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Publication Updates

10 May
British National Formulary logo
British National Formulary May 2022 Update

This update contains 6 significant changes, 1 dose change, 1 new monograph, and 1 new preparation.

Significant Changes:
• Amiodarone hydrochloride (Cordarone X®): reminder of risks of treatment and need for patient monitoring and supervision [MHRA/CHM advice].
• Cladribine (Mavenclad®): new advice to minimise risk of serious liver injury [MHRA/CHM advice].
• COVID-19: updated guidance.
• Glaucoma and ocular hypertension: updated guidance on management
• Metformin hydrochloride: study shows no safety concerns in pregnancy [MHRA/CHM advice].
• Potassium permanganate: inadvertent oral administration of potassium permanganate [National Patient Safety Alert advice].

Dose Change:
• Remdesivir [update to indications and dosing including removal of body-weight from dose statement].

New Monograph:
Aspaveli® [pegcetacoplan]

New Preparation: Nephrotrans® [sodium bicarbonate]

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

11 Apr
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British National Formulary April 2022 Update

This update contains 10 significant changes, 2 dose changes, 3 new monographs, 2 new preparations, and 3 deleted preparations.

Significant Changes:
• Antiplatelet drugs: guidance added on the use of antiplatelet drugs for transcatheter aortic valve implantation.
• Buprenorphine: updated information on available transdermal patch strengths and prescribing considerations.
• Chlorhexidine [primary therapeutic area changed to genito-urinary system, secondary therapeutic area changed to oropharynx].
• Chloroquine: increased risk of cardiovascular events when used with macrolide antibiotics; reminder of psychiatric reactions [MHRA/CHM advice].
• COVID-19 antivirals: reporting to the UK COVID-19 Antivirals Pregnancy Registry [MHRA/CHM advice] (advice in molnupiravir, nirmatrelvir with ritonavir, and remdesivir; see example in remdesivir).
• COVID-19 vaccines: updated guidance in-line with UK Health Security Agency recommendations.
• Hydroxychloroquine sulfate: increased risk of cardiovascular events when used with macrolide antibiotics; reminder of psychiatric reactions [MHRA/CHM advice].
• Immunisation schedule: updated guidance in-line with UK Health Security Agency recommendations.
• Ivacaftor: Ivacaftor, tezacaftor, elexacaftor (Kaftrio®▼) in combination with ivacaftor (Kalydeco®): risk of serious liver injury; updated advice on liver function testing [MHRA/CHM advice].
• Smoking cessation: updated guidance on management.

Dose Changes:
• Eltrombopag [addition of Southeast Asian ethnicity to dosing for treatment of chronic idiopathic thrombocytopenic purpura and aplastic anaemia].
• Etanercept [update to dosing].

New Monographs:
Minjuvi® [tafasitamab]
Paxlovid® [nirmatrelvir with ritonavir]
Vumerity® [diroximel fumarate]

New Preparations:
Luforbec® [beclometasone with formoterol]
Vaxelis® [diphtheria with tetanus, pertussis, hepatitis B, poliomyelitis and haemophilus influenzae type b vaccine]

Deleted Preparations:
Buplast® [buprenorphine]
Prenotrix® [buprenorphine]
Synflorix® [pneumococcal polysaccharide conjugate vaccine (adsorbed)]

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

08 Mar
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British National Formulary March 2022 Update

This update contains 7 significant changes, 2 dose changes, and 3 new monographs.

Significant Changes:
• COVID-19: updated guidance.
• COVID-19 vaccines: updated guidance in-line with UK Health Security Agency recommendations.
• Miconazole: oral gel no longer licensed for treatment of intestinal candidiasis.
• Obstetrics: updated guidance for the induction of labour.
• Paclitaxel formulations (conventional and nab-paclitaxel): caution required due to potential for medication error [MHRA/CHM advice].
• Phosphate imbalance: updated guidance on the use of phosphate-binding agents.
• Sex hormones: updated guidance on the use of progestogens for the prevention of miscarriage.

Dose Changes:
• Calcium chloride [update to dosing for treatment of acute severe hyperkalaemia].
• Mifepristone [update to dosing for induction of labour following intra-uterine fetal death].

New Monographs
Jemperli® [dostarlimab]
Rybrevant® [amivantamab]
Xevudy® [sotrovimab]

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

08 Feb
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British National Formulary February 2022 Update

This update contains 9 significant changes, 3 new monographs, 1 new preparation, 1 deleted monograph and 1 deleted preparation.

Significant Changes:
• Bacillus Calmette-Guérin vaccine: updated guidance for immunisation of neonates in-line with Public Health England/UK Health Security Agency recommendations.
• Brolucizumab (Beovu®): updated recommendations to minimise the known risk of intraocular inflammation, including retinal vasculitis and/or retinal vascular occlusion [MHRA/CHM advice].
• COVID-19 vaccines: updated guidance in-line with UK Health Security Agency recommendations.
• Haloperidol (Haldol®): reminder of risks when used in elderly patients for the acute treatment of delirium [MHRA/CHM advice].
• Immunisation schedule: updated guidance for immunisation of neonates and adults aged 70-79 years in-line with Public Health England/UK Health Security Agency recommendations.
• Individual monographs created for herpes-zoster vaccine (recombinant, adjuvanted), herpes-zoster vaccine, live, and varicella-zoster vaccine.
• Varicella-zoster vaccine: title changed to Varicella-zoster vaccines.
• Varicella-zoster vaccines : updated guidance for immunisation against herpes zoster in-line with Public Health England/UK Health Security Agency recommendations.
• Venetoclax (Venclyxto®): updated recommendations on tumour lysis syndrome (TLS) [MHRA/CHM advice].

New Monographs:
Shingrix® [herpes-zoster vaccine (recombinant, adjuvanted)].
Vazkepa® [icosapent ethyl].
Xofluza® [baloxavir marboxil].

New Preparations: Sixmo® [buprenorphine].

Deleted Monographs: Meningococcal group C vaccine.

Deleted Preparations: Cervarix® [human papillomavirus vaccines].

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

11 Jan
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British National Formulary January 2022 Update

This update contains 9 significant changes, 2 dose changes, 5 new monographs and 1 deleted preparation.

Significant Changes:
• Adrenaline/epinephrine auto-injectors: reminder for prescribers to support safe and effective use [MHRA/CHM advice].
• Arrhythmias: updated guidance for the management of atrial fibrillation.
• COVID-19: updated guidance.
• COVID-19 vaccines: updated guidance in-line with Public Health England/UK Health Security Agency recommendations.
• Dapagliflozin (Forxiga®) 5mg should no longer be used for the treatment of Type 1 Diabetes Mellitus [MHRA/CHM advice].
• Malaria, prophylaxis: updated guidance in-line with Public Health England recommendations.
• Mexiletine: update to include new indication for life-threatening ventricular arrhythmias.
• Phenobarbital: oral doses for children have been removed from the BNF; these can still be accessed in BNF for Children, where additional information on the available oral solutions and advice from the RCPCH/NPPG can be found in the prescribing and dispensing section of the Phenobarbital monograph.
• Yellow fever vaccine, live (Stamaril®): new pre-vaccination checklist [MHRA/CHM advice].

Dose Changes:
• Adrenaline/epinephrine [update to dosing for acute anaphylaxis].
• Calcium gluconate [update to dosing for acute severe hyperkalaemia].

New Monographs:
Lagevrio® [molnupiravir].
Lumykras® [sotorasib].
Ponvory® [ponesimod].
Tepmetko® [tepotinib].
Tukysa® [tucatinib].

Deleted Preparations: Tacni® [tacrolimus].

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

07 Dec
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British National Formulary December 2021 Update

This update contains 7 significant changes, 3 dose changes, 1 classification change and 7 new monographs.

Significant Changes:
• Acne: updated guidance on management.
• COVID-19 vaccine: title changed to COVID-19 vaccines.
• COVID-19 vaccines: updated guidance in-line with Public Health England/UK Health Security Agency recommendations.
• Nausea and labyrinth disorders: updated guidance on the management of nausea and vomiting during pregnancy.
• Rosacea and Acne: title changed to Rosacea.
• Tofacitinib (Xeljanz®): new measures to minimise risk of major adverse cardiovascular events and malignancies [MHRA/CHM advice].
• Type 1 diabetes: updated guidance on Recommended insulin regimens.

Dose Changes:
• Cabozantinib [update to dosing for advanced renal cell carcinoma].
• Chloral hydrate [update to dosing information for short-term treatment of severe insomnia].
• Tofacitinib [update to dosing for moderate to severe rheumatoid arthritis and psoriatic arthritis].

Classification Changes:
• Minoxidil [primary classification changed to Potassium-channel openers].

New Monographs:
Acarizax® [house dust mite extract].
Cibinqo® [abrocitinib].
Klisyri® [tirbanibulin].
Ontozry® [cenobamate].
Orladeyo® [berotralstat].
Rukobia® [fostemsavir].
Vocabria® [cabotegravir].

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

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