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March 2019


Welcome to the March BNF eNewsletter.

• Three new drug monographs have been added to the BNF in the last month: ertugliflozin, brigatinib and semaglutide. One new drug monograph has been added to the BNFC in the last month: tapentadol.
• We have also included dose changes for pembrolizumab, adalimumab, imipenem with cilastatin, anthrax vaccine and Japanese encephalitis vaccine.
• We have included MHRA advice on tapentadol and ipilimumab.

This month's special features include the publication of the new BNF 77.

Other topics:

Significant updates   |   Drug safety update  |   News  |   How to purchase BNF   |   Feedback

Significant updates

BNF BNF for Children Both BNF and BNFC

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

Attention deficit hyperactivity disorder: updated guidance on management.

Cholera Vaccine: updated guidance in-line with Public Health England recommendations.

Ipilimumab (Yervoy®): reports of cytomegalovirus (CMV) gastrointestinal infection or reactivation [MHRA/CHM advice].

Japanese encephalitis vaccine: updated guidance in-line with Public Health England recommendations.

Methotrexate: updated recommendations for conception and contraception.

Tapentadol (Palexia®): risk of seizures and reports of serotonin syndrome when co-administered with other medicines [MHRA/CHM advice].

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

Dose changes for both BNF and BNFC:
Adalimumab maintenance dosing updated.

Anthrax vaccine dosing schedule updated.

Imipenem with cilastatin dosing recommendation in renal impairment updated.

Japanese encephalitis vaccine dosing schedule updated.

BNF for Children BNFC Only

New monograph: Palexia® oral solution [tapentadol].

BNF BNF only

New monograph: Alunbrig® [brigatinib].

New monograph: Ozempic® [semaglutide].

New monograph: Steglatro® [ertugliflozin].

Breast cancer: updated guidance on management.

Chronic heart failure: updated guidance on management.

Heavy menstrual bleeding: updated recommendations for the use of ulipristal acetate.

Lenvatinib for untreated advanced hepatocellular carcinoma [NICE guidance].

Nivolumab for adjuvant treatment of completely resected melanoma with lymph node involvement or metastatic disease [NICE guidance].

Pembrolizumab for adjuvant treatment of resected melanoma with high risk of recurrence [NICE guidance].

Pembrolizumab with pemetrexed and platinum chemotherapy for untreated, metastatic, non-squamous non-small-cell lung cancer [NICE guidance].

Regorafenib for previously treated advanced hepatocellular carcinoma [NICE guidance].

Dose Changes for BNF only
Pembrolizumab dose for non-small cell lung cancer (following prior chemotherapy) and melanoma.

Drug Safety Update
Drug Safety Update is a monthly newsletter from the MHRA and Commission on Human Medicine. Please follow this link to review the latest Drug Safety Update.

Carbimazole: increased risk of congenital malformations; strengthened advice on contraception

Carbimazole: risk of acute pancreatitis

SGLT2 inhibitors: reports of Fournier's gangrene (necrotising fasciitis of the genitalia or perineum)


BNF app wins the 2019 Design Business Association Design Effectiveness Award
Following on from recent recognition by the BIMA awards for 'best website & app' and being awarded silver in the London Design Awards 2018, this latest win illustrates the impact that thoughtful design and functionality of the app is having on the user experience of healthcare professionals.

The BNF App continues to be a success, providing comprehensive information on prescription medicines available on the NHS. Each month, over 126,000 clinicians use the App to prescribe and advise on the use of medicines. Its core feature is an interaction checker that helps clinicians ensure the safety of their patients by intuitively checking for possible drug interactions.
BNF 77
BNF 77 available now
The new British National Formulary (BNF) 77 is now available, it is compiled of the latest guidance on prescribing, dispensing, and administering medicines. This edition continues to reflect current best practice as well as legal and professional guidelines relating to the uses of medicines.

With the formally NICE accredited editorial process and access to new monographs, advice, dosages and safety information, BNF 77 is vital for all healthcare professionals.

Please donate old copies of the BNF
Old BNF copies can be donated to certain Commonwealth countries via the Pharmaid scheme of the Commonwealth Pharmacists Association. For more information on this scheme see If you would like to donate your copy email:

How to purchase BNF

To order the March 2018 edition, visit the Pharmaceutical Press website

Purchase a print subscription, ensure access to the latest copy of BNF and save money
Outside the UK, content is available via a subscription to MedicinesComplete

Access the latest copy of BNF on your mobile device, which is available as a PDF eBook

eNewsletter Feedback
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