North East and North Cumbria
ICS Formulary
ICS Formulary
10 Musculoskeletal and joint diseases
10-01-01 Non-steroidal anti-inflammatory drugs
| Note: diclofenac use is restricted, it can be used short term use for post-operative pain | |
| Long term use |
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| Ibuprofen |
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Formulary
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Tablets: 200mg, 400mg, 600mg |
 MHRA Drug Safety Update (June 2015): High-dose ibuprofen (≥2400mg/day): small increase in cardiovascular risk MHRA Drug Safety Update (June 2023): Non-steroidal anti-inflammatory drugs (NSAIDs): potential risks following prolonged use after 20 weeks of pregnancy |
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| Naproxen tablets |
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Formulary
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Tablets: 250mg, 500mg Note: a naproxen 125mg in 5ml suspension ( |
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MHRA Drug Safety Update (June 2023): Non-steroidal anti-inflammatory drugs (NSAIDs): potential risks following prolonged use after 20 weeks of pregnancy |
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unlicensed) is also approved. | Diclofenac |
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Formulary
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Tablets: 25mg, 50mg The use of oral diclofenac is restricted. It can be used short-term for post operative pain, or as a fourth line choice for long-term use.
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MHRA Drug Safety Update (Dec 2007): NSAIDs and coxibs: balancing of cardiovascular and gastrointestinal risks MHRA Drug Safety Update (Jan 2015): Cox-2 selective inhibitors and non-steroidal anti-inflammatory drugs (NSAIDs): Cardiovascular safety. MHRA Drug Safety Update (June 2013): Diclofenac: new contraindications and warnings MHRA Drug Safety Update (June 2023): Non-steroidal anti-inflammatory drugs (NSAIDs): potential risks following prolonged use after 20 weeks of pregnancy MHRA Drug safety Update (Oct 2012): Non-steroidal anti- inflammatory drugs (NSAIDs): cardiovascular risks |
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| Diclofenac Suppositories |
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Formulary
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Diclofenac: new contraindications and warnings - GOV.UK (www.gov.uk) |
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| Mefenamic Acid |
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Formulary
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Mefenamic acid has important consequences in overdosage because it can cause convulsions, which if prolonged or recurrent, require treatment. See: Mefenamic acid - side effects |
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| Phenylbutazone |
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Formulary
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Tablets: 100mg Used only by a specialist in severe cases where other treatments have been found unsuitable. |
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Links
- Guidelines for the Management of Adults with Asymptomatic Liver Blood Test Abnormalities
- MHRA Drug Safety Update (Dec 2007): NSAIDs and coxibs: balancing of cardiovascular and gastrointestinal risks
- MHRA Drug Safety Update (Jan 2015): Cox-2 selective inhibitors and non-steroidal anti-inflammatory drugs (NSAIDs): Cardiovascular safety.
- MHRA Drug Safety Update (June 2013): Diclofenac: new contraindications and warnings
- MHRA Drug Safety Update (June 2013): Diclofenac: new contraindications and warnings
- MHRA Drug Safety Update (June 2015): High-dose ibuprofen (≥2400mg/day): small increase in cardiovascular risk
- MHRA Drug Safety Update (June 2023): Non-steroidal anti-inflammatory drugs (NSAIDs): potential risks following prolonged use after 20 weeks of pregnancy
- MHRA Drug Safety Update (June 2023): Non-steroidal anti-inflammatory drugs (NSAIDs): potential risks following prolonged use after 20 weeks of pregnancy
- MHRA Drug Safety Update (June 2023): Non-steroidal anti-inflammatory drugs (NSAIDs): potential risks following prolonged use after 20 weeks of pregnancy
- MHRA Drug Safety Update (June 2023): Non-steroidal anti-inflammatory drugs (NSAIDs): potential risks following prolonged use after 20 weeks of pregnancy
- MHRA Drug safety Update (Oct 2012): Non-steroidal anti- inflammatory drugs (NSAIDs): cardiovascular risks
- NICE NG100: Rheumatoid arthritis in adults: management
- NICE NG143: Fever in under 5s: assessment and initial management
- NICE NG226: Osteoarthritis in over 16s: diagnosis and management
- NICE TA397: Belimumab for treating active autoantibody-positive systemic lupus erythematosus
- NTAG: Transanal irrigation (TAI) systems (Peristeen Plus®, Aquaflush®, and QuFora®) for neurogenic bowel dysfunction, chronic constipation and chronic faecal incontinence