| The anticholinesterases are used as first line treatment in myasthenia gravis. Edrophonium has brief action and is used in |
| diagnosis. |
| RED Edrophonium injection 10mg/mL |
| AMBER Pyridostigmine tablets 60mg |
| |
| Acetylcholine-release enhancer, 3, 4 diaminopyridine (an orphan drug) has been approved for use in the treatment of |
| Lambert-Eaton myasthenic syndrome (LEMS), a rare disorder of neuromusculsr transmission. |
| |
| RED 3, 4 Diaminopyridine tablets 10mg |
| |
| NICE TA588 Nusinersen is recommended as an option for treating 5q spinal muscular atrophy (SMA) only if: |
| > people have pre-symptomatic SMA, or SMA types 1,2 or 3 and |
| > the condition is in the managed access agreement are followed. |
| RED Nusinersen: solution for injection 2.4 mg per 1 ml (Spinraza®) NHS England commissioned |
| |
| NICE TA755 Risdiplam is recommended as an option for treating 5q spinal muscular atrophy in people 2 months and older |
| with a clinical diagnosis of SMA types 1,2 or 3 or with pre-symptomatic SMA and 1 to 4 SMN2 copies. It is |
| recommended only if the conditions of the managed access agreement are followed. |
| RED Risdiplam oral solution 0.75mg/ml [Evrysdi] NHS England commissioned |
| |
| NICE TA748 Mexiletine is recommended, within its marketing authorisation, as an option for treating the symptoms of |
| myotonic disorders. It is recommended only if the company provides mexiletine according to the commercial |
| arrangement. |
| RED Mexiletine capsules 167mg [Namuscla®] NHS England commissioned |
| |
| 10.2.2 Skeletal muscle relaxants |
| Used for the relief of chronic muscle spasm or spasticity acting principally on the CNS. |
| GREEN Baclofen |
| tablets 10mg |
| liquid 5mg/5mL |
| GREEN Diazepam |
| tablets 2mg, 5mg, 10mg |
| syrup 2mg/5mL |
| GREEN Tizanidine |
| tablets 2mg, 4mg |
| |
| Cannabis extract – Delta-9-Tetrahydrocannabinol (THC) 27mg and Cannabidiol (CBD) 25mg (Sativex®) oromucosal spray |
| For symptom improvement in adult patients with moderate to severe spasticity due to multiple sclerosis (MS) who have |
| not responded adequately to other anti-spasticity medication. |
| This recommendation only covers the use of Delta-9-Tetrahydrocannabinol (THC) 27mg and Cannabidiol (CBD) 25mg |
| (Sativex) oromucosal spray for the indication of moderate to severe spasticity due to multiple sclerosis (MS) who have not |
| responded adequately to other anti-spasticity medication. |
| |
| SEE Cannabis-based medicinal products NG144 |
| |
| AMBER Cannabis extract – Delta-9-Tetrahydrocannabinol (THC) 27mg and Cannabidiol (CBD) 25mg (Sativex®) oromucosal |
| spray. Specialist recommendation/initiation |
| INFORMATION FOR PRESCRIBERS: click here |
| |
| BLACK Traffic Light for all other indications |
| |
| |
| |
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