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Publication Updates

08 Sep
British National Formulary logo
British National Formulary September 2020 Update

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

 
11 Aug
British National Formulary logo
British National Formulary August 2020 Update

This update contains 13 significant changes, 8 dose changes, 1 new monograph, 2 new preparations, and 3 deleted monographs.

Significant Changes:

  • Apixaban: Direct-acting oral anticoagulants (DOACs): reminder of bleeding risk, availability of reversal agents [MHRA/CHM advice].
  • Cyproterone acetate: new advice to minimise risk of meningioma [MHRA/CHM advice].
  • Dabigatran etexilate: Direct-acting oral anticoagulants (DOACs): reminder of bleeding risk, availability of reversal agents [MHRA/CHM advice].
  • Edoxaban: Direct-acting oral anticoagulants (DOACs): reminder of bleeding risk, availability of reversal agents [MHRA/CHM advice].
  • Emtricitabine with tenofovir disoproxil for pre-exposure prophylaxis to reduce the risk of sexually acquired HIV-1 infection [AWMSG guidance].
  • Fremanezumab for preventing migraine [NICE guidance].
  • Genital system infections, antibacterial therapy: updated guidance for the management of uncomplicated gonorrhoea.
  • Ketotifen for the symptomatic treatment of seasonal allergic conjunctivitis [AWMSG guidance].
  • Rivaroxaban: Direct-acting oral anticoagulants (DOACs): reminder of bleeding risk, availability of reversal agents [MHRA/CHM advice].
  • Smallpox vaccine: updated guidance in-line with Public Health England recommendations.
  • Trastuzumab emtansine for adjuvant treatment of HER2-positive early breast cancer [NICE guidance].
  • Ustekinumab for treating moderately to severely active ulcerative colitis [NICE guidance].
  • Venous thromboembolism: updated guidance for the treatment of venous thromboembolism.

Dose Changes:

  • Atovaquone with proguanil hydrochloride [update to dosing for prophylaxis of malaria].
  • Azithromycin [update to dosing for uncomplicated gonorrhoea].
  • Ceftriaxone [update to dosing for gonococcal infections].
  • Chloroquine [update to dosing for prophylaxis of malaria].
  • Ciprofloxacin [update to dosing for gonococcal infections].
  • Mefloquine [update to dosing for prophylaxis of malaria].
  • Omeprazole [update to dosing for acid reflux disease].
  • Proguanil hydrochloride [update to dosing for prophylaxis of malaria].

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

14 Jul
British National Formulary logo
BNF July 2020 Update

This update contains 12 significant changes and 2 new preparations.

Significant Changes:

  • Cyproterone acetate: Restrictions in use of cyproterone acetate due to risk of meningioma (letter) [MHRA/CHM advice].
  • Hyperthyroidism: updated guidance on management.
  • Hypothyroidism: updated guidance on management.
  • Larotrectinib for treating NTRK fusion-positive solid tumours [NICE guidance].
  • Lenalidomide: Immunomodulatory drugs and pregnancy prevention: temporary advice for management during coronavirus (COVID-19) [MHRA/CHM advice].
  • Lorlatinib for previously treated ALK-positive advanced non-small-cell lung cancer [NICE guidance].
  • Obinutuzumab with bendamustine for treating follicular lymphoma after rituximab [NICE guidance].
  • Pomalidomide: Immunomodulatory drugs and pregnancy prevention: temporary advice for management during coronavirus (COVID-19) [MHRA/CHM advice].
  • Rabies vaccine: updated guidance in-line with Public Health England recommendations.
  • Sodium valproate: Valproate Pregnancy Prevention Programme: temporary advice for management during coronavirus (COVID-19) [MHRA/CHM advice].
  • Thalidomide: Immunomodulatory drugs and pregnancy prevention: temporary advice for management during coronavirus (COVID-19) [MHRA/CHM advice].
  • Valproic acid: Valproate Pregnancy Prevention Programme: temporary advice for management during coronavirus (COVID-19) [MHRA/CHM advice].

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 

09 Jun
British National Formulary logo
BNF June 2020 Update

This update contains 7 significant changes, 2 dose changes and 8 new preparations.

Significant Changes:

  • Adrenaline/epinephrine auto-injectors (Emerade®): all strengths of auto-injector pens have been recalled from patients due to failure to activate. Healthcare professionals are advised to ensure that patients who have previously been prescribed an Emerade® 150, 300 or 500 microgram pen are supplied with a prescription for an alternative brand—see the MHRA website for full details [MHRA/CHM advice].
  • Hypoglycaemia: updated guidance on management.
  • Lenalidomide with rituximab for previously treated follicular lymphoma [NICE guidance].
  • Nurse Prescribers’ Formulary: list of medicinal preparations updated with indications for use by Community Practitioner Nurse Prescribers and links to BNF monographs. For further information, see How to use the NPF in the Nurse Prescribers’ Formulary (NPF).
  • Poisoning, emergency treatment: updated guidance on the management of beta-blockers poisoning in-line with TOXBASE recommendations.
  • Poisoning, emergency treatment: updated guidance on the management of paracetamol poisoning in-line with TOXBASE recommendations.
  • Skin infections, antibacterial therapy: updated guidance on management of impetigo.

Dose Changes:

  • Co-fluampicil [update to dosing information].
  • Fostair® NEXThaler 100/6 (beclometasone with formoterol) [dosing for maintenance and reliever therapy added].

New Preparations:

  • Ampres® [chloroprocaine hydrochloride].
  • Beovu® [brolucizumab].
  • Combisal® 25/50 [fluticasone with salmeterol].
  • Combisal® 25/125 [fluticasone with salmeterol].
  • Combisal® 25/250 [fluticasone with salmeterol].
  • Fusacomb 50/250 Easyhaler® [fluticasone with salmeterol].
  • Fusacomb 50/500 Easyhaler® [fluticasone with salmeterol].
  • Staladex® [leuprorelin acetate].

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

12 May
British National Formulary logo
BNF May 2020 Update

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

14 Apr
British National Formulary logo
BNF April 2020 Update

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

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