netFormulary Leicestershire Health Community NHS
Medicines Formulary  
 Formulary Chapter 10: Musculoskeletal and joint diseases - Full Chapter
10.03.02  Expand sub section  Rubefacients, topical NSAIDs, capsaicin, and poultices
10.03.02  Expand sub section  Topical NSAIDs and counter-irritants
  • NICE CG 59 osteoarthritis recommends that consideration be given to offering topical NSAIDs for pain relief in addition to core treatment for people with knee or hand osteoarthritis.
  • Topical capsaicin 0.025% should be considered as an adjunct to core treatment for knee or hand osteoarthritis.
  • Rubefacients are not recommended for the treatment of osteoarthritis.
Ibuprofen 5% Gel
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First Choice
Capsacin cream
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
  • Green Traffic Light For use in line with NICE CG173 for management of neuropathic pain
  • Green Traffic Light For use in line with NICE CG17 for management of Osteoarthritis 
  • Link  NICE CG 173: Neuropathic pain in adults
    Link  NICE CG 177: Osteoarthritis care and management
    Capsaicin Patch (Qutenza)
    View adult BNF View SPC online  Track Changes
    Restricted Drug Restricted
    Supported for use by the pain clinic only. For use only in patients with peripheral neuropathic pain (non-diabetic) who have tried and not responded to other pain relief - amitriptyline, gabapentin, pregabalin, duloxetine, oxycodone, tramadol and lidocaine patch
    CCG agreement for pass through payment agreed locally

     Non Formulary Items
    Capsaicin Patch  (Qutenza)

    View adult BNF View SPC online Track Changes
    Non Formulary
    For diabetic neuropathy
    Link  Leicestershire Evaluation: Qutenza in Diabetic Neuropathy
    note Notes
    Section Title Section Title (top level)
    Section Title Section Title (sub level)
    First Choice Item First Choice item
    Non Formulary Item Non Formulary section
    Restricted Drug
    Restricted Drug
    Unlicensed Drug
    Track Changes
    Display tracking information
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    Link to adult BNF
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    Link to children's BNF
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    Link to SPCs
    Scottish Medicines Consortium
    High Cost Medicine
    High Cost Medicine
    Cancer Drugs Fund
    Cancer Drugs Fund
    NHS England

    Traffic Light Status Information

    Status Description


    Drugs not recommended for use in the Leicestershire Health Community because of lack of evidence of clinical effectiveness, cost prioritization or concerns over safety. All new drugs will be black until they have been through the appropriate approval process - then they will appear as a specific entry   


    Drugs which should be prescribed only by hospital specialists (clinical review by specialist as appropriate and annually as a minimum).  

    Amber SCA

    Drugs which would initially be prescribed by a hospital specialist and then by a GP where full agreement to share the care of each specific patient has been reached under a LMSG Shared Care Agreement (SCA). Specific patient monitoring or intervention required.   

    Amber Simple

    Drugs suitable to be initiated and prescribed in primary care only after specialist assessment and recommendation. A shared care agreement is not required.  

    Green Conditional

    Drugs for which GPs are able to take full responsibility for prescribing and monitoring subject to specified conditions e.g. prescribing in line with agreed LMSG guidance or able to demonstrate suitable competence see comments under individual entries.   


    Drugs for which GPs would normally take full responsibility for prescribing and monitoring. Drugs included in this list have been specifically considered by LMSG.