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Newsletter
May 2020

Welcome to the May BNF Newsletter.

• One new drug monograph has been added to both the BNF and BNF for Children in the last month: cytomegalovirus immunoglobulin. Four new drug monographs have been added to the BNF in the last month: romosozumab, polatuzumab vedotin, mogamulizumab and ravulizumab.
• MHRA advice on baricitinib (Olumiant®), benzodiazepines, canagliflozin, dapagliflozin, empagliflozin, ertugliflozin, opioids, tofacitinib (Xeljanz®), ulipristal acetate (Esmya®) and upadacitinib (Rinvoq®).

Kind regards,
BNF Team

Other topics:

Significant changes   |   Drug Safety Update   |   Critical Illness   |   COVID-19 resources

Significant changes

BNF BNF only

New monograph: Evenity® [romosozumab] for severe osteoporosis in postmenopausal women at increased risk of fractures.

New monograph: Polivy® [polatuzumab vedotin] for relapsed or refractory diffuse large B-cell lymphoma (in combination with bendamustine and rituximab).

New monograph: Poteligeo® [mogamulizumab] for mycosis fungoides and Sézary syndrome.

New monograph: Ultomiris® [ravulizumab] for paroxysmal nocturnal haemoglobinuria.

Baricitinib (Olumiant®): risk of venous thromboembolism [MHRA/CHM advice].

Canagliflozin (SGLT2 inhibitors): monitor ketones in blood during treatment interruption for surgical procedures or acute serious medical illness [MHRA/CHM advice].

Dapagliflozin (SGLT2 inhibitors): monitor ketones in blood during treatment interruption for surgical procedures or acute serious medical illness [MHRA/CHM advice].

Empagliflozin (SGLT2 inhibitors): monitor ketones in blood during treatment interruption for surgical procedures or acute serious medical illness [MHRA/CHM advice].

Ertugliflozin (SGLT2 inhibitors): monitor ketones in blood during treatment interruption for surgical procedures or acute serious medical illness [MHRA/CHM advice].

Skin infections, antibacterial therapy: new guidance for management of leg ulcer infection.

Tofacitinib (Xeljanz®): new measures to minimise risk of venous thromboembolism and of serious and fatal infections [MHRA/CHM advice].

Ulipristal acetate (Esmya®): suspension of the licence due to risk of serious liver injury [MHRA/CHM advice].

Upadacitinib (Rinvoq®): advice for venous thromboembolism [MHRA/CHM advice].

BNF BNF for Children Both BNF and BNF for Children

New monograph: Cytotect® [cytomegalovirus immunoglobulin] for prophylaxis of cytomegalovirus infection in patients taking immunosuppressants, particularly transplant recipients.

Benzodiazepines: reminder of risk of potentially fatal respiratory depression [MHRA/CHM advice] (advice in alprazolam, chlordiazepoxide hydrochloride, clobazam, clonazepam, diazepam, flurazepam, loprazolam, lorazepam, lormetazepam, midazolam, nitrazepam, oxazepam, temazepam; see example in diazepam).

COVID-19: new guidance incorporating a collection of resources.

Opioids: reminder of risk of potentially fatal respiratory depression [MHRA/CHM advice] (advice in alfentanil, buprenorphine, codeine phosphate, diamorphine hydrochloride, dihydrocodeine tartrate, dipipanone hydrochloride, fentanyl, hydromorphone hydrochloride, meptazinol, methadone hydrochloride, morphine, oxycodone hydrochloride, pentazocine, pethidine hydrochloride, remifentanil, sufentanil, tapentadol, tramadol hydrochloride; see example in morphine).

Dose changes for both BNF and BNF for Children
Betamethasone with clioquinol [updated child age range].

Glucagon [update to age ranges for hypoglycaemia].

Sodium fluoride [updating dosing for prophylaxis of dental caries].

BNF for Children BNF for Children Only

Dose changes for BNF for Children only
Digoxin [clarification of maximum doses for children 5-9 years].

Idursulfase [updated age range].

 
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.

Coronavirus (COVID-19): latest guidance for medicines safety

 
 

News

Critical Illness

Critical Illness

We are currently developing an essential resource focussed on supporting those working in critical care, due for release next year. Due to these exceptional circumstances we are releasing as much content as we can now and at no charge, to support the NHS and MedicinesComplete users through this crisis.

View Critical Illness

or click the icon under the search bar on the MedicinesComplete homepage.

Critical Illness provides evidence-based information to help guide the most effective treatment for adult patients in intensive care. This advance release will start with 6 drug monographs including dosage and prescribing guidance.

To be notified when a full set of guidance is published in 2021 or if you would like to be involved in the further development of Critical Illness please sign up here.

Useful COVID-19 Resources

Information around medicines use in COVID-19 is changing rapidly. Stay on top of the most recent information produced by the government and the RPS, using the links below:

https://www.rpharms.com/coronavirus
https://www.nice.org.uk/covid-19
https://www.gov.uk/government/collections/mhra-guidance-on-coronavirus-covid-19

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 commonwealthpharmacy.org/what-we-do/pharmaid/. If you would like to donate your copy email: admin@commonwealthpharmacy.org.

 
 

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