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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

10.02.02 Skeletal muscle relaxants

Baclofen

First Choice
10mg Tablets
5mg/5mL Oral Liquid
First choice skeletal muscle relaxant

Cannabis extract (Sativex®)

RED
Restricted Drug Restricted

For use in line with NICE guideline:

NICE guideline [NG144]: Cannabis-based medicinal products

NB: MS specialist nurses within community services are permitted to continue prescribing for patients following specialist consultant initiation and stabilisation.

 

Entry reviewed: May 2024

Tizanidine 2mg and 4mg tablets

Formulary

For treatment of spasticity in multiple sclerosis.

 

 

Entry reviewed: September 2025

Diazepam 2mg, 5mg, 10mg
(Tablets )

Formulary

Non formulary items

Dantrolene 25mg, 100mg (Capsules )

 
Non Formulary

No longer used for spasticity

10.02.02 Other muscle relaxants
10.02.02 Nocturnal leg cramps
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.