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Welcome to the July 2015 BNF eNewsletter.

Packed with updates, this month's edition includes:

new advice issued by the MHRA for Amiodarone following reports of severe bradycardia or heart block in combination with certain anti-retroviral drugs;
new monitoring instructions to identify side-effects of Pomalidomide;
warnings for an increased risk of retinopathy in preterm infants with epoetin beta (NeoRecormon®);
information for newly licensed oral Ketoconazole (Ketoconazole HRA®) for treatment of endogenous Cushing's syndrome.

Kind regards,
The BNF Team
Significant changes More >
Changes to Appendix 3 More >
News More >
How to purchase BNF More >
Drug Safety Update More >
Feedback on our eNewsletter More >
Significant changes
This month's changes to the clinical content of these publications are described in three parts:

• BNF & BNFC update should be read by all users of the BNF or BNFC
• 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 69 and BNFC 2014-2015
BNF and BNFC update

Epoetin beta (NeoRecormon®)
The MHRA have issued new advice when considering the use of epoetin beta (NeoRecormon®) for the prevention of anaemia of prematurity in premature infants. Due to the possible increased risk of retinopathy, prescribers should consider the risk versus benefits of treatment and monitor the infant for features of retinopathy. For more information see Epoetin beta, NeoRecormon.

Ketoconazole tablets (Ketoconazole HRA®) are now available for the treatment of endogenous Cushing's syndrome in adults and adolescents. Initiation should be carried out by specialists. Prescribers should be made aware of the potential risks of hepatotoxicity and adrenal insufficiency. Patients and their carers should be informed about how to recognise signs and symptoms of liver disorder and adrenal insufficiency, and to discontinue treatment and seek prompt medical attention if symptoms such as anorexia, nausea, vomiting, fatigue, jaundice, abdominal pain, or dark urine develop. For more information, see Ketoconazole.

BNF update

Pomalidomide may cause interstitial lung disease (ILD), cardiac failure and hepatotoxicity. Patients should be carefully assessed and monitored for signs and symptoms of cardiac failure and worsening of respiratory symptoms. Regular monitoring of liver function tests are also required. For more information, see Pomalidomide.

New advice for the use of amiodarone in combination with sofosbuvir, daclatasvir, or sofosbuvir with ledipasvir has been issued by the MHRA. Concomitant use should be avoided unless an alternative antiarrhythmic cannot be given. Patients should be monitored carefully, particularly during the first weeks of treatment, and should be advised to seek urgent medical attention if they experience symptoms such as shortness of breath, light-headedness, palpitations or fainting. For more information see Amiodarone and Drug Safety Update (May 2015).

Drug information updates
You'll also find updated drug and prescribing information for a number of monographs this month, including aliskiren, sumatriptan, and omalizumab. For more information see the individual drugs.

Other changes
To review other changes in the BNF, click on changes.

BNFC update

Other changes
To review changes in BNFC, click on changes.

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Changes to Appendix 3: Cautionary and advisory labels
The following products have been updated in the BNF and BNFC Appendix 3 Product label list:

BindRen® - Colestilan - Didronel® - Envarsus® - Etidronate disodium - Fostair preps - Ketoconazole - Ketoconazole HRA®

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NICE technology appraisals
A number of NICE technology appraisals have been added to the BNF this month, including:
Apixaban for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism
Sofosbuvir for treating chronic hepatitis C
Infliximab, adalimumab and golimumab for treating moderately to severely active ulcerative colitis after the failure of conventional therapy

BNFC new publication date
Just a reminder that BNFC 2015-2016 will be published in September, rather than July as in previous years. This is to bring the updates in line with those in the BNF and the Nurse Prescribers' Formulary, achieving clinical consistency between the products.

Monthly price update reminder
Prices of all branded medicinal products in the BNF and BNFC are now updated monthly. Prices of generic preparations of medicinal products are updated every 2-4 months, to coincide with print editions of BNF and BNF for Children. The BNF team keep price information up to date using data sourced from the NHS dictionary of medicines and devices (dm+d).

How to purchase BNF
Purchase a print copy Purchase print copies
To order the March 2015 edition, visit the Pharmaceutical Press website.
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A print subscription is the best way to ensure access to the latest copy of BNF as soon as it publishes. To order bulk subscriptions contact
BNF online BNF online
Outside the UK, content is available via a subscription to MedicinesComplete. For more information contact
BNF online BNF eBook
BNF is also available as an eBook on the iBookstore. Find out more here.
BNF Discount for RPS Members
All current RPS members are eligible to receive 50% off their initial copy of the BNF and BNFC if they purchase online. This includes print BNF and BNFC, and also includes print subscriptions. No promotional code is needed - membership will be verified at checkout and the discount automatically applied.
Drug Safety Update
Drug Safety UpdateDrug 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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Feedback on our eNewsletter
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Subscribe to this eNewsletter here.

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