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Publication Updates

09 Apr
British National Formulary logo
BNF April 2019 Update

This update contains 10 significant changes, 1 dose change and 5 new preparations.

Significant Changes:   

  • Abemaciclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer [NICE guidance].
  • Carbimazole: increased risk of congenital malformations; strengthened advice on contraception [MHRA/CHM advice].
  • Carbimazole: risk of acute pancreatitis [MHRA/CHM advice].
  • Controlled drugs and drug dependence: reclassification of gabapentin and pregabalin as Class C and Schedule 3 Controlled Drugs. Note: Preparation records containing pregabalin (BNF only) or gabapentin may not display a CD3 symbol for the April 2019 monthly update but will be amended in due course.
  • Encorafenib and binimetinib for unresectable or metastatic BRAF V600 mutation-positive melanoma [NICE guidance].
  • Epilepsy inclusion of guidance for the management of Dravet syndrome and Lennox-Gastaut syndrome.
  • Olaratumab (Lartruvo®): no new patients to be prescribed due to study showing no clinical benefit [MHRA/CHM advice].
  • SGLT2 inhibitors (canagliflozin, dapagliflozin, empagliflozin, ertugliflozin): reports of Fournier’s gangrene (necrotising fasciitis of the genitalia or perineum) [MHRA/CHM advice].
  • Venetoclax with rituximab for previously treated chronic lymphocytic leukaemia [NICE guidance].
  • Yellow fever vaccine: updated guidance in-line with Public Health England recommendations.

Dose Changes: 

  • Rivaroxaban [clarification of dosing options for prophylaxis of recurrent deep-vein thrombosis and pulmonary embolism].

New Preparations: Cidofovir, Diacomit® [stiripentol], Namuscla® [mexiletine], Prevymis® [letermovir], Suliqua® [insulin glargine with lixisenatide].

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

12 Mar
British National Formulary logo
BNF March 2019 update

This update contains 16 significant changes, 5 dose changes and 3 new preparations.

Significant Changes:  

  • Anthrax vaccine: updated guidance in-line with Public Health England recommendations.
  • Attention deficit hyperactivity disorder: updated guidance on management.
  • Breast cancer: updated guidance on management.
  • Cholera vaccine: updated guidance in-line with Public Health England recommendations.
  • Chronic heart failure: updated guidance on management.
  • Heavy menstrual bleeding: updated recommendations for the use of ulipristal acetate.
  • Ipilimumab (Yervoy®): reports of cytomegalovirus (CMV) gastrointestinal infection or reactivation [MHRA/CHM advice].
  • Japanese encephalitis vaccine: updated guidance in-line with Public Health England recommendations.
  • Lenvatinib for untreated advanced hepatocellular carcinoma [NICE guidance].
  • Methotrexate: updated recommendations for conception and contraception.
  • Nivolumab for adjuvant treatment of completely resected melanoma with lymph node involvement or metastatic disease [NICE guidance].
  • Pembrolizumab for adjuvant treatment of resected melanoma with high risk of recurrence [NICE guidance].
  • Pembrolizumab with pemetrexed and platinum chemotherapy for untreated, metastatic, non-squamous non-small-cell lung cancer [NICE guidance].
  • Regorafenib for previously treated advanced hepatocellular carcinoma [NICE guidance].
  • Tapentadol (Palexia®): risk of seizures and reports of serotonin syndrome when co-administered with other medicines [MHRA/CHM advice].
  • Typhoid vaccine: updated guidance in-line with Public Health England recommendations.

Dose Changes:

  • Adalimumab [maintenance dosing updated].
  • Anthrax vaccine [dosing schedule updated].
  • Imipenem with cilastatin [dosing recommendation in renal impairment updated].
  • Japanese encephalitis vaccine [dosing schedule updated].
  • Pembrolizumab [dose for non-small cell lung cancer (following prior chemotherapy) and melanoma].

New Preparations: Alunbrig® [brigatinib], Ozempic® [semaglutide], Steglatro® [ertugliflozin].

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

12 Feb
British National Formulary logo
BNF February 2019 update

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

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
British National Formulary logo
BNF January 2019 update

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

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
British National Formulary logo
BNF December 2018 update

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

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
British National Formulary logo
BNF November 2018 update

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

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

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