The BNF for Children is the unrivalled guidance on prescribing, dispensing and administering medicines to children.

BNF for Children is the only child-focused drug formulary in the world that is both independent, and has rigorous, accredited content creation processes. It is trusted by health professionals worldwide as their primary source for minimising medication errors in paediatrics.

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Publication Updates

13 Jul
British National Formulary for Children logo
BNF for Children July 2021 Update

This update contains 10 significant changes, 1 dose change, 2 new monographs and 1 deleted monograph.

Significant Changes:
• Contraceptives, interactions: updated guidance.

• COVID-19: updated guidance.

• COVID-19 vaccine: updated guidance in-line with Public Health England recommendations.

• Eczema: updated guidance on the management of infection.

• Emergency contraception: updated guidance.

• Levothyroxine sodium: new prescribing advice for patients who experience symptoms on switching between different levothyroxine products [MHRA/CHM advice].

• Oral anticoagulants: updated guidance in overview.

• Rabies vaccine: addition of new guidance for post-exposure management.

• Skin infections, antibacterial therapy: new guidance for the management of secondary bacterial infection of common skin conditions.

• Vitamins: addition of new guidance for vitamin D.

Dose Change:
• Perampanel [update to include dosing in children from 4 years old for treatment of focal seizures and from 7 years old for primary generalised tonic-clonic seizures].

New Monographs:
Ruconest® [conestat alfa].

Ultomiris® [ravulizumab].

Deleted Monograph: Emollient bath and shower products, tar-containing.

For further details on changes in the BNFC click on
https://www.medicinescomplete.com/#/content/bnfc/PHP107699?hspl=changes

08 Jun
British National Formulary for Children logo
BNF for Children June 2021 Update

This update contains 8 significant changes, 6 dose changes and 2 new preparations.

Significant Changes:
• Esomeprazole: updated breast feeding statement.

• Hypoglycaemia: updated guidance.

• Immune thrombocytopenic purpura: updated guidance.

• Lansoprazole: updated breast feeding statement.

• Life support algorithm (image): newborn life support algorithm, paediatric advanced life support algorithm, and paediatric basic life support algorithm images updated.

• Life support algorithm (image): paediatric out-of-hospital basic life support algorithm image added.

• Polyethylene glycol (PEG) laxatives and starch-based thickeners: potential interactive effect when mixed, leading to an increased risk of aspiration [MHRA/CHM advice] (advice in macrogol 3350 with anhydrous sodium sulfate, potassium chloride, sodium bicarbonate and sodium chloride, macrogol 3350 with potassium chloride, sodium bicarbonate and sodium chloride; see example in macrogol 3350 with anhydrous sodium sulfate, potassium chloride, sodium bicarbonate and sodium chloride).

• Sodium nitrite: risk of death from unintended administration of sodium nitrite [NPSA advice].

Dose Changes:
• Amiodarone hydrochloride [update to dosing for the treatment of ventricular fibrillation or pulseless ventricular tachycardia refractory to defibrillation (for cardiopulmonary resuscitation)].

Budenofalk® capsules and granules (budesonide) [update to dosing for microscopic colitis].

Entocort® capsules (budesonide) [update to dosing for microscopic colitis].

• Glucose [update to dosing for hypoglycaemia].

• Medical emergencies in the community [update to dosing of glucose for hypoglycaemia].

• Naloxone hydrochloride [update to dosing for treatment of acute opioid overdosage including high- and low-dose regimens].

New Preparations:

Miprosed® [midazolam].

Ozalin® [midazolam].

For further details on changes in the BNFC click on
https://www.medicinescomplete.com/#/content/bnfc/PHP107699?hspl=changes

11 May
British National Formulary for Children logo
BNF for Children May 2021 Update

This update contains 4 significant changes, 2 dose changes and 1 new monograph.

Significant Changes:
• Anthrax: updated guidance.

• Botulism antitoxin: updated guidance.

• Pneumococcal vaccine: new guidance added on prioritisation of the 23-valent pneumococcal vaccine while supplies remain limited.

• Poisoning, emergency treatment: new guidance on storage of specialist antidotes.

Dose Changes:
• Dupilumab [update to include dosing in children from 6 years old for severe atopic eczema].

• Oxycodone hydrochloride [update to include oral dosing in children from 12 years old for severe pain].

New Monograph:
Latuda® [lurasidone hydrochloride].

For further details on changes in the BNFC click on https://www.medicinescomplete.com/#/content/bnfc/PHP107699?hspl=changes

13 Apr
British National Formulary for Children logo
BNF for Children April 2021 Update

This update contains 9 significant changes, 3 dose changes, 2 new monographs and 2 deleted monographs.

Significant Changes:

• Contraceptives, hormonal: updated guidance in-line with Faculty of Sexual and Reproductive Healthcare recommendations for progestogen-only contraceptives.

• COVID-19 vaccine: updated guidance in-line with Public Health England recommendations.

• Fever: new guidance on management.

• Hepatitis B vaccine: updated guidance in-line with Public Health England recommendations.

• Hydrocortisone (Alkindi®): risk of acute adrenal insufficiency in children when switching from hydrocortisone tablet formulations to granules [MHRA/CHM advice].

• Immunoglobulins: updated guidance in-line with Public Health England recommendations for the use of hepatitis B immunoglobulin.

• Metreleptin for treating lipodystrophy [NICE guidance].

• Prescribing in breast-feeding: Medicines in pregnancy and breastfeeding–new initiative for consistent guidance; report on optimising data for medicines used during pregnancy [MHRA/CHM advice].

• Prescribing in pregnancy: Medicines in pregnancy and breastfeeding–new initiative for consistent guidance; report on optimising data for medicines used during pregnancy [MHRA/CHM advice].

Dose Changes:

• Dexamethasone [update to dosing for adjunctive treatment of suspected bacterial meningitis].

• Dexamethasone [update to dosing for the treatment of severe or critical COVID-19].

• Dexamethasone [update to dosing for treatment of life-threatening cerebral oedema].

New Monographs:

Myalepta® [metreleptin].

• Von Willebrand factor.

Deleted Monographs: Hydrocortisone with pramocaine; Methylcellulose.

For further details on changes in the BNFC click on
https://www.medicinescomplete.com/#/content/bnfc/PHP107699?hspl=changes

09 Mar
British National Formulary for Children logo
BNF for Children March 2021 Update

This update contains 8 significant changes, 5 dose changes and 1 new monograph.

Significant Changes:
• Aminoglycosides: increased risk of deafness in patients with mitochondrial mutations [MHRA/CHM advice] (advice in amikacin, gentamicin, gentamicin with hydrocortisone, neomycin sulfate, tobramycin; see example in gentamicin).

• Epilepsy: updated advice on antiepileptic drugs in pregnancy following comprehensive safety review [MHRA/CHM advice].

• Erythromycin: updated pregnancy statement.

• Melatonin (Slenyto®) for the treatment of insomnia in children aged 2 years and over with autism spectrum disorder (ASD) and/or Smith-Magenis syndrome, where sleep hygiene measures have been insufficient [SMC guidance].

• Oropharyngeal infections, antibacterial therapy: updated guidance on management.

• Psychoses and related disorders: updated guidance on management.

• Skin infections, antibacterial therapy: updated guidance for the management of human and animal bites.

• SSRI/SNRI antidepressant medicines: small increased risk of postpartum haemorrhage when used in the month before delivery [MHRA/CHM advice] (advice in citalopram, fluoxetine, fluvoxamine maleate, sertraline; see example in fluoxetine).

Dose Changes:
• Atropine sulfate [update to dosing for treatment of symptomatic bradycardia due to acute overdosage of beta-blockers].

• Glucagon [update to dosing for treatment of severe hypotension, heart failure or cardiogenic shock due to acute overdosage of beta-blockers].

• Normal immunoglobulin [update to dosing for post-exposure prophylaxis against hepatitis A infection].

• Rosuvastatin [dose adjustments due to interactions updated].

• Vitamins A and D 4000 units/400 units [child age range].

New Monograph:
Cosentyx® [secukinumab].

For further details on changes in the BNFC click on https://www.medicinescomplete.com/#/content/bnfc/PHP107699?hspl=changes

09 Feb
British National Formulary for Children logo
BNF for Children February 2021 Update

This update contains 10 significant changes, 2 new monographs and 1 new preparation.

Significant Changes:
• Caplacizumab with plasma exchange and immunosuppression for treating acute acquired thrombotic thrombocytopenic purpura [NICE guidance].

• COVID-19: updated guidance.

• COVID-19 vaccine: new guidance in-line with Public Health England recommendations.

• Erythromycin: caution required due to cardiac risks (QT interval prolongation); drug interaction with rivaroxaban [MHRA/CHM advice].

• Erythromycin: update on known risk of infantile hypertrophic pyloric stenosis [MHRA/CHM advice].

• Fingolimod (Gilenya®): updated advice about the risks of serious liver injury and herpes meningoencephalitis [MHRA/CHM advice].

• Immunisation schedule: updated National flu immunisation programme in-line with Public Health England recommendations.

• Influenza vaccine: updated guidance in-line with Public Health England recommendations.

• Methylprednisolone as sodium succinate (Solu-Medrone®) 40 mg powder and solvent for solution for injection: change from lactose-containing to a lactose-free formulation; risk of serious allergic reactions if formulations are confused [MHRA/CHM advice].

• Quinolones (systemic and inhaled fluoroquinolones): small risk of heart valve regurgitation; consider other therapeutic options first in patients at risk [MHRA/CHM advice] (advice in ciprofloxacin, ofloxacin; see example in ciprofloxacin).

New Monographs:
Cablivi® [caplacizumab].

• COVID-19 vaccine.

New Preparation:

Kalydeco® granules in sachet [ivacaftor].

For further details on changes in the BNFC click on
https://www.medicinescomplete.com/#/content/bnfc/PHP107699?hspl=changes

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