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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Evidence Grading: As part of NICE accreditation recommendations, BNF content is now evidence graded to reflect the strength of evidence behind them, increasing transparency to support healthcare professionals with clinical decision making
Always up-to-date: The content is revalidated, revised, and updated on a monthly basis, making sure you have access to the very latest prescribing knowledge
Worldwide credibility: The BNF uses clinical evidence from a diverse range of sources and a network of experts, giving you the confidence to select medicines safely
*based on average data in the last 12 months
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
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
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
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
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
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
