British National Formulary - MedicinesComplete

The British National Formulary is the unrivalled guidance on prescribing, dispensing and administering medicines.

The BNF is the only 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.

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Publication Updates

12 Feb

BNF February 2019 update

This update contains 10 significant changes, 2 dose changes and 4 new preparations.

See details

Significant Changes: 

Direct-acting antivirals for chronic hepatitis C (daclatasvir, dasabuvir, elbasvir with grazoprevir, glecaprevir with pibrentasvir, and ombitasvir with paritaprevir and ritonavir): risk of hypoglycaemia in patients with diabetes [MHRA/CHM advice].
Direct-acting antivirals for chronic hepatitis C (sofosbuvir): risk of hypoglycaemia in patients with diabetes [MHRA/CHM advice].
Emollients (see Emollient and barrier preparations): new information about risk of severe and fatal burns with paraffin-containing and paraffin-free emollients [MHRA/CHM advice].
Gemtuzumab ozogamicin for untreated acute myeloid leukaemia [NICE guidance].
Hydrocortisone muco-adhesive buccal tablets: should not be used off-label for adrenal insufficiency in children due to serious risks [MHRA/CHM advice].
Liposomal daunorubicin with cytarabine for untreated acute myeloid leukaemia [NICE guidance].
Smoking cessation: updated guidance.
Tofacitinib for moderately to severely active ulcerative colitis [NICE guidance].
Valproate medicines (see sodium valproate and valproic acid): are you acting in compliance with the pregnancy prevention measures? [MHRA/CHM advice].
Vandetanib for treating medullary thyroid cancer [NICE guidance].

Dose Changes:

Oseltamivir [duration of treatment in immunocompromised patients].
Secukinumab [dosing for psoriatic arthritis].

New Preparations: Braftovi® [encorafenib], Ilumetri® [tildrakizumab], Mektovi® [binimetinib], Verzenios® [abemaciclib]

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

15 Jan

BNF January 2019 update

This update contains 6 significant changes, 2 dose changes and 4 new preparations.

See details

Significant Changes: 

Doxycycline: license extension into children aged 8 to 11 years.
Hydrochlorothiazide: risk of non-melanoma skin cancer, particularly in long-term use [MHRA/CHM advice].
Guidance on prescribing: New Medicines Service and Medicines Use Review service information included, and highlighted in the relevant treatment summaries.
Systemic and inhaled fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin, norfloxacin, and ofloxacin): small increased risk of aortic aneurysm and dissection; advice for prescribing in high-risk patients [MHRA/CHM advice].
Vaccines: updated guidance on the influenza vaccine in-line with Public Health England recommendations.
Vaccines: updated guidance on the routine immunisation schedule in-line with Public Health England recommendations.

Dose Changes:

Colistimethate sodium [dosing recommendations for inhalation of nebulised solution and for intravenous use].
Miconazole (Gyno-Daktarin® 2% vaginal cream) [dosing recommendation for vaginal and vulval candidiasis].

New Preparations: Cetraxal Plus® [ciprofloxacin with fluocinolone acetonide], Imfinzi® [durvalumab], Reagila® [cariprazine], Vesierra® [esketamine].

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

11 Dec

BNF December 2018 update

This update contains 7 significant changes, 13 dose changes and 3 new preparations.

See details

Significant Changes: 

Cabozantinib for untreated advanced renal cell carcinoma [NICE guidance]
Dabrafenib with trametinib for adjuvant treatment of resected BRAF V600 mutation-positive melanoma [NICE guidance].
Eltrombopag for treating chronic immune (idiopathic) thrombocytopenic purpura [NICE guidance].
Lyme disease: updated guidance on management.
Rheumatoid arthritis: updated guidance on management.
Romiplostim for the treatment of chronic immune (idiopathic) thrombocytopenic purpura [NICE guidance].
Tofacitinib for treating active psoriatic arthritis after inadequate response to DMARDs [NICE guidance].

Dose Changes:

Amoxicillin [update to indications and doses for Lyme Disease].
Azithromycin [update to indication and doses for Lyme Disease].
Ceftriaxone [update to indications and doses for Lyme Disease].
Chloral hydrate [dose for insomnia using Chloral Mixture, BP 2000 deleted as preparation no longer available].
Clarithromycin [dosing recommendation for Lyme Disease deleted in line with updated guidance].
Dabigatran etexilate [update to duration for prophylaxis of venous thromboembolism following hip or knee surgery].
Dabigatran etexilate [update to initial dose for prophylaxis of venous thromboembolism following hip or knee surgery in patients receiving concomitant treatment with amiodarone or verapamil].
Doxycycline [update to indications and doses for Lyme Disease].
Erythromycin [dosing recommendation for Lyme Disease deleted in line with updated guidance].
Gabapentin [clarification of dosing in renal impairment].
Influenza vaccine [update to indication of annual immunisation against seasonal influenza (for children in clinical risk groups who have not received seasonal influenza vaccine previously)].
Roflumilast [initial dosing recommendation].
Tapentadol [update to dose adjustments in hepatic impairment].

New Preparations: Aimovig® [erenumab]; Rubraca® [rucaparib]; Vyxeos® [daunorubicin with cytarabine].

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

13 Nov

BNF November 2018 update

This update contains 5 significant changes, 3 dose changes and 3 new preparations.

See details

Significant Changes: 

Dementia: updated guidance on management.
Inotuzumabozogamicin for treating relapsed or refractory B-cell acute lymphoblastic leukaemia [NICE guidance].
Pembrolizumab for treating relapsed or refractory classical Hodgkin lymphoma [NICE guidance].
Ponatinib (Iclusig®): reports of posterior reversible encephalopathy syndrome [MHRA/CHM advice].
Transdermal fentanyl patches: life-threatening and fatal opioid toxicity from accidental exposure, particularly in children [MHRA/CHM advice].

Dose Changes:

Levonorgestrel [update to timings of administration of intra-uterine devices and advice on additional contraceptive precautions].
Tolvaptan (Jinarc®) [update to indication and addition of dosing recommendations for use with potent and moderate CYP3A4 inhibitors].
Tolvaptan (Samsca®) [option of reduced starting dose for patients at risk of overly rapid correction of serum-sodium concentration].

New Preparations: Senshio® [ospemifene]; Xonvea® [doxylamine with pyridoxine]; Zanosar® [streptozocin].

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

08 Oct

BNF October 2018 update

This update contains 9 significant changes, 2 dose changes and 4 new preparations.

See details

Significant Changes:

Side-effects and their further information sections have been reviewed against the current product literature and terms used to define these have been standardised across all drug monographs for this update.
Alectinib for untreated ALK-positive advanced non-small-cell lung cancer [NICE guidance] (BNF only).
Dinutuximab beta for treating neuroblastoma [NICE guidance].
Dupilumab for treating moderate to severe atopic dermatitis [NICE guidance] (BNF only).
Ear, Ear infections, antibacterial therapy: updated guidance on management of otitis media.
Heavy menstrual bleeding: updated guidance on management.
Ixekizumab for treating active psoriatic arthritis after inadequate response to DMARDs [NICE guidance] (BNF only).
Lenvatinib and sorafenib for treating differentiated thyroid cancer after radioactive iodine [NICE guidance] (BNF only).
Nusinersen (Spinraza®): reports of communicating hydrocephalus not related to meningitis or bleeding [MHRA/CHM advice].

Dose Changes:

Golimumab [maintenance dose for patients with ulcerative colitis and body-weight less than 80␣kg] (BNF only).
Rufinamide [update to age range for use in children and dosing information for use with valproate].

New Preparations: Biktarvy® [bictegravir with emtricitabine and tenofovir alafenamide] (BNF only); Diclofenac mouthwash [diclofenac] (BNF only); Elmiron® [pentosane polysulfate sodium] (BNF only); Qarziba® [dinutuximab beta].

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

14 Sep

BNF September 2018 update

This update contains 16 significant changes and 6 dose changes.

See details

Significant Changes:

Atezolizumab for untreated PD-L1-positive locally advanced or metastatic urothelial cancer when cisplatin is unsuitable [NICE guidance].
Cenegermin for treating neurotrophic keratitis [NICE guidance].
Crizotinib for treating ROS1-positive advanced non-small-cell lung cancer [NICE guidance].
Darunavir boosted with cobicistat (darunavir with cobicistat): avoid use in pregnancy due to risk of treatment failure and maternal-to-child transmission of HIV-1 [MHRA/CHM advice].
Darunavir boosted with cobicistat (darunavir with cobicistat, emtricitabine and tenofovir alafenamide): avoid use in pregnancy due to risk of treatment failure and maternal-to-child transmission of HIV-1 [MHRA/CHM advice].
Eltrombopag (Revolade®): reports of interference with bilirubin and creatinine test results [MHRA/CHM advice].
Interferon beta and glatiramer acetate for treating multiple sclerosis [NICE guidance].
Niraparib for maintenance treatment of relapsed, platinum-sensitive ovarian, fallopian tube and peritoneal cancer [NICE guidance].
Nivolumab for treating locally advanced unresectable or metastatic urothelial cancer after platinum-containing chemotherapy [NICE guidance].
Ocrelizumab for treating relapsing–remitting multiple sclerosis [NICE guidance].
Parenteral amphotericin B: reminder of risk of potentially fatal adverse reaction if formulations confused [MHRA/CHM advice].
Pembrolizumab for untreated PD-L1-positive locally advanced or metastatic urothelial cancer when cisplatin is unsuitable [NICE guidance].
Pembrolizumab for untreated PD-L1-positive metastatic non-small-cell lung cancer [NICE guidance].
Pressurised metered dose inhalers (pMDI): risk of airway obstruction from aspiration of loose objects [MHRA/CHM advice], see Respiratory system, drug delivery.
Stable angina: updated guidance on management.
Ulipristal acetate (Esmya®) for symptoms of uterine fibroids: restrictions to use and requirement to check liver function before, during and after treatment [MHRA/CHM advice].
Venous thromboembolism: updated guidance on prophylaxis.Dose Changes:
Anakinra [dosing in severe renal impairment].
Dasatinib [addition of information on dose adjustment due to side-effects].
Esmya® (ulipristal acetate) [dosing information for pre-operative treatment of moderate to severe symptoms of uterine fibroids].
Hexetidine [update to age-range for use in children].
Hydroxocobalamin [frequency of maintenance dosing for macrocytic anaemia without neurological involvement].
Hydroxocobalamin [frequency of maintenance dosing for pernicious anaemia without neurological involvement].

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

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