The British National Formulary is the unrivalled guidance on prescribing, dispensing and administering medicines.
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*based on average data in the last 12 months
This update contains 29 significant changes, 5 dose changes and 4 new monographs.
Significant Changes:
• Aflibercept: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection [MHRA/CHM advice].
• Amphotericin: name change to amphotericin B.
• Amphotericin B: Liposomal and lipid-complex formulations: name change to reduce medication errors [MHRA/CHM advice].
• Andexanet alfa (Ondexxya®): Commercial anti-FXa activity assays are unsuitable for measuring anti-FXa activity following administration of andexanet alfa [MHRA/CHM advice].
• Atezolizumab (Tecentriq®) with carboplatin and etoposide for untreated extensive-stage small-cell lung cancer [NICE guidance].
• Atezolizumab (Tecentriq®) with nab-paclitaxel for untreated PD-L1-positive, locally advanced or metastatic, triple-negative breast cancer [NICE guidance].
• Axitinib: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection [MHRA/CHM advice].
• Bevacizumab: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection [MHRA/CHM advice].
• BNF updates for Community Practitioner Nurse Prescribers: For BNF app and online versions of the BNF – list of medicinal preparations (renamed as Approved list for prescribing by Community Practitioner Nurse Prescribers (NPF)) updated with indications for use by Community Practitioner Nurse Prescribers and links to BNF monographs; general guidance and treatment summaries for use by Community Practitioner Nurse Prescribers have also been added. For BNF print editions – list of medicinal preparations (Nurse Prescribers’ Formulary (NPF)) updated with indications for use by Community Practitioner Nurse Prescribers and cross-references to BNF monographs. For further information, see How to use the NPF above the list of medicinal preparations.
• Cabozantinib: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection [MHRA/CHM advice].
• Capecitabine: Fluorouracil (i.v.), capecitabine and tegafur containing products: Pre-treatment testing to identify DPD-deficient patients at increased risk of severe and fatal toxicity [MHRA/CHM advice].
• Cytarabine: Liposomal and lipid-complex formulations: name change to reduce medication errors [MHRA/CHM advice].
• Daunorubicin: Liposomal and lipid-complex formulations: name change to reduce medication errors [MHRA/CHM advice].
• Daunorubicin with cytarabine: Liposomal and lipid-complex formulations: name change to reduce medication errors [MHRA/CHM advice].
• Doxorubicin hydrochloride: Liposomal and lipid-complex formulations: name change to reduce medication errors [MHRA/CHM advice].
• Flucytosine: Updated recommendations for the use in patients with dihydropyrimidine dehydrogenase (DPD) deficiency [MHRA/CHM advice].
• Fluorouracil: Fluorouracil (i.v.), capecitabine and tegafur containing products: Pre-treatment testing to identify DPD-deficient patients at increased risk of severe and fatal toxicity [MHRA/CHM advice].
• Irinotecan hydrochloride: Liposomal and lipid-complex formulations: name change to reduce medication errors [MHRA/CHM advice].
• Lenvatinib: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection [MHRA/CHM advice].
• Nintedanib: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection [MHRA/CHM advice].
• Pazopanib: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection [MHRA/CHM advice].
• Ponatinib: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection [MHRA/CHM advice].
• Ramucirumab: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection [MHRA/CHM advice].
• Regorafenib: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection [MHRA/CHM advice].
• Sorafenib: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection [MHRA/CHM advice].
• Sunitinib: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection [MHRA/CHM advice].
• Tegafur with gimeracil and oteracil: Fluorouracil (i.v.), capecitabine and tegafur containing products: Pre-treatment testing to identify DPD-deficient patients at increased risk of severe and fatal toxicity [MHRA/CHM advice].
• Tivozanib: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection [MHRA/CHM advice].
• Vandetanib: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection [MHRA/CHM advice].
Dose Changes:
• Cefixime [update to dosing for uncomplicated gonorrhoea].
• Ofloxacin [update to dosing for complicated skin and soft-tissue infections].
• Ofloxacin [update to dosing for complicated urinary-tract infections].
• Ofloxacin [update to dosing for lower respiratory-tract infections].
• Ofloxacin [update to dosing for urinary-tract infections].
New Monographs:
• Cefazolin.
• Quofenix® [delafloxacin].
• Sarclisa® [isatuximab].
• Veklury® [remdesivir].
For further details on changes in the BNF click on http://www.medicinescomplete.com/mc/bnf/current/PHP107699-changes.htm
This update contains 13 significant changes, 8 dose changes, 1 new monograph, 2 new preparations, and 3 deleted monographs.
Significant Changes:
Dose Changes:
New Monograph: Tavlesse® [fostamatinib].
New Preparations: Lenzetto® [estradiol]; Spravato® [esketamine].
Deleted Monographs: Collagenase; Pergolide; Stavudine.
For further details on changes in the BNF click on http://www.medicinescomplete.com/mc/bnf/current/PHP107699-changes.htm
This update contains 12 significant changes and 2 new preparations.
Significant Changes:
New Preparations: Medabon® [mifepristone and misoprostol], Nubeqa® [darolutamide].
For further details on changes in the BNF click on http://www.medicinescomplete.com/mc/bnf/current/PHP107699-changes.htm
This update contains 7 significant changes, 2 dose changes and 8 new preparations.
Significant Changes:
Dose Changes:
New Preparations:
For further details on changes in the BNF click on http://www.medicinescomplete.com/mc/bnf/current/PHP107699-changes.htm
This update contains 12 significant changes, 3 dose changes and 5 new preparations.
Significant Changes:
• Baricitinib (Olumiant®): risk of venous thromboembolism [MHRA/CHM advice].
• Benzodiazepines: reminder of risk of potentially fatal respiratory depression [MHRA/CHM advice] (advice in alprazolam, chlordiazepoxide hydrochloride, clobazam, clonazepam, diazepam, flurazepam, loprazolam, lorazepam, lormetazepam, midazolam, nitrazepam, oxazepam, temazepam; see example in diazepam).
• Canagliflozin (SGLT2 inhibitors): monitor ketones in blood during treatment interruption for surgical procedures or acute serious medical illness [MHRA/CHM advice].
• COVID-19: new guidance incorporating a collection of resources.
• Dapagliflozin (SGLT2 inhibitors): monitor ketones in blood during treatment interruption for surgical procedures or acute serious medical illness [MHRA/CHM advice].
• Empagliflozin (SGLT2 inhibitors): monitor ketones in blood during treatment interruption for surgical procedures or acute serious medical illness [MHRA/CHM advice].
• Ertugliflozin (SGLT2 inhibitors): monitor ketones in blood during treatment interruption for surgical procedures or acute serious medical illness [MHRA/CHM advice].
• Opioids: reminder of risk of potentially fatal respiratory depression [MHRA/CHM advice] (advice in alfentanil, buprenorphine, codeine phosphate, diamorphine hydrochloride, dihydrocodeine tartrate, dipipanone hydrochloride, fentanyl, hydromorphone hydrochloride, meptazinol, methadone hydrochloride, morphine, oxycodone hydrochloride, pentazocine, pethidine hydrochloride, remifentanil, sufentanil, tapentadol, tramadol hydrochloride; see example in morphine).
• Skin infections, antibacterial therapy: new guidance for management of leg ulcer infection.
• Tofacitinib (Xeljanz®): new measures to minimise risk of venous thromboembolism and of serious and fatal infections [MHRA/CHM advice].
• Ulipristal acetate (Esmya®): suspension of the licence due to risk of serious liver injury [MHRA/CHM advice].
• Upadacitinib (Rinvoq®▼): advice for venous thromboembolism [MHRA/CHM advice].
Dose Changes:
• Betamethasone with clioquinol [updated child age range].
• Glucagon [update to age ranges for hypoglycaemia].
• Sodium fluoride [updating dosing for prophylaxis of dental caries].
New Preparations: Cytotect® [cytomegalovirus immunoglobulin], Evenity® [romosozumab], Polivy® [polatuzumab vedotin], Poteligeo® [mogamulizumab], Ultomiris® [ravulizumab].
For further details on changes in the BNF click on http://www.medicinescomplete.com/mc/bnf/current/PHP107699-changes.htm
This update contains 13 significant changes, 5 dose changes and 2 new preparations.
Significant Changes:
• Adrenaline/epinephrine (Emerade®) pre-filled auto-injector: update on failure to activate [MHRA/CHM advice].
• Alemtuzumab (Lemtrada®): updated restrictions and strengthened monitoring requirements following review of serious cardiovascular and immune-mediated reactions [MHRA/CHM advice].
• Antimicrobial stewardship: new guidance.
• Cardiovascular disease risk assessment and prevention: updated guidance.
• Dapagliflozin with insulin for treating type 1 diabetes [NICE guidance].
• Diverticular disease and diverticulitis: updated guidance on management.
• Etonogestrel (Nexplanon®) contraceptive implants: new insertion site to reduce rare risk of neurovascular injury and implant migration [MHRA/CHM advice].
• Gastro-intestinal system infections, antibacterial therapy: updated guidance for acute diverticulitis.
• Ingenol mebutate gel (Picato®): suspension of the licence due to risk of skin malignancy [MHRA/CHM advice].
• Medicines optimisation: new guidance.
• Modafinil: potential risk of congenital malformations during pregnancy [MHRA/CHM advice].
• Patiromer calcium for treating hyperkalaemia [NICE guidance].
• Peginterferon beta-1a for treating relapsing–remitting multiple sclerosis [NICE guidance].
Dose Changes:
• Benzoin tincture, compound [updated child age range].
• Ergotamine tartrate with caffeine hydrate and cyclizine hydrochloride [addition of max. courses per month].
• Eucalyptus with menthol [frequency of dosing].
• Fluocinolone acetonide with clioquinol [updated dosing frequency].
• Paracetamol with buclizine hydrochloride and codeine phosphate [child age ranges].
New Preparations:
Benzathine benzylpenicillin, Mayzent® [ siponimod ].
For further details on changes in the BNF click on http://www.medicinescomplete.com/mc/bnf/current/PHP107699-changes.htm
