Significant Changes:
• Antibacterials, use for prophylaxis: updated guidance for the prevention of secondary Haemophilus influenzae type b disease.
• Atezolizumab (Tecentriq®) in combination with carboplatin and etoposide, is indicated for the first-line treatment of adult patients with extensive-stage small cell lung cancer [SMC guidance].
• Atezolizumab (Tecentriq®) in combination with nab-paclitaxel for the treatment of adult patients with unresectable locally advanced or metastatic triple-negative breast cancer whose tumours have PD-L1 expression at a level of 1 % or more and who have not received prior chemotherapy for metastatic disease [SMC guidance].
• Avatrombopag for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure [NICE guidance].
• Bupropion hydrochloride (Zyban®): risk of serotonin syndrome with use with other serotonergic drugs [MHRA/CHM advice].
• Carfilzomib for previously treated multiple myeloma [NICE guidance].
• Darolutamide (Nubeqa®) for the treatment of adult men with non-metastatic castration-resistant prostate cancer who are at high risk of developing metastatic disease [SMC guidance].
• Darolutamide with androgen deprivation therapy for treating hormone-relapsed non-metastatic prostate cancer [NICE guidance].
• Darunavir with cobicistat (Rezolsta®) in combination with other antiretroviral medicinal products for the treatment of human immunodeficiency virus-1 (HIV-1) infection in adults and adolescents (aged 12 years and older with body weight at least 40 kg) [AWMSG guidance].
• Eye: updated guidance for expiration of eye preparations.
• Ferric carboxymaltose (Ferinject®▼): risk of symptomatic hypophosphataemia leading to osteomalacia and fractures [MHRA/CHM advice].
• Frequently asked questions—clinical: updated guidance for expiration of eye preparations.
• Galcanezumab for preventing migraine [NICE guidance].
• Interactions: drugs that cause myelosuppression: pharmacodynamic effects drug group revalidated and updated.
• Isatuximab with pomalidomide and dexamethasone for treating relapsed and refractory multiple myeloma [NICE guidance].
• Modafinil (Provigil®): increased risk of congenital malformations if used during pregnancy [MHRA/CHM advice].
• National funding decisions: advice from NICE, SMC, and AWMSG now briefly referenced in relevant monographs—funding body website should be accessed for full details; see Guidance on prescribing.
• Patiromer calcium (Veltassa®) for the treatment of hyperkalaemia in adults [SMC guidance].
• Pembrolizumab for untreated metastatic or unresectable recurrent head and neck squamous cell carcinoma [NICE guidance].
• Pirfenidone (Esbriet®): risk of serious liver injury; updated advice on liver function testing [MHRA/CHM advice].
• Romosozumab (Evenity®) for the treatment of severe osteoporosis in postmenopausal women at high risk of fracture [SMC guidance].
• Siponimod for treating secondary progressive multiple sclerosis [NICE guidance].
• Trabectedin (Yondelis®) for the treatment of adult patients with advanced soft tissue sarcoma, after failure of anthracyclines and ifosfamide, or who are unsuited to receive these agents [SMC guidance].
• Trastuzumab emtansine (Kadcyla®) as a single agent, for the adjuvant treatment of adult patients with HER2-positive early breast cancer who have residual invasive disease, in the breast and/or lymph nodes, after neoadjuvant taxane-based and HER2-targeted therapy [SMC guidance].
• Vaccination, general principles: updated guidance.
Dose Changes:
• Clinorette® (estradiol with norethisterone) [update to dosing].
• Elleste-Duet® Conti (estradiol with norethisterone) [update to dosing].
• Evorel® Conti (estradiol with norethisterone) [update to dosing].
• Evorel® Sequi (estradiol with norethisterone) [update to dosing].
• Kliofem® (estradiol with norethisterone) [update to dosing].
• Kliovance® (estradiol with norethisterone) [update to dosing].
• Novofem® (estradiol with norethisterone) [update to dosing].
• Sumatriptan [update to dosing for treatment of acute migraine].
• Trisequens® (estradiol with norethisterone) [update to dosing].
New Monographs:
• Calquence®▼ [acalabrutinib].
• Doptelet® [avatrombopag].
• Enerzair Breezhaler® [mometasone furoate with glycopyrronium bromide and indacaterol].
• Otigo® [phenazone with lidocaine].
• Zeposia® [ozanimod].
New Preparations: Lecicarbon A® [sodium acid phosphate with sodium bicarbonate]; Lecicarbon C® [sodium acid phosphate with sodium bicarbonate]; Symbicort® 100 micrograms/3 micrograms per actuation pressurised inhalation [budesonide with formoterol].
Deleted Monographs: Sodium stibogluconate; Telbivudine; Ticarcillin with clavulanic acid.
Deleted Preparations: Climagest® 1 mg [estradiol with norethisterone]; Climagest® 2 mg [estradiol with norethisterone]; Climesse® [estradiol with norethisterone].
For further details on changes in the BNF click on http://www.medicinescomplete.com/mc/bnf/current/PHP107699-changes.htm