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Publication Updates

11 Jan
British National Formulary logo
British National Formulary January 2022 Update

This update contains 9 significant changes, 2 dose changes, 5 new monographs and 1 deleted preparation.

Significant Changes:
• Adrenaline/epinephrine auto-injectors: reminder for prescribers to support safe and effective use [MHRA/CHM advice].
• Arrhythmias: updated guidance for the management of atrial fibrillation.
• COVID-19: updated guidance.
• COVID-19 vaccines: updated guidance in-line with Public Health England/UK Health Security Agency recommendations.
• Dapagliflozin (Forxiga®) 5mg should no longer be used for the treatment of Type 1 Diabetes Mellitus [MHRA/CHM advice].
• Malaria, prophylaxis: updated guidance in-line with Public Health England recommendations.
• Mexiletine: update to include new indication for life-threatening ventricular arrhythmias.
• Phenobarbital: oral doses for children have been removed from the BNF; these can still be accessed in BNF for Children, where additional information on the available oral solutions and advice from the RCPCH/NPPG can be found in the prescribing and dispensing section of the Phenobarbital monograph.
• Yellow fever vaccine, live (Stamaril®): new pre-vaccination checklist [MHRA/CHM advice].

Dose Changes:
• Adrenaline/epinephrine [update to dosing for acute anaphylaxis].
• Calcium gluconate [update to dosing for acute severe hyperkalaemia].

New Monographs:
Lagevrio® [molnupiravir].
Lumykras® [sotorasib].
Ponvory® [ponesimod].
Tepmetko® [tepotinib].
Tukysa® [tucatinib].

Deleted Preparations: Tacni® [tacrolimus].

For further details on changes in the BNF click on https://www.medicinescomplete.com/#/content/bnf/PHP107699

07 Dec
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British National Formulary December 2021 Update

This update contains 7 significant changes, 3 dose changes, 1 classification change and 7 new monographs.

Significant Changes:
• Acne: updated guidance on management.
• COVID-19 vaccine: title changed to COVID-19 vaccines.
• COVID-19 vaccines: updated guidance in-line with Public Health England/UK Health Security Agency recommendations.
• Nausea and labyrinth disorders: updated guidance on the management of nausea and vomiting during pregnancy.
• Rosacea and Acne: title changed to Rosacea.
• Tofacitinib (Xeljanz®): new measures to minimise risk of major adverse cardiovascular events and malignancies [MHRA/CHM advice].
• Type 1 diabetes: updated guidance on Recommended insulin regimens.

Dose Changes:
• Cabozantinib [update to dosing for advanced renal cell carcinoma].
• Chloral hydrate [update to dosing information for short-term treatment of severe insomnia].
• Tofacitinib [update to dosing for moderate to severe rheumatoid arthritis and psoriatic arthritis].

Classification Changes:
• Minoxidil [primary classification changed to Potassium-channel openers].

New Monographs:
Acarizax® [house dust mite extract].
Cibinqo® [abrocitinib].
Klisyri® [tirbanibulin].
Ontozry® [cenobamate].
Orladeyo® [berotralstat].
Rukobia® [fostemsavir].
Vocabria® [cabotegravir].

For further details on changes in the BNF click on
https://www.medicinescomplete.com/#/content/bnf/PHP107699

09 Nov
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British National Formulary November 2021 Update

This update contains 3 significant changes, 4 dose changes, 5 new monographs, 2 new preparations and 1 deleted monograph.

Significant Changes:
• Antihistamines, allergen immunotherapy and allergic emergencies: updated guidance for the management of anaphylaxis.

• Gastro-intestinal system infections, antibacterial therapy: updated guidance on the management of Clostridioides difficile infection.

• Topical corticosteroids: information on the risk of topical steroid withdrawal reactions [MHRA/CHM advice] (advice in alclometasone dipropionate, beclometasone dipropionate, benzyl benzoate with bismuth oxide, bismuth subgallate, hydrocortisone acetate, peru balsam and zinc oxide, betamethasone, cinchocaine hydrochloride with fluocortolone caproate and fluocortolone pivalate, cinchocaine with hydrocortisone, cinchocaine with prednisolone, clobetasol propionate, diflucortolone valerate, fludroxycortide, fluocinolone acetonide, fluticasone, hydrocortisone, hydrocortisone with lidocaine; see example in hydrocortisone).

Dose Changes:
• Adrenaline/epinephrine [update to dosing for emergency treatment of acute anaphylaxis].

• COVID-19 vaccine [update to dosing for immunisation against COVID-19].

• Dolutegravir [update to dosing for the treatment of HIV infection].

• Vancomycin [update to dosing for Clostridioides difficile infection].

New Monographs:
Bimzelx® [bimekizumab].

Evrenzo® [roxadustat].

Ryaltris® [mometasone furoate with olopatadine].

Ryeqo® [relugolix with estradiol and norethisterone acetate].

Trodelvy® [sacituzumab govitecan].

New Preparations: Arikayce® liposomal nebuliser dispersion [amikacin]; Trimbow NEXThaler 88/5/9® [beclometasone with formoterol and glycopyrronium].

Deleted Monograph: Tinidazole.

For further details on changes in the BNF click on
https://www.medicinescomplete.com/#/content/bnf/PHP107699

12 Oct
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British National Formulary October 2021 Update

This update contains 9 significant changes, 7 new monographs, and 1 deleted preparation.

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

• Dapagliflozin: update to advice on use in renal impairment, including new indication for chronic kidney disease.

• Diabetic hyperglycaemic emergencies: updated guidance.

• Diabetic Ketoacidosis: title changed to Diabetic hyperglycaemic emergencies.

• 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.

• Remdesivir: update to treatment duration.

• Tofacitinib (Xeljanz®): increased risk of major adverse cardiovascular events and malignancies with use of tofacitinib relative to TNF-alpha inhibitors [MHRA/CHM advice].

• Trientine dihydrochloride: name change to trientine, and update to dosing for Wilson’s disease.

New Monographs:
Adakveo® [crizanlizumab].

Adtralza® [tralokinumab].

Besremi® [ropeginterferon alfa-2b].

Bijuve® [estradiol with progesterone].

Byfavo® [remimazolam].

Pemazyre® [pemigatinib].

Verquvo® [vericiguat].

Deleted Preparations: Mysodelle® [misoprostol].

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

14 Sep
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British National Formulary September 2021 Update

This update contains 6 significant changes and 4 new monographs.

Significant Changes:
• Chloramphenicol eye drops containing borax or boric acid buffers: use in children younger than 2 years [MHRA/CHM advice].

• Low back pain and sciatica: updated guidance on management.

• Migraine: updated guidance on preventative migraine treatment.

• Oral retinoid medicines: temporary monitoring advice during coronavirus (COVID-19) pandemic [MHRA/CHM advice] (advice in acitretin, alitretinoin, isotretinoin; see example in isotretinoin).

• Pain, Chronic: updated guidance on management.

• Venetoclax (Venclyxto®): updated recommendations on tumour lysis syndrome (TLS) in CLL patients [MHRA/CHM advice].

New Monographs:
Dropizol® [opium].

Evrysdi® [risdiplam].

Fintepla® [fenfluramine].

Inrebic® [fedratinib].

For further details on changes in the BNF click on https://www.medicinescomplete.com/#/content/bnf/PHP107699

10 Aug
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British National Formulary August 2021 Update

This update contains 9 significant changes, 1 dose change, 4 new monographs, 1 new preparation and 1 deleted monograph.

Significant Changes:
• Adrenal insufficiency: updated guidance on management.

• Atezolizumab (Tecentriq®) and other immune-stimulatory anti-cancer drugs: risk of severe cutaneous adverse reactions (SCARs) [MHRA/CHM advice] (advice in atezolizumab, avelumab, cemiplimab, durvalumab, ipilimumab, nivolumab, pembrolizumab; see example in atezolizumab).

• CDK4/6 inhibitors: reports of interstitial lung disease and pneumonitis, including severe cases [MHRA/CHM advice] (advice in abemaciclib, palbociclib, ribociclib; see example in abemaciclib).

• Corticosteroids, replacement therapy: title changed to Adrenal insufficiency.

• COVID-19 vaccine: reports of myocarditis and pericarditis with the Pfizer/BioNTech and Moderna vaccines.

• Heavy menstrual bleeding: updated guidance.

• Immunoglobulins: updated guidance in-line with Public Health England recommendations for the use of immunoglobulin for tetanus infection and prophylaxis.

• Prescribing in renal impairment: updated guidance.

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

Dose Change:
Enstilar® (calcipotriol with betamethasone) [update to dosing for the treatment of psoriasis].

New Monographs:
Blenrep® [belantamab mafodotin].

Isturisa® [osilodrostat].

Kesimpta® [ofatumumab].

Zibor® [bemiparin sodium].

New Preparation: Fixkoh Airmaster® [fluticasone with salmeterol].

Deleted Monograph: Telavancin.

For further details on changes in the BNF click on https://www.medicinescomplete.com/#/content/bnf/PHP107699

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