netFormulary NHS
South Staffordshire Joint Formulary
Cannock Chase Clinical Commissioning Group
East Staffordshire Clinical Commissioning Group
South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group
Stafford and Surrounds Clinical Commissioning Group
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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
Cytotoxic Drug Methotrexate
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Formulary
Amber E

Methotrexate_Tab 2.5mg

ONLY recommended for GP to prescribe if fully conversant with therapy and can reliably provide the necessary review and monitoring requirement within the context of a Shared Care Arrangement

Prescribe WEEKLY (on the same day each week)as 2.5mg Tablets (Local Agreement)

MHRA/CHM advice: Methotrexate once-weekly for autoimmune diseases: new measures to reduce risk of fatal overdose due to inadvertent daily instead of weekly dosing (September 2020)

 
Link  CG79 The Management of Rheumatoid Arthritis in Adults
Link  UKMI Q&A: Methotrexate and alcohol guidance
   
Cytotoxic Drug Azathioprine
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Formulary
Amber E

25mg and 50mg Tablets

ESCA covers rheumatology and gastroenterology patients only

 
Link  CG79 The Management of Rheumatoid Arthritis in Adults
   
Ciclosporin
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Formulary
Amber E
Prescribing and dispensing of ciclosporin should be by brand name to avoid inadvertent switching.

25mg, 50mg and 100mg Capsules available in all Brands

10mg Capsules only availble as Neoral 
Link  CG79 The Management of Rheumatoid Arthritis in Adults
   
Leflunomide
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Formulary
Amber E

Leflunomide_Tab 10mg
Leflunomide_Tab 20mg

GP only to continue prescribing where a shared care agreement is provided


 
Link  CG79 The Management of Rheumatoid Arthritis in Adults
   
Abatacept (Orencia®)
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Restricted Drug Restricted
Red
This is an NHS England Specialised Commissioning Drug for Paediatric Indications (where adult TA available) or Juvenile arthritis
 
Link  NICE TA195: Adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a TNF inhibitor
Link  NICE TA373: Abatacept, adalimumab, etanercept and tocilizumab for treating juvenile idiopathic arthritis
Link  NICE 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
   
Adalimumab (Humira®)
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Restricted Drug Restricted
Red
This is a Specialised Drug which would not be routinely commissioned by CCGs for Uveitis or Hidradenitis Suppurativa. This would go through a South Staffs CCGs Individual Funding Request (IFR)

See all NICE Guidance 
Link  NICE TA195: Rheumatoid arthritis - drugs for treatment of arthritis after failure of a TNF inhibitor
Link  NICE TA375: Rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed
Link  NICE TA383: TNF-alpha inhibitors for ankylosing spondylitis and non-radiographic axial spondyloarthritis
Link  NICE TA373: Juvenile idiopathic arthritis- abatacept, adalimumab, etanercept and tocilizumab
Link  NICE TA392 Adalimumab for treating moderate to severe hidradenitis suppurativa
   
Apremilast (Otzela®)
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Restricted Drug Restricted
Red
High Cost Medicine

 This is commissioned by CCGs but is a hospital only drug

 In Line with NICE guidance

For use in psoriasis click here

 
Link  NICE TA 433: Apremilast for treating active psoriatic arthritis
   
BrodalumabBlack Triangle (Kyntheum®)
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Restricted Drug Restricted
Red
CCG

This is commissioned by CCGs but is a hospital only drug

In line with NICE

 
Link  NICE TA511: Brodalumab for treating moderate to severe plaque psoriasis
   
Certolizumab Pegol (Cimzia®)
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Restricted Drug Restricted
Red
High Cost Medicine
This is a Specialised Drug which would not be routinely commissioned by CCGs for Paediatric Indications. This would go through a South Staffs CCGs Individual Funding Request (IFR)

For adults this is commissioned from CCGs in line with NICE but is hospital only prescribing.

Available via Home Care


 
Link  NICE TA375: Adalimumab, eternecept, infliximab, certolizumabpegol, golimumab, tocilizumab and abatacept for rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed
Link  NICE TA383: TNF-alpha inhibitors for ankylosing spondylitis and non-radiographic axial spondyloarthritis
Link  NICE TA415: Certolizumab pegol for treating rheumatoid arthritis after inadequate response to a TNF-alpha inhibitor
Link  NICE TA445: Certolizumab pegol and secukinumab for treating active psoriatic arthritis after inadequate response to DMARDs
Link  NICE TA574: Certolizumab pegol for treating moderate to severe plaque psoriasis
   
Etanercept (Enbrel®)
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Restricted Drug Restricted
Red
This is an NHS England Specialised Commissioning Drug for Paediatric indications (where adult T/A available)
This is an NHS England Specialised Commissioning Drug for Juvenile Arthritis
 
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 TA373: Juvenile idiopathic arthritis- abatacept, adalimumab, etanercept and tocilizumab
Link  NICE TA383: TNF alpha inhibitors for ankylosing spondylitis and non-radiographic axial spondyloarthritis
Link  NICE TA455: Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young people
Link  NICE TA375: Rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed.
   
Golimumab (Simponi®)
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Restricted Drug Restricted
Red
High Cost Medicine
CCG

Commissioned by CCG's

Hospital only

In line with NICE

 
Link  NICE TA220: Golimumab for the treatment of psoriatic arthritis
Link  NICE TA225: Golimumab for the treatment of rheumatoid arthritis after the failure of previous disease-modifying anti-rheumatic drugs
Link  NICE 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
Link  NICE TA383: TNF-alpha inhibitors for ankylosing spondylitis and non-radiographic axial spondyloarthritis
Link  NICE TA497: Golimumab for treating non-radiographic axial spondyloarthritis
   
Infliximab (Remicade®)
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Restricted Drug Restricted
Red
This is an NHS England Specialised Commissioning Drug for Paediatric Indications (where adult TA available)

This is an NHS England Specialised Commissioning Drug for Crohn's Disease in Children

This is a Specialised Drug which would not be routinely commissioned by CCGs for Connective tissue disease - interstital lung disease. This would go through a South Staffs CCGs Individual Funding Request (IFR)

This is a Specialised Drug which would not be routinely commissioned by CCGs for Graft versus host disease. This would go through a South Staffs CCGs Individual Funding Request (IFR)

This is a Specialised Drug which would not be routinely commissioned by CCGs for Renal, Sarcoidosis, Uveitis and Hidradenitis Suppurativa. This would go through a South Staffs CCGs Individual Funding Request (IFR)
 
Link  NICE TA195: Adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a TNF inhibitor
Link  NICE TA199: Etanercept, infliximab and adalimumab for the treatment of psoriatic arthritis
Link  NICE 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
Link  NICE TA383: TNF-alpha inhibitors for ankylosing spondylitis and non-radiographic axial spondyloarthritis
   
Rituximab (rheumatology) (MabThera®)
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Restricted Drug Restricted
Red
This is an NHS England Specialised Commissioning Drug for ANCA-positive vascullitis

This is an NHS England Specialised Commissioning Drug for Paediatric indications (where adult TA available

This is an NHS England Specialised Commissioning Drug for SLE

This is an NHS England Specialised Commissioning Drug for Neuromyelitis optica

This is an NHS England Specialised Commissioning Drug for ABO-incompatible kidney transplants

This is an NHS England Specialised Commissioning Drug for Juvenile arthritis

This is a Specialised Drug which would not be routinely commissioned by CCGs for Haemophilia. This would go through a South Staffs CCGs Individual Funding Request (IFR)

This is a Specialised Drug which would not be routinely commissioned by CCGs for Phemphigus vulgaris. This would go through a South Staffs CCGs Individual Funding Request (IFR)


This is a Specialised Drug which would not be routinely commissioned by CCGs for Connective Tissue Disease - interstitial lung disease. This would go through a South Staffs CCGs Individual Funding Request (IFR)

This is a Specialised Drug which would not be routinely commissioned by CCGs for Graft versus host disease. This would go through a South Staffs CCGs Individual Funding Request (IFR)

This is a Specialised Drug which would not be routinely commissioned by CCGs for Myositis. This would go through a South Staffs CCGs Individual Funding Request (IFR)

This is a Specialised Drug which would not be routinely commissioned by CCGs for Nephritis. This would go through a South Staffs CCGs Individual Funding Request (IFR)
 
Link  NICE TA195: Adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a TNF inhibitor
Link  NICE TA308: Rituximab in combination with glucocorticoids for treating anti-neutrophil cytoplasmic antibody-associated vasculitis
   
Sarilumab (Kevzara®)
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Restricted Drug Restricted
Red

 For use in specialist settings only. Commissioned by CCG's

 
Link  NICE TA485: Sarilumab for moderate to severe rheumatoid arthritis
   
Tocilizumab (RoActemra®)
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Restricted Drug Restricted
Red

This is an NHS England Specialised Commissioning Drug for Paediatric indications (where Adult TA available)

This is an NHS England Specialised Commissioning Drug for Juvenile Arthritis

This is a Specialised Drug which would not be routinely commissioned by CCGs for Large Vessel Vaculitis. This would go through a South Staffs CCGs Individual Funding Request (IFR)

 

MHRA advice(July 2019): Rare risk of serious liver injury including cases requiring transplantation.

 
Link  NICE TA238: Tocilizumab for the treatment of systemic juvenile idiopathic arthritis
Link  NICE TA247: Tocilizumab for the treatment of rheumatoid arthritis
Link  NICE 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
Link  NICE TA518: Tocilizumab for treating giant cell arteritis
   
10.01.03  Expand sub section  Sulfasalazine
 ....
 Non Formulary Items
Anakinra  (Kineret®)

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Non Formulary This is an NHS England Specialised Commissioning Drug for Juvenile Arthritis

This is an NHS England Specialised Commissioning Drug for Cryoprin Associated Periodic Syndrome

This is a Specialised Drug which would not be routinely commissioned by CCGs for Specialist Autoinflammatory disease or Paediatric indications. This would go through a South Staffs CCGs Individual Funding Request (IFR)
 
Cytotoxic Drug  Cyclophosphamide

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Non Formulary
 
Methotrexate  (Ebetrex®)

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Non Formulary
 
Methotrexate  (Metoject®)

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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
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

Red

Drugs which require special consideration. These are drugs for Consultant Prescribing ONLY. They should not be prescribed in Primary Care.  

Amber

Drugs that should be initiated by a Specialist but are suitable for continuation in Primary Care. For some drugs there may be a Ricad in place to aid the transition to primary care.  

Amber E

Drugs that should be initiated by a Specialist but are suitable for continuation in Primary Care but also require and ESCA (Shared Care Agreement)   

Green

Suitable first-line drugs for implementation in Primary Care  

On Formulary

South Staffs Formulary Choice  

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