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 Formulary Chapter 10: Musculoskeletal and joint diseases - Full Chapter
10.02  Expand sub section  Drugs used in neuromuscular disorders
Ataluren (Translarna®)
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Formulary
Red
High Cost Medicine

For treating Duchenne muscular dystrophy with a nonsense mutation in the dystrophin gene.

Funded by specialised commissioning.

APCO September 2016.

 
Link  NICE HST3: Ataluren for treating Duchenne muscular dystrophy with a nonsense mutation in the dystrophin gene
   
Nusinersen (Spinraza®)
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Formulary
Red
NHS England

For treating spinal muscular atrophy as per NICE TA588.

Funded by specialised commissioning.

APCO September 2019. 

 

 
Link  NICE TA588: Nusinersen for treating spinal muscular atrophy
   
10.02.01  Expand sub section  Drugs which enhance neuromuscular transmission
10.02.01  Expand sub section  Anticholinesterases
Neostigmine
(Injection)
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Formulary
Red

Secondary care use only.

 
Link  UKMI Q&A: Converting from oral pyridostigmine or neostigmine to parenteral neostigmine
   
Neostigmine
(Tablets)
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Formulary
Amber Continuation

Suitable for prescribing in primary care following specialist recommendation.

 
Link  UKMI Q&A: Converting from oral pyridostigmine or neostigmine to parenteral neostigmine
   
Pyridostigmine Bromide (Mestinon®)
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Formulary
Amber Continuation

Suitable for prescribing in primary care following specialist recommendation.

 
   
10.02.01  Expand sub section  Immunosuppressant therapy
10.02.01  Expand sub section  Acetylcholine-release enhancers to top
10.02.02  Expand sub section  Skeletal muscle relaxants
Baclofen
(Oral)
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Formulary
Green
 
   
Diazepam
(Muscle relaxant)
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Formulary
Green
 
   
Dantrolene  (Dantrium®)
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Formulary
Green
 
   
Tizanidine
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Formulary
Amber Continuation

For use in multiple sclerosis or in spinal cord injury/disease (second line therapy after baclofen).

 
   
Baclofen
(Intrathecal injection)
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Formulary
Red

For use by Neurology Consultants only.

APCO November 2007. 

 
   
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
 
Link  Cochrane review of the evidence
   
 ....
 Non Formulary Items
Amifampridine  (Firdapse®)

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Non Formulary
Black

For symptomatic treatment of Lambert-Eaton myasthenic syndrome.

APCO January 2011.

 
Controlled Drug  Cannabis extract  (Sativex®)

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Non Formulary
Black

For spasticity in multiple sclerosis in line with Clinical Commissioning Policy 133B.

APCO November 2010.

 
Carisoprodol  (Carisoma®)

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Non Formulary
 
Distigmine Bromide

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Non Formulary
 
Edrophonium Chloride

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Non Formulary

Licensed product discontinued in the UK.

 
Methocarbamol  (Robaxin®)

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Non Formulary

BNF recommends less suitable for prescribing.

 
  
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

Red

Red: Medicines which should only be prescribed in secondary care by a specialist.  

Amber Continuation

Amber Continuation: Medicines which should be initiated or recommended by a specialist for continuation in primary care. The specialist must notify the GP that the prescribing responsibility has been transferred.   

Amber Shared Care Protocol

Amber Shared Care Protocol: Medicines which are appropriate to be initiated and stabilised by a specialist, once stabilised the medicine may be appropriate for responsibility to be transferred from secondary to primary care with the agreement of a GP and a formal ‘shared care’ agreement. The shared care protocol must be approved by the Area Prescribing Committee Oxfordshire (APCO).   

Green

Green: Medicines which are suitable for initiation and ongoing prescribing within primary care.   

Brown

Brown: Medicines which should only be prescribed in restricted circumstances.  

Black

Black: Medicines which are not recommended for use because of lack of evidence of clinical effectiveness, cost effectiveness or safety.  

OCCG Green

not used  

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