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Publication Updates

13 Sep
British National Formulary logo
British National Formulary September 2022 Update

This update contains 9 significant changes, 6 new monographs, and 1 deleted preparation.

Significant Changes:
• Controlled drugs and drug dependence: updated guidance on the prescribing of drugs associated with dependence and withdrawal.
• Cystic fibrosis transmembrane conductance regulator modulators: update to hepatic impairment advice (see example in ivacaftor).
• Dexmedetomidine: clinical trial finds increased risk of mortality in intensive care unit (ICU) patients aged 65 years or younger [MHRA/CHM advice].
• Epilepsy: updated guidance on management.
• Hydrocortisone: addition of children’s dosing for adrenal crisis.
• Immunisation schedule: updated guidance for immunisation against influenza.
• Influenza vaccine: updated guidance for immunisation.
• Tezacaftor with ivacaftor and elexacaftor: name change to ivacaftor with tezacaftor and elexacaftor.
• Topiramate (Topamax®): start of safety review triggered by a study reporting an increased risk of neurodevelopmental disabilities in children with prenatal exposure [MHRA/CHM advice].

New Monographs:
Aklief® [trifarotene].
Brukinsa® [zanubrutinib].
• Magnesium citrate.
NovoThirteen® [factor XIII A-subunit (recombinant)].
Padcev® [enfortumab vedotin].
Palforzia® [peanut protein].

Deleted Preparation:
• Codeine phosphate solution for injection.

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

09 Aug
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British National Formulary August 2022 Update

This update contains 4 significant changes, 3 dose changes, 5 new monographs and 2 new preparations.

Significant Changes:
• Meropenem with vaborbactam [update to how dose is expressed].
• Metformin hydrochloride: reduced vitamin B12 levels and new advice for monitoring patients at risk [MHRA/CHM advice].
• Type 1 diabetes: inclusion of continuous glucose monitoring in aims of treatment.
• Type 2 diabetes: updated guidance for the use of non-insulin antidiabetic drugs.

Dose Changes:
• Cyanocobalamin [update to indications and dose].
• Empagliflozin [update to indication and dose (age ranges and heart failure indication amended), and advice on use and dosing in renal impairment].
• Sotrovimab [update to indications and dose to remove body-weight from dose statement].

New Monographs:
Bylvay® [odevixibat].
Ducressa® [dexamethasone with levofloxacin].
Gavreto® [pralsetinib].
Vabysmo® [faricimab].
Xerava® [eravacycline].

New Preparations: Orobalin® [cyanocobalamin]; Uxil® [dasatinib].

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

12 Jul
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British National Formulary July 2022 Update

This update contains 3 significant changes, 5 new monographs, and 2 new preparations.

Significant Changes:
• Anagrelide: risk of thrombosis, including cerebral infarction, if treatment discontinued abruptly [MHRA/CHM advice].
• Denosumab (Prolia®): should not be used in patients under 18 years due to the risk of serious hypercalcaemia [MHRA/CHM advice].
• Tacrolimus: updated pregnancy, breast-feeding and monitoring advice.

New Monographs:
Exkivity® [mobocertinib].
Kerendia® [finerenone].
Netildex® [dexamethasone with netilmicin].
Nettacin® [netilmicin].
Tenkasi® [oritavancin].

New Preparations:
Dailiport® [tacrolimus]
Ogluo® [glucagon].

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

14 Jun
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British National Formulary June 2022 Update

This update contains 8 significant changes, 3 dose changes, 1 new monograph, and 2 new preparations.

Significant Changes:
• Colecalciferol [maximum daily dose added for treatment of vitamin D deficiency].
• Ear: updated guidance for the management of acute otitis media.
• Ergocalciferol [maximum daily dose added for treatment of vitamin D deficiency].
• Esketamine (Spravato®): new requirement to register patients onto Spravato® Register and Alert system.
• Human papillomavirus vaccine: updated guidance in-line with UK Health Security Agency recommendations.
• Immunisation schedule: updated guidance for immunisation against human papillomavirus and influenza.
• Influenza vaccine: updated guidance in-line with UK Health Security Agency recommendations.
• Pregabalin (Lyrica®): findings of safety study on risks during pregnancy [MHRA/CHM advice].

Dose Changes:
• Erythromycin [amended age range for otitis media and sore throat in children].
• Human papillomavirus vaccines [update to indications and dosing].
• Isavuconazole [addition of dose equivalence and conversion statement].

New Monographs:
Givlaari® [givosiran].

New Preparations:
Xaqua® [metolazone].
Zubsolv® [buprenorphine with naloxone].

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

10 May
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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

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