British National Formulary for Children

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

12 Jan

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.

See details

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

BNF for Children December 2020 Update

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

See details

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

BNF for Children November 2020 Update

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

See details

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

13 Oct

BNF for Children October 2020 Update

This update contains 19 significant changes, 6 dose changes, 1 new monograph and 1 new preparation.

See details

Significant Changes: 

Amisulpride: Clozapine and other antipsychotics: monitoring blood concentrations for toxicity [MHRA/CHM advice].
Aripiprazole: Clozapine and other antipsychotics: monitoring blood concentrations for toxicity [MHRA/CHM advice].
Belimumab as add-on therapy for active, autoantibody-positive systemic lupus erythematosus with a high degree of disease activity despite standard therapy [AWMSG guidance].
Bisacodyl: Stimulant laxatives (bisacodyl, senna and sennosides, sodium picosulfate) available over-the-counter: new measures to support safe use [MHRA/CHM advice].
Clozapine: Clozapine and other antipsychotics: monitoring blood concentrations for toxicity [MHRA/CHM advice].
Entrectinib for treating NTRK fusion-positive solid tumours [NICE guidance].
Hydroxycarbamide for the prevention of vaso-occlusive complications of sickle-cell disease in patients over 2 years of age [AWMSG guidance].
Hydroxycarbamide for the prevention of vaso-occlusive complications of sickle-cell disease in patients over 2 years of age [SMC guidance].
Immunisation schedule: updated National flu immunisation programme in-line with Public Health England recommendations.
Influenza: updated guidance on management.
Influenza vaccine: updated guidance in-line with Public Health England recommendations.
Isotretinoin (Roaccutane®▼): reminder of important risks and precautions [MHRA/CHM advice].
Olanzapine: Clozapine and other antipsychotics: monitoring blood concentrations for toxicity [MHRA/CHM advice].
Quetiapine: Clozapine and other antipsychotics: monitoring blood concentrations for toxicity [MHRA/CHM advice].
Risperidone: Clozapine and other antipsychotics: monitoring blood concentrations for toxicity [MHRA/CHM advice].
Senna: Stimulant laxatives (bisacodyl, senna and sennosides, sodium picosulfate) available over-the-counter: new measures to support safe use [MHRA/CHM advice].
Sodium picosulfate: Stimulant laxatives (bisacodyl, senna and sennosides, sodium picosulfate) available over-the-counter: new measures to support safe use [MHRA/CHM advice].
Sulpiride: Clozapine and other antipsychotics: monitoring blood concentrations for toxicity [MHRA/CHM advice].
Tick-borne encephalitis vaccine: updated guidance in-line with Public Health England recommendations.

Dose Changes:

Benlysta® (belimumab) [dosing in children added].
Gaviscon infant® (alginic acid) [update to dosing for management of gastro-oesophageal reflux disease].
Influenza vaccine [update to dosing for immunisation].
Isotretinoin [indication updated].
Oseltamivir [update to dosing for treatment and prevention of influenza].
Zanamivir [update to dosing for treatment of influenza].

New Monograph:

Rozlytrek® [entrectinib].

New Preparation: Trecondi® [treosulfan].

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

08 Sep

BNF for Children September 2020 Update

This update contains 6 significant changes, 1 dose change and 2 new monographs.

See details

Significant Changes:
• Amphotericin: name change to amphotericin B.
• Amphotericin B: Liposomal and lipid-complex formulations: name change to reduce medication errors [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].
• 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].

Dose Change:
• Cefixime [update to dosing for uncomplicated gonorrhoea].

New Monographs:
• Cefazolin.
• Veklury® [remdesivir].

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

11 Aug

BNF for Children August 2020 Update

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

See details

Significant Changes:

Genital system infections, antibacterial therapy: updated guidance for the management of uncomplicated gonorrhoea.
Ketotifen for the symptomatic treatment of seasonal allergic conjunctivitis [AWMSG guidance].
Smallpox vaccine: updated guidance in-line with Public Health England recommendations.

Dose Changes:

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].
Doxycycline [update to dosing for prophylaxis of malaria].
Proguanil hydrochloride [update to age range for prophylaxis of malaria].
Solifenacin succinate [update to include child dosing].
Tipranavir [dose removed for child 2-11 years as oral solution formulation discontinued].

Deleted Monograph: Stavudine

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

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