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Publication Updates

13 Apr
Clarity’s Diagnosis and Treatment Guidance April 2021 Update

This update contains 8 significant changes, 15 minor changes and 1 new topic.

Significant Changes:

• Obstructive sleep apnoea – reviewed. A literature search was conducted in January 2021 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of this topic. The recommendations have been updated in line with current evidence in the literature. No major changes to the recommendations have been made.

• Gilbert’s syndrome – reviewed. A literature search was conducted in February 2021 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of this topic. No major changes to the recommendations have been made, but the topic has been restructured.

• Immunization – childhood – reviewed. A literature search was conducted in January 2021 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. No major changes to clinical recommendations have been made.

• Chlamydia – uncomplicated genital – reviewed. A literature search was conducted in February 2021 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. No major changes to clinical recommendations have been made.

• Itch – widespread – reviewed. A literature search was conducted in December 2020 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of this topic. In the Scenario on Management, the sections on management of itch of known and unknown cause have been merged to avoid repetition of text. The recommendations have been updated in line with current evidence in the literature. The recommendations on prescribing oral antihistamines have been amended to consider the use of non-sedating oral antihistamines first line unless there is a history of troublesome nocturnal itch. New sections on Cetirizine, Loratadine, and Fexofenadine have been added to the section on Prescribing information.

• Contraception – progestogen-only – reviewed. A literature search was conducted in February 2021 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic.

• Bruising – reviewed. A literature search was conducted in February 2021 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of this topic. The topic has undergone restructuring. No major changes to the recommendations have been made.

• Earwax – reviewed. A literature search was conducted in March 2021 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. No changes to clinical recommendations have been made, but the topic has been restructured.

Minor Changes:

• Epilepsy – minor update. Adverse effects of antiepileptic drugs updated to contain information on severe liver damage in children.

• Coronavirus – COVID-19 – minor update. Information on the Moderna COVID-19 vaccine has been added to this topic, information relating to immunization in pregnancy has been updated, as well as prevalence data. A typographical error has also been corrected.

• Scrotal pain and swelling – minor update. A typographical error has been corrected.

• Eczema – atopic – minor update. Updated to align with Secondary bacterial infection of eczema and other common skin conditions: antimicrobial prescribing [NICE, 2021].

• Sinusitis – minor update. A link to a patient information leaflet has been removed from the topic.

• Insomnia – minor update. Information on the risks associated with melatonin have been clarified to align with the updated NICE Key therapeutic topic on Insomnia.

• HIV infection and AIDs – minor update. Recommendations on post-exposure prophylaxis have been updated in line with the British Association for Sexual Health and HIV (BASHH) UK Guideline for the use of HIV Post-Exposure Prophylaxis 2021.

• Pyelonephritis – acute – minor update. Information on signs and symptoms of acute pyelonephritis have been clarified.

• Immunizations – travel – minor update. Adverse effects of meningococcal meningitis vaccination updated in line with revised manufacturer’s SPC.

• Opioid dependence – minor update. Drug interactions for methadone updated in line with revised manufacturer’s SPC.

• Depression – minor update. Suicide/suicidal thoughts and aggression in patients during discontinuation of venlafaxine has been added in line with updated manufacturer’s SPC. A typographical error has also been corrected.

• Deep vein thrombosis – minor update. A typographical error has been corrected.

• Malaria prophylaxis – minor update. Suicidal behaviour and psychiatric disorders have been added to the adverse effects of chloroquine in line with updated manufacturer’s SPC.

• Contraception – emergency – minor update. The section on types of emergency contraception has been clarified. Links have been amended in the section on continuing or starting regular contraception.

• Contraception – IUS/IUD – minor update. The recommendations on switching from a progestogen-only implant to the levonorgestrel intrauterine system (LNG-IUS) and the copper intrauterine device (Cu-IUD) have been updated in line with the Faculty of Sexual and Reproductive Healthcare (FSRH) guideline Progestogen-only implant [FSRH, 2021].

New Topic:

• Platelets – abnormal counts and cancer – is a new topic. A literature search was conducted in January 2020 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials. The evidence base has been reviewed in detail and recommendations are clearly justified and transparently linked to the supporting evidence.

13 Apr
Stockley's Interactions Checker_logo
Stockley’s Interactions Checker April 2021 Update

New and updated interactions now available

For April, 677 new interactions have been added, and 90 existing interactions have been updated.

13 Apr
Dietary Supplements logo
Dietary Supplements April 2021 Update

This update contains revisions to Conjugated Linoleic Acid, Dehydroepiandrosterone, Dong Quai, Flaxseed oil, and Zinc.

13 Apr
Stockley's Herbal Medicines Interactions logo
Stockley’s Herbal Medicines April 2021 Update

Fish Oils has been renamed as Omega-3 Fatty Acids and has been selectively revised. Garlic, Ginkgo, Glucosamine, and St John’s wort have also been selectively revised. Pharmacopoeial information has also been updated.

Selective Revisions: Fish Oils, Garlic, Glucosamine, Ginkgo, and St John’s wort.

Minor Updates: Valerian has been amended. European Pharmacopoeia and USP-NF information has been globally updated.

13 Apr
Palliative Care Formulary April 2021 Update

This update contains 4 revised monographs.

The following monographs have been fully revised: Fentanyl, Quick Clinical Guide: Use of transdermal fentanyl patches.

The following monographs have undergone minor revision: Morphine, Spironolactone.

13 Apr
British National Formulary for Children logo
BNF for Children April 2021 Update

This update contains 9 significant changes, 3 dose changes, 2 new monographs and 2 deleted monographs.

Significant Changes:

• Contraceptives, hormonal: updated guidance in-line with Faculty of Sexual and Reproductive Healthcare recommendations for progestogen-only contraceptives.

• COVID-19 vaccine: updated guidance in-line with Public Health England recommendations.

• Fever: new guidance on management.

• Hepatitis B vaccine: updated guidance in-line with Public Health England recommendations.

• Hydrocortisone (Alkindi®): risk of acute adrenal insufficiency in children when switching from hydrocortisone tablet formulations to granules [MHRA/CHM advice].

• Immunoglobulins: updated guidance in-line with Public Health England recommendations for the use of hepatitis B immunoglobulin.

• Metreleptin for treating lipodystrophy [NICE guidance].

• Prescribing in breast-feeding: Medicines in pregnancy and breastfeeding–new initiative for consistent guidance; report on optimising data for medicines used during pregnancy [MHRA/CHM advice].

• Prescribing in pregnancy: Medicines in pregnancy and breastfeeding–new initiative for consistent guidance; report on optimising data for medicines used during pregnancy [MHRA/CHM advice].

Dose Changes:

• Dexamethasone [update to dosing for adjunctive treatment of suspected bacterial meningitis].

• Dexamethasone [update to dosing for the treatment of severe or critical COVID-19].

• Dexamethasone [update to dosing for treatment of life-threatening cerebral oedema].

New Monographs:

Myalepta® [metreleptin].

• Von Willebrand factor.

Deleted Monographs: Hydrocortisone with pramocaine; Methylcellulose.

For further details on changes in the BNFC click on
https://www.medicinescomplete.com/#/content/bnfc/PHP107699?hspl=changes

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