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

October 2019

Welcome to the October BNF Newsletter.

• Five new drug monographs have been added to the BNF in the last month: andexanet alfa, cemiplimab, galcanezumab, lamivudine with dolutegravir, and patisiran.
• We have included dose changes for vitamin B substances with ascorbic acid to the BNF.
• We have also included MHRA advice on carfilzomib (Kyprolis®), daratumumab (Darzalex®), naltrexone with bupropion (Mysimba®), and pentosan polysulfate sodium (Elmiron®) to the BNF.

Kind regards,
BNF Team

Other topics:

Significant changes   |   Drug safety update   |   News   |   Feedback

Significant changes

BNF BNF only

New monograph: Ondexxya® [andexanet alfa] for reversal of apixaban or rivaroxaban in life-threatening or uncontrolled bleeding (specialist supervision in hospital).

New monograph: Libtayo® [cemiplimab] for cutaneous squamous cell carcinoma (specialist use only).

New monograph: Emgality® [galcanezumab] for prophylaxis of migraine [in patients who have at least 4 migraine days per month] (initiated by a specialist).

New monograph: Dovato® [lamivudine with dolutegravir] for HIV-1 infection.

New monograph: Onpattro® [patisiran] for stage 1 or stage 2 polyneuropathy in patients with hereditary transthyretin amyloidosis (hATTR) (initiated under specialist supervision).

Carfilzomib (Kyprolis®): reminder of risk of potentially fatal cardiac events [MHRA/CHM advice].

Cemiplimab for treating metastatic or locally advanced cutaneous squamous cell carcinoma [NICE guidance].

Dacomitinib for untreated EGFR mutation-positive non-small-cell lung cancer [NICE guidance].

Dapagliflozin with insulin for treating type 1 diabetes [NICE guidance].

Daratumumab (Darzalex®): risk of reactivation of hepatitis B virus [MHRA/CHM advice].

Naltrexone with bupropion (Mysimba®): risk of adverse reactions that could affect ability to drive [MHRA/CHM advice].

Olaparib for maintenance treatment of BRCA mutation-positive advanced ovarian, fallopian tube or peritoneal cancer after response to first-line platinum-based chemotherapy [NICE guidance].

Patisiran for treating hereditary transthyretin amyloidosis [NICE guidance].

Pentosan polysulfate sodium (Elmiron®): risk of pigmentary maculopathy [MHRA/CHM advice].

Ribociclib with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer [NICE guidance].

Risankizumab for treating moderate to severe plaque psoriasis [NICE guidance].

Vedolizumab for treating moderately to severely active ulcerative colitis [NICE guidance].

Hyperparathyroidism: new guidance on management of primary hyperparathyroidism.

Prostate Cancer: updated guidance on management.

Dose Changes for BNF only
Vitamin B substances with ascorbic acid: Duration and route for the treatment of suspected or established Wernicke's encephalopathy, and prophylaxis of Wernicke's encephalopathy updated.

BNF for Children BNFC Only

Depression: updated guidance management.

BNF BNF for Children Both BNF and BNFC

Ulcerative colitis: updated guidance on management.

Rotavirus 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.

Elmiron (pentosan polysulfate sodium): rare risk of pigmentary maculopathy.

Fingolimod (Gilenya): increased risk of congenital malformations; new contraindication during pregnancy and in women of childbearing potential not using effective contraception.

Hormone replacement therapy (HRT): further information on the known increased risk of breast cancer with HRT and its persistence after stopping.

Montelukast (Singulair): reminder of the risk of neuropsychiatric reactions.




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






Newsletter Feedback
Please let us know if there are any issues that you'd like us to address in our newsletters. 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.

If you want to unsubscribe from emails from Pharmaceutical Press click here.

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