red

Drugs designated red are considered to be specialist medicines and prescribing responsibility for these medicines should normally remain with the consultant or specialist clinician. These drugs should not be initiated or prescribed in primary care. It is recommended that the supply of these specialist medicines should be organised via the hospital pharmacy, this may include arranging for supply via a home care company.   

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