Email not displaying correctly? View it in your browser
Forward to a colleague | Sign up to BNF eNews

July 2019


Welcome to the July BNF eNewsletter.

Celebrating 70 years Celebrating 70 years of the BNF... coming soon!
Join us as we celebrate the BNF from next month and highlight its key milestones over the past 70 years... Learn more

• Two new drug monographs have been added to the BNF in the last month: risankizumab and sodium zirconium cyclosilicate. One new drug monograph has been added to both BNF and BNFC in the last month: cefepime.
• We have included dose changes for pembrolizumab to the BNF, iloprost to the BNFC and emicizumab to both the BNF and BNFC.
• We have also included MHRA advice on alemtuzumab (Lemtrada®), magnesium sulfate and tofacitinib.
• We have updated NICE guidances in the BNF.

Kind regards,
BNF Team

Other topics:

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

Significant changes

BNF BNF only

New monograph: Renapime® [cefepime] for mild to severe infections due to sensitive Gram-positive and Gram-negative bacteria and for mild to moderate urinary tract infections.

New monograph: Skyrizi® [risankizumab] for moderate-to-severe plaque psoriasis (specialist use only).

New monograph: Lokelma® [sodium zirconium cyclosilicate] for hyperkalaemia.

New preparation: Jorveza® [budesonide] for eosinophilic oesophagitis (initiated by a specialist).

New preparation: Cuprior® [trientine dihydrochloride] for Wilson's disease in patients intolerant of penicillamine.

Abemaciclib with fulvestrant for treating hormone receptor-positive, HER2-negative advanced breast cancer after endocrine therapy [NICE guidance].

Alemtuzumab (Lemtrada®) and serious cardiovascular and immune-mediated adverse reactions: new restrictions to use and strengthened monitoring requirements [MHRA/CHM advice].

Durvalumab for treating locally advanced unresectable non-small-cell lung cancer after platinum-based chemoradiation [NICE guidance].

Cerebral palsy and spasticity inclusion of overview.

Enzalutamide for hormone-relapsed non-metastatic prostate cancer [NICE guidance].

Inotersen for treating hereditary transthyretin amyloidosis [NICE guidance].

Nivolumab with ipilimumab for untreated advanced renal cell carcinoma [NICE guidance].

Tofacitinib (Xeljanz®): restriction of 10 mg twice daily dose in patients at high risk of pulmonary embolism while safety review is ongoing [MHRA/CHM advice].

Dose Changes for BNF only
Emicizumab [alternative dosing for existing indications added].

Pembrolizumab [alternative dosing for monotherapy indications added].

BNF for Children BNFC Only

New monograph: Renapime® [cefepime] for mild to severe infections due to sensitive Gram-positive and Gram-negative bacteria and mild to moderate urinary tract infections.

New preparation: Cuprior® [trientine dihydrochloride] for Wilson's disease in patients intolerant of penicillamine

Dose Changes for BNFC only
Emicizumab [alternative dosing for existing indications added].

Iloprost [expression of rate of intravenous infusion updated; dosing recommendation unchanged].

BNF BNF for Children Both BNF and BNFC

Magnesium sulfate: risk of skeletal adverse effects in the neonate following prolonged or repeated use in pregnancy [MHRA/CHM advice].

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.

Direct-acting oral anticoagulants (DOACs): increased risk of recurrent thrombotic events in patients with antiphospholipid syndrome

GLP-1 receptor agonists: reports of diabetic ketoacidosis when concomitant insulin was rapidly reduced or discontinued

Lartruvo® (olaratumab): withdrawal of the EU marketing authorisation due to lack of efficacy

Oral retinoid medicines: revised and simplified pregnancy prevention educational materials for healthcare professionals and women


Report Illicit Drug Reactions (RIDR)
Report Illicit Drug Reactions (RIDR) is a national scheme and joint project between Public Health England (PHE) and the Medicines and Healthcare products Regulatory Agency (MHRA). RIDR enables professionals to report the adverse reactions to illicit drugs that they encounter, using a secure online portal. It aims to improve understanding of illicit drug health harms and increase the speed at which they are detected. The more reports received from professionals, the better the guidance on responding to emerging drug health harms will be.

This system uses the architecture of the Yellow Card Scheme by the MHRA, but is separately branded because of the different nature of what is being reported. Collated information about the reported effects of illicit drugs can be found on the RIDR website.

Report Illicit Drug Reactions (RIDR):

Further information on the Yellow Card Scheme can be found under "Adverse reactions to drugs" in the front pages of the BNF (Adverse reactions to drugs).

Celebrating 70 years

Celebrating 70 years of the BNF... coming soon!
Since 1949 the British National Formulary (BNF) has been the UK’s most trusted & authoritative healthcare resource, helping to ensure the safe and effective use of medicines at the point of care.

Now, as part of our anniversary celebrations, we want to showcase the rigorous editorial process that goes into creating the content that you rely on for your everyday practice. We will also go behind the scenes at the BNF in our 'A day in the life' articles. To find out more visit

We really appreciate the support you have given the BNF for our first 70 years - including the launch of the first edition of the BNF for Children in 2005, created to meet the needs of healthcare professionals working with children.

If you have a story to tell about how the BNF has been pivotal in your healthcare journey, we'd love to hear about it on social media, just use hashtag #BNF70years.

Find out more about the BNF's first 70 years on August 15th at

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

To order the March 2019 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
Please let us know if there are any issues that you'd like us to address in our eNewsletters. We welcome your feedback. If you have any comments or suggestions, please let us know at


Copyright © 2019 BMJ Publishing Group Ltd and the Royal Pharmaceutical Society of Great Britain. All rights reserved.

Terms of use

Copyright © 2019 BMJ Publishing Group Ltd, the Royal Pharmaceutical Society of Great Britain and RCPCH Publications. All rights reserved.

Terms of use

If you do not wish to receive such mailings in the future please click here to unsubscribe.

Pharmaceutical Press, 66-68 East Smithfield, London, E1W 1AW, United Kingdom.