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Publication Updates

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

08 Oct
British National Formulary logo
BNF October 2018 update

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

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
British National Formulary logo
BNF September 2018 update

This update contains 16 significant changes and 6 dose changes.

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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