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Bedfordshire and Luton Joint Formulary
Bedfordshire Hospitals NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes ICB
Formulary Chapter: 10 - Musculoskeletal and joint diseases 
Notes:

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing

10.01.01 Non-steroidal anti-inflammatory drugs

Ibuprofen

First Choice
First choice NSAID
200mg & 400mg Tablets
100mg/5mL Sugar-free Suspension

Naproxen

Second Choice
250mg & 500mg Tablets
250mg & 500mg Enteric Coated Tablets

Diclofenac

Third Choice

Following new safety data (see below) the use of diclofenac is restricted to use where the risks and benefits of continued treatment have been considered.
All decisions to initiate or continue use of diclofenac should be clearly documented and communicated across healthcare interfaces.

50mg Tablets
75mg Sustained Release Tablets (not routinely stocked)
12.5mg, 25mg, 50mg & 100mg Suppositories
75mg/3mL injection

Celecoxib

Fifth Choice

100mg & 200mg Capsules

Restricted - on recommendation of Consultant Rheumatologists only

 

Entry reviewed: September 2023

Indometacin

Formulary

25mg and 50mg Capsules
100mg Suppositories

Mefenamic Acid
(Capsules, tablets)

Formulary

Available as 250mg or 500mg tablets and 250mg capsules

a) Restricted to first line use only in patients that require a reduction in blood flow, e.g. patient with both menorrhagia and dysmenorrhea.
b) Restricted to second line use in patients intolerant to other NSAIDs.

Licensed for menorrhagia, but naproxen (and maybe ibuprofen) are equally effective. See CKS review of evidence.

 

NB: 250mg capsules are the most expensive

 

Entry reviewed: July 2025

Ibuprofen intravenous infusion 200mg, 400mg

RED
Restricted Drug Restricted

In adults and children for pain where Diclofenac or Parecoxib is too potent : To be used only on the advice of pain consultants /pain team.

[DTC Sept 2023]

Non formulary items

Aceclofenac

 
Non Formulary

Acelofenac (Preservex®)

 
Non Formulary

Acemetacin (Emflex®)

 
Non Formulary

Azapropazone (Rheumox®)

 
Non Formulary

Dexibuprofen (Seractil®)

 
Non Formulary

Dexketoprofen (Keral®)

 
Non Formulary

Diclofenac with Misoprostol (Arthrotec 50 and 75®)

 
Non Formulary

Dicolfenac Sodium (Diclomax Retard®)

 
Non Formulary

Dicolfenac Sodium (Motifene® 75mg)

 
Non Formulary

Dicolfenac Sodium (Voltarol® 75 mg SR)

 
Non Formulary

Dicolfenac Sodium (Voltarol® Radid)

 
Non Formulary

Dicolfenac Sodium (Voltarol® Retard)

 
Non Formulary

Etodolac

 
Non Formulary

Etodolac (Lodine SR®)

 
Non Formulary

Fenbufen

 
Non Formulary

Fenbufen (Lederfen®)

 
Non Formulary

Fenoprofen (Fenopron®)

 
Non Formulary

Flurbiprofen

 
Non Formulary

Flurbiprofen (Froben SR®)

 
Non Formulary

Flurbiprofen (Froben®)

 
Non Formulary

Ibuprofen (Brufen Retard®)

 
Non Formulary

Ibuprofen and famotidine (Duexis®)

 
Non Formulary

Ketoprofen

 
Non Formulary

Ketoprofen (Axorid®)

 
Non Formulary

Ketoprofen (Orudis®)

 
Non Formulary

Ketoprofen (Oruvail®)

 
Non Formulary

Ketoprofen (Oruvail® MR)

 
Non Formulary

Lumiracoxib (Prexige®)

 
Non Formulary

Meloxicam

 
Non Formulary

Meloxicam (Mobic®)

 
Non Formulary

Nabumetone

 
Non Formulary

Nabumetone (Relifex®)

 
Non Formulary

Naproxen & esomeprazole (Vimovo®)

 
Non Formulary

Naproxen with Misoprostol (Napratec®)

 
Non Formulary

Piroxicam

 
Non Formulary

Piroxicam (Brexidol®)

 
Non Formulary

Piroxicam (Feldene®)

 
Non Formulary

Sulindac

 
Non Formulary

Sulindac (Clinoril®)

 
Non Formulary

Tenoxicam (Mobiflex®)

 
Non Formulary

Tiaprofenic Acid

 
Non Formulary

Tiaprofenic Acid (Surgam®)

 
Non Formulary
10.01.01 Aspirin
Classifications
May be initiated in any care setting
Specialist to advise therapy and provide first 28 days supply, continuation in Primary Care
Specialist to initiate and stabilise medicine prior to continuation in Primary Care
To be prescribed as per Shared Care Guidance. If no SCG in place status reverts to red.
Red medicines are designated as specialist only medicines which should only be prescribed by a specialist, usually within secondary care (either due to the requirement for specialist knowledge, long-term monitoring requirements, or restrictions that mean medicine supplies are only available to hospitals).
A decision has been made either locally and/or nationally not to routinely commission this preparation. Do not prescribe.
To be purchased over the counter. May be prescribed for chronic, long term conditions or on admission to hospital if essential.