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September 2018 Share this issue Facebook LinkedIn Twitter
 
I Welcome
Welcome to the September BNF eNewsletter.
Three new drug monographs have been added to the BNFC in the last month, anakinra, dasatinib, and fosaprepitant.

This issue includes dose changes for adenosine, anakinra, dasatinib, hexetidine, hydroxocobalamin, raltegravir, and ulipristal acetate. We also have updated guidance on prophylaxis of venous thromboembolism and stable angina. We have included MHRA advice on darunavir boosted with cobicistat to avoid use in pregnancy due to risk of treatment failure and maternal-to-child transmission of HIV-1 and pressurised metered dose inhalers (pMDI) and the risk of airway obstruction from aspiration of loose objects. You will also find NICE technology appraisals for atezolizumab for untreated PD-L1-positive locally advanced or metastatic urothelial cancer when cisplatin is unsuitable, cenegermin for treating neurotrophic keratitis, crizotinib for treating ROS1-positive advanced non-small-cell lung cancer, and nivolumab for treating locally advanced unresectable or metastatic urothelial cancer after platinum-containing chemotherapy.
Kind regards,
BNF Team
I In this issue
BNF app wins BIMA award More >  
BNF 76 available to order More >  
New BNF for Children 2018-2019 More >  
Significant changes More >  
News More >  
How to purchase BNF More >  
Drug safety update More >  
Feedback More >  
I BNF app wins prestigious BIMA award
The British National Formulary (BNF) App has won the Website & App Impact award and the overall category award for best Website & App at the British Interactive Media (BIMA) Awards.

The BNF App contains comprehensive information about all the prescription medicines available on the NHS. Its core feature is an interaction checker that helps clinicians ensure the safety of their patients by intuitively checking for possible drug interactions. Each month over 126,000 clinicians use the App to prescribe and advise on the use of medicines.

Read more here.
BNF BNFC
BNF BNF 76 available to order now!
The BNF continues to provide unrivalled guidance on selecting and administering medicines. It is the only 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.

Significant new content updates include:
New guidance on endometriosis.
Updated guidance on acute sinusitis, chronic asthma, country recommendations for malaria prophylaxis, and cystic fibrosis.
New drug monographs including benralizumab, guselkumab, midostaurin, niraparib, ocrelizumab, tenofovir alafenamide, tivozanib, and tramadol with dexketoprofen.
New safety information about mycophenolate mofetil and mycophenolic acid with updated contraception advice for male patients, and valproate medicines now contraindicated in women and girls of childbearing potential unless conditions of Pregnancy Prevention Programme are met.
Updated advice about alendronic acid, ibandronic acid, risedronate sodium and zoledronic acid for treating osteoporosis and raloxifene for the primary prevention of osteoporotic fragility fractures in postmenopausal women.
Significant dose changes including the initial dose for erectile dysfunction and neurogenic erectile dysfunction for Viridal® Duo (alprostadil), bosutinib and olaparib doses in renal impairment, candesartan cilexetil clarification of maximum dose in heart failure, and chloroquine clarification of dose equivalence statement and dosing for rheumatoid arthritis and systemic discoid lupus erythematosus.
 
Order your copy of BNF 76
BNF 76

ISBN: 978 0 85711 338 2
Sep 2018 • Paperback • 1,640pp

BNF New BNF for Children 2018-2019!
Significant new content updates include:
Updated guidance on chronic asthma, cystic fibrosis, prescribing in multimorbidity and deprescribing, and urinary tract infections.
New drug monographs including daptomycin, emtricitabine with tenofovir disoproxil, ipilimumab, ledipasvir with sofosbuvir, nilotinib, sofosbuvir, and tenofovir alafenamide.
New safety information on head lice eradication products and the risk of serious burns if treated hair is exposed to open flames or other sources of ignition and valproate medicines now contraindicated in women and girls of childbearing potential unless conditions of Pregnancy Prevention Programme are met.
Significant dose changes including adalimumab doses for plaque psoriasis, polyarticular juvenile idiopathic arthritis, and enthesitis-related arthritis, chloroquine clarification of dose equivalence statement, co-codamol doses for children aged 12 to 15 years, elvitegravir with cobicistat, emtricitabine and tenofovir alafenamide age-range extension, and lopinavir with ritonavir update to licensed age range.
 
Order your copy of BNFC 2018-2019
BNFC 2018-2019

ISBN: 978 0 85711 336 8
Sep 2018 • Paperback • 1,120pp

I Significant changes
This month's changes to the clinical content of these publications are described in three parts:

BNF and BNFC update should be read by all users
BNF update should be read by all users of the BNF
BNFC update should be read by all users of the BNF for Children
BNF 76 - BNFC 2018-2019
BNF BNF for Children Update
Darunavir boosted with cobicistat (darunavir with cobicistat, emtricitabine and tenofovir alafenamide): avoid use in pregnancy due to risk of treatment failure and maternal-to-child transmission of HIV-1 [MHRA advice]
For further information, see darunavir with cobicistat, emtricitabine and tenofovir alafenamide.
Pressurised metered dose inhalers (pMDI): risk of airway obstruction from aspiration of loose objects [MHRA advice]
For further information, see respiratory system, drug delivery.
Eltrombopag (Revolade®): reports of interference with bilirubin and creatinine test results [MHRA advice]
For further information, see eltrombopag.
Parenteral amphotericin B: reminder of risk of potentially fatal adverse reaction if formulations confused [MHRA advice]
For further information, see amphotericin.
Venous thromboembolism: updated guidance on prophylaxis
For further information, see venous thromboembolism.
Dose changes
Anakinra [dosing in severe renal impairment]
For further information, see anakinra.
Hydroxocobalamin [frequency of maintenance dosing for macrocytic anaemia without neurological involvement]
For further information, see hydroxocobalamin.
Hexetidine [update to age-range]
For further information, see hexetidine.
BNF for Children Update
Anakinra: new drug monograph
For further information, see anakinra.
Dasatinib: new drug monograph
For further information, see dasatinib.
Fosaprepitant: new drug monograph
For further information, see fosaprepitant.
Dose changes
Adenosine [dose clarification for neonate and children under 12 years for termination of supraventricular tachycardias and diagnosis of supraventricular arrhythmias]
For further information, see adenosine.
Budenofalk® (budesonide) [deletion of dosing information for collagenous colitis and update on advice on reducing dose following treatment in Crohn's disease]
For further information, see budesonide.
Raltegravir [directions for administration for granules for oral suspension deleted as available packs may contain conflicting advice; see individual packs for instructions on reconstitution]
For further information, see raltegravir.
Other changes
To review other changes in BNF for Children, click on changes.
BNF Update
Darunavir boosted with cobicistat (darunavir with cobicistat): avoid use in pregnancy due to risk of treatment failure and maternal-to-child transmission of HIV-1 [MHRA advice]
For further information, see darunavir with cobicistat.
Hydroxocobalamin [frequency of maintenance dosing for pernicious anaemia without neurological involvement]
For further information, see hydroxocobalamin.
Esmya® (ulipristal acetate) for symptoms of uterine fibroids: restrictions to use and requirement to check liver function before, during and after treatment
For further information, see ulipristal acetate.
Stable angina: updated guidance on management
For further information, see stable angina.
Dose changes
Esmya® (ulipristal acetate) [dosing information for pre-operative treatment of moderate to severe symptoms of uterine fibroids]
For further information, see ulipristal acetate.
Dasatinib [addition of information on dose adjustment due to side-effects]
For further information, see dasatinib.
NICE technology appraisal update:
NICE technology appraisals that have been added to the BNF this month include:
Atezolizumab for untreated PD-L1-positive locally advanced or metastatic urothelial cancer when cisplatin is unsuitable
Beta interferons and glatiramer acetate for treating multiple sclerosis
Niraparib for maintenance treatment of relapsed, platinum-sensitive ovarian, fallopian tube and peritoneal cancer
Nivolumab for treating locally advanced unresectable or metastatic urothelial cancer after platinum-containing chemotherapy
Ocrelizumab for treating relapsing-remitting multiple sclerosis
Other changes
To review other changes in BNF, click on changes.
I News
Reminder - help from CPPE with BNF 75
An interactive PDF e-learning programme from the Centre for Pharmacy Postgraduate Education (CPPE) will help you familiarise yourself with recommendations in BNF 75. It comprises 10 practical case studies that help you keep up to date with recent changes in the BNF, and can be accessed here.
BNF 74
I How to purchase BNF
Purchase Print copies
Purchase print copies
To order the March 2018 edition, visit the Pharmaceutical Press website.
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BNF online
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Outside the UK, content is available via a subscription to MedicinesComplete.
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BNF eBook
BNF eBook
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Drug Safety Update
Drug Safety Update is a monthly newsletter from
the MHRA and Commission on Human Medicine.
Please follow this link to review this month's Drug Safety Update.
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