British National Formulary (BNF)

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

14 May

BNF May 2019 Update

This update contains 11 significant changes, 1 dose changes and 5 new preparations.

See details

Significant Changes: 

Benralizumab for treating severe eosinophilic asthma [NICE guidance].
Brigatinib for treating ALK-positive advanced non-small-cell lung cancer after crizotinib [NICE guidance].
Ertugliflozin as monotherapy or with metformin for treating type 2 diabetes [NICE guidance].
Fluoroquinolone antibiotics (ciprofloxacin): new restrictions and precautions for use due to very rare reports of disabling and potentially long-lasting or irreversible side effects [MHRA/CHM advice].
Fluoroquinolone antibiotics (levofloxacin, moxifloxacin, ofloxacin): new restrictions and precautions for use due to very rare reports of disabling and potentially long-lasting or irreversible side effects [MHRA/CHM advice].
Irinotecan hydrochloride, liposomal formulations (Onivyde®): reports of serious and fatal thromboembolic events [MHRA/CHM advice].
Pertuzumab for adjuvant treatment of HER2-positive early stage breast cancer [NICE guidance].
Pneumococcal vaccine: updated guidance in-line with Public Health England recommendations.
Prescribing in pregnancy: medicines with teratogenic potential: what is effective contraception and how often is pregnancy testing needed? [MHRA/CHM advice].
Respiratory system infections, antibacterial therapy: new guidance for acute exacerbations of Bronchiectasis (non-cystic fibrosis
Respiratory system infections, antibacterial therapy: updated guidance for acute exacerbations of Chronic obstructive pulmonary disease.

Dose Changes:

Alirocumab [Dosing options for Primary hypercholesterolaemia or mixed dyslipidaemia].

New Preparations: Buvidal® [buprenorphine], Erleada® [apalutamide], Fortacin® [lidocaine with prilocaine], Symkevi® [tezacaftor with ivacaftor], Tegsedi® [inotersen].

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

09 Apr

BNF April 2019 Update

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

See details

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

BNF March 2019 update

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

See details

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

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

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