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10.5 Soft tissue and joint disorders

First line drugs Second line drugs Specialist drugs Secondary care drugs

Traffic light status explained:

  • Green: Routine prescribing within licensed indication
  • Amber 1: specialist recommendation followed by GP initiation and continuation
  • Amber 2: specialist or GP initiation in line with local guideline after 1st line failure followed by GP continuation
  • Amber 3: specialist initiation and stabilisation followed by GP continuation
  • Amber SCG: specialist initiation and stabilisation followed by GP continuation in line with an agreed shared care guideline
  • Red: Hospital or specialist prescribing only
  • Double Red: These medicines have been evaluated and rejected by MKPAG and are NOT approved for use within MK. They are not recommended for use because of lack of clinical effectiveness, cost effectiveness or safety.

 

 

10.5.1 Local inflammation of joints and soft tissue

 

Corticosteroids

 

Dexamethasone

  • Injection 8mg in 2mL

 

Hydrocortisone acetate

  • Injection 25mg in 1mL

 

Methylprednisolone acetate

  • Depo-Medrone, Injection 40mg in 1mL
  • Depo-Medrone with Lidocaine, Injection 40mg plus lidocaine 10mg in 1mL     

 

Triamcinolone acetonide

  • Injection 50mg in 5mL 
  • Injection 40mg in 1mL

 

Triamcinolone hexacetonide (Amber 2)

  • Injection 20mg in 1mL 

 

 

10.5.2 Soft Tissue Disorders

 

 Collagenase clostridium histolyticum

  • Xiapex® 0.9mg powder and solvent for solution for injection in vial

Note:

 

 

 

Hyaluronidase

  • Powder for reconstitution 1500 unit amp

Notes:

  • This is not the intra-articular preparation
  • Enhance permeation of sc or im injection

 

 

 

Other

 

Autologous chondrocyte implantation (ACI) 

  • Spherox® 10 to 70 spheroids are applied per square centimetre of defect
 
Note:

 

 

 

 

 

Traffic light status explained:

  • Green: Routine prescribing within licensed indication
  • Amber 1: specialist recommendation followed by GP initiation and continuation
  • Amber 2: specialist or GP initiation in line with local guideline after 1st line failure followed by GP continuation
  • Amber 3: specialist initiation and stabilisation followed by GP continuation
  • Amber SCG: specialist initiation and stabilisation followed by GP continuation in line with an agreed shared care guideline
  • Red: Hospital or specialist prescribing only
  • Double Red: These medicines have been evaluated and rejected by MKPAG and are NOT approved for use within MK. They are not recommended for use because of lack of clinical effectiveness, cost effectiveness or safety.

 

Return to Chapter: 10. Musculoskeletal and Joint Diseases

Last updated by: Sheila Wood on 03-01-2019 13:23