10.2. Drugs used in neuromuscular disorders
10.2.1. Drugs that enhance neuromuscular transmission
Restrictions:
Restricted to specialist initiation.
Prescribing Notes:
This medication is used for myasthenia gravis.
10.2.2. Skeletal muscle relaxants
Prescribing Notes:
Available as quinine sulphate and quinine bisulphate tablets, oral quinine is used primarily for nocturnal leg cramps. Patients should be reviewed regularly to establish benefit.
Restrictions: Baclofen injection is restricted to use in specialist units only. Slow withdrawal of baclofen over one to two weeks is recommended.
Restrictions:
Restricted to specialist initiation. Restricted to recommendation by designated specialists.
10.2.3. Other neuromuscular drugs
Restrictions:
Restricted to specialist use only for the treatment of type II and III 5q spinal muscular atrophy (SMA).
Prescribing Notes:
- This therapy is available via the Scottish Government Ultra-orphan pathway
- Formulary status will be reconsidered following the reassessment by SMC (expected July 2022).
- SMA type I is already accepted for use by SMC and is available in the GGC Paediatric Formulary.
Restrictions:
Restricted to specialist use for the symptomatic treatment of myotonia in adults with non-dystrophic myotonic disorders.
Restrictions:
Restricted to specialist use only in the treatment of 5q spinal muscular atrophy (SMA) in patients 2 months of age and older, with a clinical diagnosis of SMA type 1, type 2 or type 3 or with one to four SMN2 [survival of motor neuron 2] copies.