BNF 88 (British National Formulary) September 2024

BNF 88 - September 2024

The British National Formulary (BNF) is the first choice for concise medicines information. Trusted by healthcare professionals across the world to support confident decision-making at the point of care. The new edition (BNF 87) provides up-to-date guidance on prescribing, dispensing, and administering medicines, plus legal and professional guidelines.

Unique Benefits

• Up-to-date information on prescribing, dispensing, and administering medicines
• Authoritative, independent guidance on best practice enabling healthcare professionals to select safe and effective medicines
• Information healthcare professionals trust for quality and reliability
• Everything healthcare professionals need at their fingertips, all in one book.

Extensive content updates in the BNF 88 edition include:

New monographs for:

• Adacel ® [diphtheria with tetanus and pertussis vaccine] for immunisation against diphtheria, tetanus, and pertussis, and passive immunisation against pertussis in pregnant women
• Cytisine ® [cytisinicline] to aid smoking cessation
• Domnisol ® [calcifediol monohydrate] for primary prevention and treatment of vitamin D deficiency
• Ebglyss ® [lebrikizumab] for moderate to severe atopic eczema
• Evkeeza ® [evinacumab] for homozygous familial hypercholesterolaemia
• Litfulo ® [ritlecitinib] for alopecia areata
• Rezzayo ® [rezafungin] for invasive candidiasis
• SimAlvia ® [alverine with simeticone] for abdominal pain in irritable bowel syndrome
• Slynd ® [drospirenone] for contraception
• Velsipity ® [etrasimod] for ulcerative colitis
• Veoza ® [fezolinetant] for moderate to severe vasomotor symptoms associated with menopause

MHRA advice on:

• Aripiprazole: risk of pathological gambling
• Codeine phosphate linctus (codeine oral solutions): reclassification to prescription-only medicine
• Nirmatrelvir with ritonavir (Paxlovid ®): be alert to the risk of drug interactions with ritonavir
• Omega-3-acid ethyl esters (Omacor ® / Teromeg ® 1000mg capsules): dose-dependent increased risk of atrial fibrillation in patients with established cardiovascular diseases or cardiovascular risk factors
• Pseudoephedrine hydrochloride: very rare risk of posterior reversible encephalopathy syndrome (PRES) and reversible cerebral vasoconstriction syndrome (RCVS)
• Quinolones: must now only be prescribed when other commonly recommended antibiotics are inappropriate
• Semaglutide (Ozempic ®), Liraglutide (Saxenda ®): vigilance required due to potentially harmful falsified products
• Valproate: new safety and educational materials to support regulatory measures in men and women under 55 years of age
• Vitamin B12: advise patients with known cobalt allergy to be vigilant for sensitivity reaction

Other significant changes include updated guidance on:

• Bromocriptine: update to important safety information
• Budesonide dosing for modified-release capsules
• Controlled drugs and drug dependence: control of nitrous oxide
• Management of diabetic hyperglycaemic emergencies in individuals aged 16-18 years
• Empagliflozin use in renal impairment and new indication for chronic kidney disease
• Ezetimibe for prevention of cardiovascular events
• Hyoscine butylbromide: update to important safety information
• Insulin degludec (Tresiba ®): potential for inappropriate dosing of insulin when switching (Tresiba ®) products [National Patient Safety Alert advice]
• Malaria prophylaxis
• Meningococcal vaccines
• Metformin hydrochloride for type 1 diabetes mellitus
• Pneumococcal vaccine
• Prescribing in renal impairment: removal of race from CKD-EPI equation
• Management of type 2 diabetes
• Vaccination, general principles: for individuals with asplenia, splenic dysfunction, or complement disorders
• Valproate: organisations to prepare for new regulatory measures for oversight of prescribing to new patients and existing female patients [National Patient Safety Alert advice]
• Varicella-zoster vaccines: immunisation against herpes zoster (shingles)