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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Speed and safety: Provides rapid reference to essential information on the selection of safe and effective medicines for individual patients

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

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Publication Updates

14 Jan

BNF January 2020 Update

This update contains 12 significant changes and 5 new preparations.

See details

Significant Changes: 

Ambrisentan (Volibris®): patient alert card available [MHRA/CHM advice].
Asthma, acute: updated guidance on management.
Asthma, chronic: updated guidance on management.
Carfilzomib (Kyprolis®): risk of reactivation of hepatitis B virus [MHRA/CHM advice].
Chronic obstructive pulmonary disease: updated guidance on management.
Dyspepsia, Gastro-oesophageal reflux disease, and Peptic ulcer disease: updated guidance and dosing regimens.
Fluocinolone acetonide intravitreal implant for treating chronic diabetic macular oedema in phakic eyes after an inadequate response to previous therapy [NICE guidance].
Helicobacter pylori infection: updated guidance and dosing regimens.
Neratinib for extended adjuvant treatment of hormone receptor-positive, HER2-positive early stage breast cancer after adjuvant trastuzumab [NICE guidance].
Pentosan polysulfate sodium for treating bladder pain syndrome [NICE guidance].
Rucaparib for maintenance treatment of relapsed platinum-sensitive ovarian, fallopian tube or peritoneal cancer [NICE guidance].
Yellow fever vaccine, live: stronger precautions in people with weakened immunity and in those aged 60 years or older [MHRA/CHM advice].

New Preparations: Nerlynx® [neratinib], Pepto-Bismol® [bismuth subsalicylate], Softacort® [hydrocortisone eye drops], Vaborem® [meropenem with vaborbactam], Xospata® [gilteritinib].

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

10 Dec

BNF December 2019 Update

This update contains 11 significant changes, 4 new preparations, and 1 new monograph.

See details

Significant Changes: 

Adrenaline/epinephrine auto-injectors: recent action taken to support safety [MHRA/CHM advice].
Bacillus Calmette-Guérin vaccine: updated guidance in-line with Public Health England recommendations.
Botulinum toxin type A for treating chronic sialorrhea [NICE guidance].
Idelalisib for treating refractory follicular lymphoma [NICE guidance].
Ingenol mebutate gel (Picato®): increased incidence of skin tumours seen in some clinical studies [MHRA/CHM advice].
Lanadelumab for preventing recurrent attacks of hereditary angioedema [NICE guidance].
Nivolumab (Opdivo®): reports of cytomegalovirus (CMV) gastrointestinal infection or reactivation [MHRA/CHM advice].
Prescribing in renal impairment: using the appropriate estimate of renal function to avoid the risk of adverse drug reactions [MHRA/CHM advice].
Respiratory system infections, antibacterial therapy: updated guidance for community-acquired pneumonia.
Respiratory system infections, antibacterial therapy: updated guidance for hospital-acquired pneumonia.
Rivaroxaban for preventing atherothrombotic events in people with coronary or peripheral artery disease [NICE guidance].

New Preparations: Cablivi® [caplacizumab], Lamivudine with tenofovir disoproxil, Rizmoic® [naldemedine], Takhzyro® [lanadelumab].

New Monographs: Cannabidiol.

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

12 Nov

BNF November 2019 Update

This update contains 11 significant changes, 2 dose changes and 7 new preparations.

See details

Significant Changes: 

Benralizumab for treating severe eosinophilic asthma (updated advice) [NICE guidance].
Fingolimod (Gilenya®): increased risk of congenital malformations; new contraindication during pregnancy and in women of childbearing potential not using effective contraception [MHRA/CHM advice].
Hormone replacement therapy (HRT) (conjugated oestrogens (equine) and estradiol): further information on the known increased risk of breast cancer with HRT and its persistence after stopping [MHRA/CHM advice].
Human papillomavirus vaccine updated guidance in-line with Public Health England recommendations.
Hypertension: updated guidance on the management of hypertension in pregnancy.
Immunisation schedule: updated national human papillomavirus immunisation programme in-line with Public Health England recommendations.
Mitomycin (Mitomycin-C Kyowa® 40 mg): restricted to intravesical administration only for treatment of superficial bladder cancer [MHRA/CHM advice].
Montelukast (Singulair®): reminder of the risk of neuropsychiatric reactions [MHRA/CHM advice].
Pembrolizumab with carboplatin and paclitaxel for untreated metastatic squamous non-small-cell lung cancer [NICE guidance].
Pentosan polysulfatesodium (Elmiron®): rare risk of pigmentary maculopathy [MHRA/CHM advice].
Sodium zirconium cyclosilicate for treating hyperkalaemia [NICE guidance].

Dose Changes:

Magnesium sulfate: Change to additional dose for seizure recurrence in pre-eclampsia and eclampsia.
Human papillomavirus vaccines: Dosing now includes male patients.

New Preparations:
Dupixent® [dupilumab], Gardasil 9® [human papillomavirus vaccines], Lorviqua® [lorlatinib], Nyxoid® [naloxone hydrochloride], Talzenna® [talazoparib], Vitrakvi® [larotrectinib], Waylivra® [volanesorsen].

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

08 Oct

BNF October 2019 Update

This update contains 16 significant changes, 1 dose change and 5 new preparations.

See details

Significant Changes:

Carfilzomib (Kyprolis®): reminder of risk of potentially fatal cardiac events [MHRA/CHM advice].
Cemiplimab for treating metastatic or locally advanced cutaneous squamous cell carcinoma [NICE guidance].
Dacomitinib for untreated EGFR mutation-positive non-small-cell lung cancer [NICE guidance].
Dapagliflozin with insulin for treating type 1 diabetes [NICE guidance].
Daratumumab (Darzalex®): risk of reactivation of hepatitis B virus [MHRA/CHM advice].
Hyperparathyroidism : New guidance on management of primary hyperparathyroidism.
Naltrexone with bupropion (Mysimba®): risk of adverse reactions that could affect ability to drive [MHRA/CHM advice].
Olaparib for maintenance treatment of BRCA mutation-positive advanced ovarian, fallopian tube or peritoneal cancer after response to first-line platinum-based chemotherapy [NICE guidance].
Patisiran for treating hereditary transthyretin amyloidosis [NICE guidance].
Pentosan polysulfate sodium (Elmiron®): risk of pigmentary maculopathy [MHRA/CHM advice].
Prostate Cancer : updated guidance on management.
Ribociclib with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer [NICE guidance].
Risankizumab for treating moderate to severe plaque psoriasis [NICE guidance].
Rotavirus vaccine : updated guidance in-line with Public Health England recommendations.
Ulcerative colitis : updated guidance on management.
Vedolizumab for treating moderately to severely active ulcerative colitis [NICE guidance].

Dose Changes:

Vitamin B substances with ascorbic acid : Duration and route for the treatment of suspected or established Wernicke’s encephalopathy, and prophylaxis of Wernicke’s encephalopathy updated (BNF only).

New Preparations: Dovato® [ lamivudine with dolutegravir ], Emgality® [ galcanezumab ], Libtayo® [ cemiplimab ], Ondexxya® [ andexanet alfa ], Onpattro® [ patisiran ].

For further details on changes in the BNF click on

http://www.medicinescomplete.com/mc/bnf/current/PHP107699-changes.htm

10 Sep

BNF September 2019 Update

This update contains 11 significant changes, 1 dose change and 3 new preparations.

See details

Significant Changes:

Blinatumomab for treating acute lymphoblastic leukaemia in remission with minimal residual disease activity [NICE guidance].
Febuxostat (Adenuric®): increased risk of cardiovascular death and all-cause mortality in clinical trial in patients with a history of major cardiovascular disease [MHRA/CHM advice].
Fluocinolone acetonide intravitreal implant for treating recurrent non-infectious uveitis [NICE guidance].
Letermovir for preventing cytomegalovirus disease after a stem cell transplant [NICE guidance].
Migraine: updated guidance on management.
Nusinersen for treating spinal muscular atrophy [NICE guidance].
Rivaroxaban (Xarelto®): reminder that 15 mg and 20 mg tablets should be taken with food [MHRA/CHM advice].
Stroke: updated guidance on management.
Tocilizumab (RoActemra®): rare risk of serious liver injury including cases requiring transplantation [MHRA/CHM advice].
Typhoid vaccine: updated guidance in line with Public Health England recommendations.
Urinary-tract infections: updated guidance on management.

Dose Changes:

Typhoid vaccine [booster dose added].

New Preparations: Imvaggis^® pessary [estriol], Ledaga^® gel [chlormethine], Renoxitin^® [cefoxitin].

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

13 Aug

BNF August 2019 Update

This update contains 14 significant changes, 1 dose change and 6 new preparations.

See details

Significant Changes:

Atezolizumab in combination for treating metastatic non-squamous non-small-cell lung cancer [NICE guidance].
Contraceptives, hormonal: updated guidance on combined hormonal contraceptives.
Crohn’s disease: updated guidance on management.
Direct-acting oral anticoagulants (DOACs) (apixaban, dabigatran etexilate, edoxaban, and rivaroxaban): increased risk of recurrent thrombotic events in patients with antiphospholipid syndrome [MHRA/CHM advice].
Ertugliflozin with metformin and a dipeptidyl peptidase-4 inhibitor for treating type 2 diabetes [NICE guidance].
Lenalidomide plus dexamethasone for multiple myeloma after 1 treatment with bortezomib [NICE guidance].
Lenalidomide plus dexamethasone for previously untreated multiple myeloma [NICE guidance].
Lenalidomide for the treatment of multiple myeloma in people who have received at least 2 prior therapies [NICE guidance].
Lenalidomide for treating myelodysplastic syndromes associated with an isolated deletion 5q cytogenetic abnormality [NICE guidance].
GLP-1 receptor agonists (dulaglutide, exenatide, liraglutide (Victoza®), lixisenatide, and semaglutide): reports of diabetic ketoacidosis when concomitant insulin was rapidly reduced or discontinued [MHRA/CHM advice].
Ocrelizumab for treating primary progressive multiple sclerosis [NICE guidance].
Olaratumab (Lartruvo®): withdrawal of the EU marketing authorisation due to lack of efficacy [MHRA/CHM advice].
Oral retinoid medicines (acitretin, alitretinoin, bexarotene, isotretinoin, and tretinoin): revised and simplified pregnancy prevention educational materials for healthcare professionals and women [MHRA/CHM advice].
Urinary incontinence and pelvic organ prolapse in women: updated guidance on management.

Dose Changes:

Epipen® preparations (adrenaline/epinephrine) [body-weight ranges for children’s dosing updated].

New Preparations: Ajovy® [fremanezumab], Glyxambi® [empagliflozin with linagliptin], Brinavess® [vernakalant], Vizimpro® [dacomitinib], Betesil® [betamethasone], Blissel® [estriol].

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

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