The Pennine Acute Hospitals
NHS Trust Formulary
 
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10 Musculoskeletal and joint diseases
10-01-01 Non-steroidal anti-inflammatory drugs

Ibuprofen
First Choice
Tablets
Oral suspension
5% gel
Link  UKMI Q&A: Can breastfeeding mothers take ibuprofen?
 

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Naproxen
Second Choice
Tablets

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Etoricoxib Arcoxia®
Formulary
Tablets
Link  MHRA Safety Update: Revised dosing recommendations
 

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Celecoxib Celebrex®
Formulary
Capsules

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Diclofenac
Restricted
Suppositories
Injection


Restricted Item Diclofenac is contraindicated in patients with established:

•ischaemic heart disease
•peripheral arterial disease
•cerebrovascular disease
•congestive heart failure (New York Heart Association [NYHA] classification II–IV)

Diclofenac treatment should only be initiated after careful consideration for patients with significant risk factors for cardiovascular events (eg, hypertension, hyperlipidaemia, diabetes mellitus, smoking).

Link  MHRA Drug Safety Update: Diclofenac contraindications and warnings
 

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Etodolac
Formulary
Capsules
Modified release tablets

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Indometacin
Formulary
Capsules
Modified-release capsules
Suppositories

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Mefenamic Acid
Formulary
Capsules
Tablets
Oral suspension

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Meloxicam
Formulary
Tablets

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Nabumetone
Formulary
Tablets
Oral suspension

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Acelofenac Preservex®
Non Formulary

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Acemetacin Emflex®
Non Formulary

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Azapropazone Rheumox®
Non Formulary

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Dexibuprofen Seractil®
Non Formulary

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Dexketoprofen Keral®
Non Formulary

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Diclofenac
Non Formulary
Tablets
Dispersible tablets
Modified-Release Capsules/Tablets

Diclofenac is contraindicated in patients with established:

•ischaemic heart disease
•peripheral arterial disease
•cerebrovascular disease
•congestive heart failure (New York Heart Association [NYHA] classification II–IV)
Patients with these conditions should be switched to an alternative treatment at their next routine appointment.

Link  MHRA Drug Safety Update June 2013: Diclofenac Cardiovascular Safety
Link  MHRA Drug Safety Update October 2012: Diclofenac Cardiovascular Risk
 

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Diclofenac with Misoprostol Arthrotec 50 and 75®
Non Formulary
Tablets
Link  MHRA Drug Safety Update June 2013: Diclofenac Cardiovascular Safety
Link  MHRA Drug Safety Update October 2012: Diclofenac Cardiovascular Risk
 

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Fenbufen
Non Formulary

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Fenoprofen Fenopron®
Non Formulary

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Flurbiprofen
Non Formulary

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Ibuprofen and famotidine Duexis®
Non Formulary

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Ketoprofen
Non Formulary

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Lumiracoxib Prexige®
Non Formulary

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Naproxen & esomeprazole Vimovo®
Non Formulary

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Naproxen with Misoprostol Napratec®
Non Formulary

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Piroxicam
Non Formulary
Link  CHMP advice June 2007: Restricted use of piroxicam
 

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Sulindac
Non Formulary

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Tenoxicam Mobiflex®
Non Formulary

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Tiaprofenic Acid
Non Formulary

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