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February 2020

Welcome to the February BNF Newsletter.

• One new drug monograph has been added to the BNF in the last month: lusutrombopag. One new drug has been added to the BNF for Children in the last month: cinacalcet.
• We have also included a dose change for Syner-KINASE® (urokinase) to the BNF.
• MHRA have provided advice on domperidone.

Kind regards,
BNF Team

Other topics:

Significant changes   |   Drug Safety Update   |   News

Significant changes

BNF BNF only

New monograph Mulpleo® [lusutrombopag] for thrombocytopenia [in patients with chronic liver disease undergoing invasive procedures] (under expert supervision).

Cladribine for treating relapsing–remitting multiple sclerosis [NICE guidance].

Hypertension: updated guidance on management.

Multiple sclerosis and Nausea and labyrinth disorders: updated guidance for use of cannabis-based medicinal products.

Dose Changes for BNF only
Syner-KINASE® (urokinase) [clarification of the intravenous infusion dosage units for the follow-on treatment of pulmonary embolism].

BNF for Children BNF for Children Only

New monograph: Mimpara® [cinacalcet] for secondary hyperparathyroidism [in patients with end-stage renal disease on dialysis] (under expert supervision), hypercalcaemia in parathyroid carcinoma and primary hyperparathyroidism [in patients where parathyroidectomy is inappropriate].

BNF BNF for Children Both BNF and BNF for Children

Domperidone for nausea and vomiting: lack of efficacy in children; reminder of contraindications in adults and adolescents [MHRA/CHM advice].

Immunisation schedule: changes to infant schedule for pneumococcal polysaccharide conjugate vaccine in-line with Public Health England recommendations.

Skin infections, antibacterial therapy: updated guidance for management of cellulitis and erysipelas.

Tuberculosis: updated guidance on management.

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

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.

Ondansetron: small increased risk of oral clefts following use in the first 12 weeks of pregnancy.

Mecasermin (Increlex): risk of benign and malignant neoplasia.



BNF 79 now available!

Compiled with the advice of clinical experts and continually updated to reflect the latest evidence from credible sources worldwide, the new edition of the British National Formulary 79 (BNF) provides up-to-date guidance on prescribing, dispensing, and administering medicines.

Purchase your copy

BNF 79

Extensive content updates in the BNF 79 edition include:

New Monographs added on
Renoxitin® [cefoxitin] for complicated urinary tract infections and pyelonephritis
Ledaga® gel [chlormethine] for mycosis fungoides
Ondexxya® [andexanet alfa] for reversal of apixaban or rivaroxaban in life-threatening or uncontrolled bleeding
Epidyolex® [cannabidiol] for seizures associated with Lennox-Gastaut syndrome and seizures associated with Dravet syndrome [adjunctive treatment with clobazam]
Rizmoic® [naldemedine] for opioid-induced constipation.
MHRA advice on
Febuxostat (Adenuric®): increased risk of cardiovascular death and all-cause mortality in clinical trial in patients with a history of major cardiovascular disease
Pentosan polysulfate sodium (Elmiron®): rare risk of pigmentary maculopathy
Hormone replacement therapy (HRT) (conjugated oestrogens (equine) and estradiol): further information on the known increased risk of breast cancer with HRT and its persistence after stopping.
Dose changes including magnesium sulfate: change to additional dose for seizure recurrence in pre-eclampsia and eclampsia.

Updated guidance on vaccines in-line with Public Health England recommendations.

Please donate old copies of the BNF

The PharmAid Scheme is an initiative of the Commonwealth Pharmacists Association where recent versions of medicines information resources including the BNF are redistributed to low and middle income countries. You can make a difference in another commonwealth country by simply donating your old BNF copies to them.

For more information on this scheme see If you would like to donate your copy email:


How to purchase BNF






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