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Publication Updates

09 Nov
British National Formulary logo
British National Formulary November 2021 Update

This update contains 3 significant changes, 4 dose changes, 5 new monographs, 2 new preparations and 1 deleted monograph.

Significant Changes:
• Antihistamines, allergen immunotherapy and allergic emergencies: updated guidance for the management of anaphylaxis.

• Gastro-intestinal system infections, antibacterial therapy: updated guidance on the management of Clostridioides difficile infection.

• Topical corticosteroids: information on the risk of topical steroid withdrawal reactions [MHRA/CHM advice] (advice in alclometasone dipropionate, beclometasone dipropionate, benzyl benzoate with bismuth oxide, bismuth subgallate, hydrocortisone acetate, peru balsam and zinc oxide, betamethasone, cinchocaine hydrochloride with fluocortolone caproate and fluocortolone pivalate, cinchocaine with hydrocortisone, cinchocaine with prednisolone, clobetasol propionate, diflucortolone valerate, fludroxycortide, fluocinolone acetonide, fluticasone, hydrocortisone, hydrocortisone with lidocaine; see example in hydrocortisone).

Dose Changes:
• Adrenaline/epinephrine [update to dosing for emergency treatment of acute anaphylaxis].

• COVID-19 vaccine [update to dosing for immunisation against COVID-19].

• Dolutegravir [update to dosing for the treatment of HIV infection].

• Vancomycin [update to dosing for Clostridioides difficile infection].

New Monographs:
Bimzelx® [bimekizumab].

Evrenzo® [roxadustat].

Ryaltris® [mometasone furoate with olopatadine].

Ryeqo® [relugolix with estradiol and norethisterone acetate].

Trodelvy® [sacituzumab govitecan].

New Preparations: Arikayce® liposomal nebuliser dispersion [amikacin]; Trimbow NEXThaler 88/5/9® [beclometasone with formoterol and glycopyrronium].

Deleted Monograph: Tinidazole.

For further details on changes in the BNF click on
https://www.medicinescomplete.com/#/content/bnf/PHP107699

12 Oct
British National Formulary logo
British National Formulary October 2021 Update

This update contains 9 significant changes, 7 new monographs, and 1 deleted preparation.

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

• Dapagliflozin: update to advice on use in renal impairment, including new indication for chronic kidney disease.

• Diabetic hyperglycaemic emergencies: updated guidance.

• Diabetic Ketoacidosis: title changed to Diabetic hyperglycaemic emergencies.

• 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.

• Remdesivir: update to treatment duration.

• Tofacitinib (Xeljanz®): increased risk of major adverse cardiovascular events and malignancies with use of tofacitinib relative to TNF-alpha inhibitors [MHRA/CHM advice].

• Trientine dihydrochloride: name change to trientine, and update to dosing for Wilson’s disease.

New Monographs:
Adakveo® [crizanlizumab].

Adtralza® [tralokinumab].

Besremi® [ropeginterferon alfa-2b].

Bijuve® [estradiol with progesterone].

Byfavo® [remimazolam].

Pemazyre® [pemigatinib].

Verquvo® [vericiguat].

Deleted Preparations: Mysodelle® [misoprostol].

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

14 Sep
British National Formulary logo
British National Formulary September 2021 Update

This update contains 6 significant changes and 4 new monographs.

Significant Changes:
• Chloramphenicol eye drops containing borax or boric acid buffers: use in children younger than 2 years [MHRA/CHM advice].

• Low back pain and sciatica: updated guidance on management.

• Migraine: updated guidance on preventative migraine treatment.

• Oral retinoid medicines: temporary monitoring advice during coronavirus (COVID-19) pandemic [MHRA/CHM advice] (advice in acitretin, alitretinoin, isotretinoin; see example in isotretinoin).

• Pain, Chronic: updated guidance on management.

• Venetoclax (Venclyxto®): updated recommendations on tumour lysis syndrome (TLS) in CLL patients [MHRA/CHM advice].

New Monographs:
Dropizol® [opium].

Evrysdi® [risdiplam].

Fintepla® [fenfluramine].

Inrebic® [fedratinib].

For further details on changes in the BNF click on https://www.medicinescomplete.com/#/content/bnf/PHP107699

10 Aug
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British National Formulary August 2021 Update

This update contains 9 significant changes, 1 dose change, 4 new monographs, 1 new preparation and 1 deleted monograph.

Significant Changes:
• Adrenal insufficiency: updated guidance on management.

• Atezolizumab (Tecentriq®) and other immune-stimulatory anti-cancer drugs: risk of severe cutaneous adverse reactions (SCARs) [MHRA/CHM advice] (advice in atezolizumab, avelumab, cemiplimab, durvalumab, ipilimumab, nivolumab, pembrolizumab; see example in atezolizumab).

• CDK4/6 inhibitors: reports of interstitial lung disease and pneumonitis, including severe cases [MHRA/CHM advice] (advice in abemaciclib, palbociclib, ribociclib; see example in abemaciclib).

• Corticosteroids, replacement therapy: title changed to Adrenal insufficiency.

• COVID-19 vaccine: reports of myocarditis and pericarditis with the Pfizer/BioNTech and Moderna vaccines.

• Heavy menstrual bleeding: updated guidance.

• Immunoglobulins: updated guidance in-line with Public Health England recommendations for the use of immunoglobulin for tetanus infection and prophylaxis.

• Prescribing in renal impairment: updated guidance.

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

Dose Change:
Enstilar® (calcipotriol with betamethasone) [update to dosing for the treatment of psoriasis].

New Monographs:
Blenrep® [belantamab mafodotin].

Isturisa® [osilodrostat].

Kesimpta® [ofatumumab].

Zibor® [bemiparin sodium].

New Preparation: Fixkoh Airmaster® [fluticasone with salmeterol].

Deleted Monograph: Telavancin.

For further details on changes in the BNF click on https://www.medicinescomplete.com/#/content/bnf/PHP107699

13 Jul
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British National Formulary July 2021 Update

This update contains 14 significant changes, 1 dose change, 2 new monographs and 4 deleted monographs.

Significant Changes:
• Acute coronary syndromes: updated guidance on management.

• Aflibercept (Eylea® solution for intravitreal injection): higher risk of intraocular pressure increase with the pre-filled syringe [MHRA/CHM advice].

• 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.

• Estradiol [dosing added for the prophylaxis of recurrent urinary-tract infection in postmenopausal women].

• Estriol [dosing added for the prophylaxis of recurrent urinary-tract infection in postmenopausal women].

• 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 and addition of new guidance for direct-acting oral anticoagulants.

• 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 Changes:
• 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:
Leqvio® [inclisiran].

Retsevmo® [selpercatinib].

Deleted Monographs: Emollient bath and shower products, tar-containing; Ergotamine tartrate with caffeine hydrate and cyclizine hydrochloride; Fluphenazine decanoate; Sodium aurothiomalate.

For further details on changes in the BNF click on http://www.medicinescomplete.com/mc/bnf/current/PHP107699-changes.htm

08 Jun
British National Formulary logo
British National Formulary June 2021 Update

This update contains 13 significant changes and 7 dose changes.

Significant Changes:
• Atezolizumab (Tecentriq®▼): risk of severe cutaneous adverse reactions (SCARs) [MHRA/CHM advice].

• Esomeprazole: updated breast feeding statement.

• Hypoglycaemia: updated guidance.

• Immune thrombocytopenic purpura: updated guidance.

• Lansoprazole: updated breast feeding statement.

• Life support algorithm (image): adult advanced life support algorithm image updated.

• Pantoprazole: updated breast feeding statement.

• Polycystic ovary syndrome: updated guidance on management.

• 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, macrogol 3350 with anhydrous sodium sulfate, ascorbic acid, potassium chloride, sodium ascorbate and sodium chloride, 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).

• Prescribing in dental practice: updated guidance on the management of hypoglycaemia.

• Rabeprazole sodium: updated breast feeding statement.

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

• Tofacitinib (Xeljanz®▼): initial clinical trial results of increased risk of major adverse cardiovascular events and malignancies (excluding NMSC) with use of tofacitinib relative to TNF-alpha inhibitors [MHRA/CHM 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].

• Canagliflozin [update to dosing in renal impairment].

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].

For further details on changes in the BNF click on http://www.medicinescomplete.com/mc/bnf/current/PHP107699-changes.htm

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