The BNF for Children is the unrivalled guidance on prescribing, dispensing and administering medicines to children.

BNF for Children is the only child-focused 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 in paediatrics.

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Publication Updates

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

09 Mar
British National Formulary for Children logo
BNF for Children March 2021 Update

This update contains 8 significant changes, 5 dose changes and 1 new monograph.

Significant Changes:
• Aminoglycosides: increased risk of deafness in patients with mitochondrial mutations [MHRA/CHM advice] (advice in amikacin, gentamicin, gentamicin with hydrocortisone, neomycin sulfate, tobramycin; see example in gentamicin).

• Epilepsy: updated advice on antiepileptic drugs in pregnancy following comprehensive safety review [MHRA/CHM advice].

• Erythromycin: updated pregnancy statement.

• Melatonin (Slenyto®) for the treatment of insomnia in children aged 2 years and over with autism spectrum disorder (ASD) and/or Smith-Magenis syndrome, where sleep hygiene measures have been insufficient [SMC guidance].

• Oropharyngeal infections, antibacterial therapy: updated guidance on management.

• Psychoses and related disorders: updated guidance on management.

• Skin infections, antibacterial therapy: updated guidance for the management of human and animal bites.

• SSRI/SNRI antidepressant medicines: small increased risk of postpartum haemorrhage when used in the month before delivery [MHRA/CHM advice] (advice in citalopram, fluoxetine, fluvoxamine maleate, sertraline; see example in fluoxetine).

Dose Changes:
• Atropine sulfate [update to dosing for treatment of symptomatic bradycardia due to acute overdosage of beta-blockers].

• Glucagon [update to dosing for treatment of severe hypotension, heart failure or cardiogenic shock due to acute overdosage of beta-blockers].

• Normal immunoglobulin [update to dosing for post-exposure prophylaxis against hepatitis A infection].

• Rosuvastatin [dose adjustments due to interactions updated].

• Vitamins A and D 4000 units/400 units [child age range].

New Monograph:
Cosentyx® [secukinumab].

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

09 Feb
British National Formulary for Children logo
BNF for Children February 2021 Update

This update contains 10 significant changes, 2 new monographs and 1 new preparation.

Significant Changes:
• Caplacizumab with plasma exchange and immunosuppression for treating acute acquired thrombotic thrombocytopenic purpura [NICE guidance].

• COVID-19: updated guidance.

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

• Erythromycin: caution required due to cardiac risks (QT interval prolongation); drug interaction with rivaroxaban [MHRA/CHM advice].

• Erythromycin: update on known risk of infantile hypertrophic pyloric stenosis [MHRA/CHM advice].

• Fingolimod (Gilenya®): updated advice about the risks of serious liver injury and herpes meningoencephalitis [MHRA/CHM advice].

• Immunisation schedule: updated National flu immunisation programme in-line with Public Health England recommendations.

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

• Methylprednisolone as sodium succinate (Solu-Medrone®) 40 mg powder and solvent for solution for injection: change from lactose-containing to a lactose-free formulation; risk of serious allergic reactions if formulations are confused [MHRA/CHM advice].

• Quinolones (systemic and inhaled fluoroquinolones): small risk of heart valve regurgitation; consider other therapeutic options first in patients at risk [MHRA/CHM advice] (advice in ciprofloxacin, ofloxacin; see example in ciprofloxacin).

New Monographs:
Cablivi® [caplacizumab].

• COVID-19 vaccine.

New Preparation:

Kalydeco® granules in sachet [ivacaftor].

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

12 Jan
British National Formulary for Children logo
BNF for Children January 2021 Update

This update contains 7 significant changes, 1 dose change, 3 new monographs, 3 new preparations and 2 deleted monographs.

Significant Changes:
• Antibacterials, use for prophylaxis: updated guidance for the prevention of secondary Haemophilus influenzae type b disease.

• 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].

• Interactions: drugs that cause myelosuppression: pharmacodynamic effects drug group revalidated and updated.

• 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.

• Vaccination, general principles: updated guidance.

Dose Change:
• Sodium feredetate [update to dosing for iron-deficiency anaemia (prophylactic)].

New Monographs:
Otigo® [phenazone with lidocaine].

Rezolsta® [darunavir with cobicistat].

Tybost® [cobicistat].

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; Ticarcillin with clavulanic acid.

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

08 Dec
British National Formulary for Children logo
BNF for Children December 2020 Update

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

Significant Changes:

  • Dolutegravir (Tivicay®▼, Triumeq®▼, Juluca®▼): updated advice on increased risk of neural tube defects [MHRA/CHM advice].
  • Flucytosine (Ancotil®): new contraindication in patients with DPD deficiency [MHRA/CHM advice].
  • Haemophilus influenzae type B conjugate vaccine: updated guidance in-line with Public Health England recommendations.
  • Hepatitis A vaccine: updated guidance in-line with Public Health England recommendations.
  • Immunoglobulins: updated guidance in-line with Public Health England recommendations for the use of normal immunoglobulin for protection against hepatitis A infection.
  • Introduction of a new symbol to indicate manufacturer information: the symbol M (manufacturer information) will be used within text to indicate when recommendations are based on summaries of product characteristics; see How BNF Publications are constructed.
  • Skin infections, antibacterial therapy: new guidance for the management of insect bites and stings.
  • Warfarin sodium: monitoring of patients during the COVID-19 pandemic [MHRA/CHM advice].

Dose Change:

  • Subgam® (normal immunoglobulin) [update to dosing for hepatitis A prophylaxis].

New Monograph:

  • Atectura Breezhaler® [indacaterol with mometasone furoate].

Deleted Monographs: Fenticonazole nitrate; Interferon alfa; Nedocromil sodium.

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

10 Nov
British National Formulary for Children logo
BNF for Children November 2020 Update

This update contains 10 significant changes, 2 dose changes and 2 new monographs.

Significant Changes:

  • Bedaquiline in combination regimen for multiple-drug resistant pulmonary tuberculosis [AWMSG guidance].
  • Cannabidiol with clobazam for therapy of seizures associated with Dravet syndrome [SMC guidance].
  • Cannabidiol with clobazam for therapy of seizures associated with Lennox-Gastaut syndrome [SMC guidance].
  • Fentanyl transdermal patches for non-cancer pain: do not use in opioid-naive patients [MHRA/CHM advice].
  • Immunoglobulins: updated guidance on the use of varicella-zoster immunoglobulin in-line with Public Health England recommendations.
  • Insulins (all types): risk of cutaneous amyloidosis at injection site [MHRA/CHM advice] (advice in biphasic insulin aspart, biphasic insulin lispro, biphasic isophane insulin, insulin, insulin aspart, insulin degludec, insulin detemir, insulin glargine, insulin glulisine, insulin lispro, isophane insulin; see example in insulin).
  • Methotrexate once-weekly for autoimmune diseases: new measures to reduce risk of fatal overdose due to inadvertent daily instead of weekly dosing [MHRA/CHM advice].
  • Opioids: risk of dependence and addiction [MHRA/CHM advice] (advice in alfentanil, buprenorphine, co-codamol, codeine phosphate, co-phenotrope, diamorphine hydrochloride, dihydrocodeine tartrate, fentanyl, hydromorphone hydrochloride, methadone hydrochloride, morphine, oxycodone hydrochloride, pethidine hydrochloride, remifentanil, tapentadol, tramadol hydrochloride; see example in morphine).
  • Poisoning, emergency treatment: updated guidance on the management of paracetamol poisoning in-line with TOXBASE recommendations.
  • Varicella-zoster vaccine: updated guidance in-line with Public Health England recommendations.

Dose Changes:

  • Glycopyrronium bromide [oral dosing in children updated].
  • Mercaptamine [update to dosing for nephropathic cystinosis].

New Monographs:

  • Kaftrio® [tezacaftor with ivacaftor and elexacaftor].
  • Sirturo® [bedaquiline].

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

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