BNF 87 (British National Formulary) March 2024

BNF 87 - March 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 87 edition include:

New monographs for:

• Aquipta ® [atogepant] for prophylaxis of migraine
• Filsuvez ® [birch bark extract] to promote wound healing
• Omvoh ® [mirikizumab] for ulcerative colitis
• Qdenga ® [dengue vaccine] for immunisation against dengue virus infection
• Quviviq ® [daridorexant] for insomnia
• Roclanda ® [latanoprost with netarsudil] for ocular hypertension and raised intra-ocular pressure in open-angle glaucoma
• Sotyktu ® [deucravacitinib] for plaque psoriasis
• Vaxchora ® [cholera vaccine (live)] for immunisation against cholera

MHRA advice on:

• Calcium chloride, calcium gluconate: potential risk of underdosing with calcium gluconate in severe hyperkalaemia
• Direct-acting oral anticoagulants: reminder of dose adjustments in patients with renal impairment
• Febuxostat: updated advice for the treatment of patients with a history of major cardiovascular disease
• Hyoscine hydrobromide patches (Scopoderm ®): risk of anticholinergic side effects, including hyperthermia
• Isotretinoin (Roaccutane ®): introduction of new safety measures, including additional oversight of the initiation of treatment for patients under 18 years of age
• Janus kinase (JAK) inhibitors: new measures to reduce risks of major cardiovascular events, malignancy, venous thromboembolism, serious infections and increased mortality
• Methotrexate: advise patients to take precautions in the sun to avoid photosensitivity reactions
• Nitrofurantoin: reminder of the risks of pulmonary and hepatic adverse drug reactions
• Non-steroidal anti-inflammatory drugs: potential risks following prolonged use after 20 weeks of pregnancy
• Quinolones: reminder of the risk of disabling and potentially long-lasting or irreversible side effects, risk of suicidal thoughts and behaviour
• Statins: very infrequent reports of myasthenia gravis
• Valproate: full pack dispensing, re-analysis of study on risks in children of men taking valproate, reminder of current Pregnancy Prevention Programme requirements; information on new safety measures to be introduced in the coming months

Other significant changes include updated guidance on:

• Adverse reactions to drugs: updated information on MHRA Yellow Card scheme and medication error reporting.
• Appendix 1 interactions: pharmacodynamic effects drug groups revalidated and updated
• Benzathine benzylpenicillin, benzylpenicillin sodium: important safety information
• Carvedilol for primary prevention of decompensated cirrhosis and prevention of bleeding oesophageal varices
• Guidance for drug interactions between HIV antiretroviral therapy and contraceptives
• Erythromycin: pregnancy advice
• Management of miscarriage
• Management of obesity
• Management of otitis media with effusion
• Management of stroke
• Management of syphilis
• Prescription requirements for Schedule 2 and 3 Controlled Drugs
• Prevention of secondary cases of diphtheria
• Rabies vaccine
• Selective serotonin re-uptake inhibitors: pregnancy and breast-feeding advice
• Vaccination, general principles during pregnancy and breast-feeding
• Vaccine drug monographs: class restructure into live and inactivated monographs
• Varicella-zoster vaccine