BNF for Children (BNFC) 2022-2023 (NEW)

Extensive content updates in the BNF for Children 2022-2023 edition include:

New monographs for:

• Acarizax® [house dust mite extract] for house dust mite allergic rhinitis
• Adakveo® [crizanlizumab] for vaso-occlusive crises in sickle-cell disease
• Cibinqo® [abrocitinib] for atopic eczema
• Dificlir® [fidaxomicin] for Clostridioides difficile infection
• Evrysdi® [risdiplam] for 5q spinal muscular atrophy
• Fintepla® [fenfluramine] for adjunctive therapy of seizures associated with Dravet syndrome
• Givlaari® [givosiran] for acute hepatic porphyria
• Keytruda® [pembrolizumab] for classical Hodgkin lymphoma
• Koselugo® [selumetinib] for inoperable plexiform neurofibromas in patients with neurofibromatosis type 1
• Liraglutide for weight management or type 2 diabetes mellitus
• Orladeyo® [berotralstat] for hereditary angioedema
• Pradaxa® [dabigatran etexilate] for prophylaxis or treatment of venous thromboembolism
• Rinvoq® [upadacitinib] for atopic eczema
• Ruconest® [conestat alfa] for hereditary angioedema in patients with C1-esterase inhibitor deficiency
• Ryaltris® [mometasone furoate with olopatadine] for allergic rhinitis
• Taltz® [ixekizumab] for plaque psoriasis
• Ultomiris® [ravulizumab] for atypical haemolytic uraemic syndrome or paroxysmal nocturnal haemoglobinuria
• Xarelto® [rivaroxaban] for prophylaxis or treatment of venous thromboembolism
• Xeljanz® [tofacitinib] for polyarticular juvenile idiopathic arthritis or juvenile psoriatic arthritis
• Xevudy® [sotrovimab] for COVID-19
• Xofluza® [baloxavir marboxil] for post-exposure prophylaxis or treatment of influenza

MHRA advice on:

• Adrenaline/epinephrine auto-injectors: reminder for prescribers to support safe and effective use
• Amiodarone hydrochloride (Cordarone X®): reminder of risks of treatment and need for patient monitoring and supervision
• Atezolizumab (Tecentriq®) and other immune-stimulatory anti-cancer drugs: risk of severe cutaneous adverse reactions (SCARs)
• Chloral hydrate, cloral betaine (Welldorm®): restriction of paediatric indication
• Chloramphenicol eye drops containing borax or boric acid buffers: use in children younger than 2 years
• Chloroquine: increased risk of cardiovascular events when used with macrolide antibiotics; reminder of psychiatric reactions
• Hydroxychloroquine sulfate: increased risk of cardiovascular events when used with macrolide antibiotics; reminder of psychiatric reactions
• Ivacaftor, tezacaftor, elexacaftor (Kaftrio®▼) in combination with ivacaftor (Kalydeco®): risk of serious liver injury; updated advice on liver function testing
• Levothyroxine sodium: new prescribing advice for patients who experience symptoms on switching between different levothyroxine products
• Metformin hydrochloride: study shows no safety concerns in pregnancy
• Oral retinoid medicines: temporary monitoring advice during COVID-19 pandemic
• Remdesivir: reporting to the UK COVID-19 Antivirals Pregnancy Registry
• Tofacitinib (Xeljanz®): new measures to minimise risk of major adverse cardiovascular events and malignancies
• Topical corticosteroids: information on the risk of topical steroid withdrawal reactions
• Yellow fever vaccine, live (Stamaril®): new pre-vaccination checklist

Other significant changes include updated guidance on:

• Aciclovir: important safety information added to highlight different approaches to calculating doses depending on the age of the child
• Management of acne
• Management of anaphylaxis
• Contraceptives, interactions
• COVID-19 updated guidance in-line with Public Health England/UK Health Security Agency recommendations, including reports of myocarditis and pericarditis with the Pfizer/BioNTech and Moderna vaccines and update to age range of Pfizer/BioNTech vaccine
• Diabetic hyperglycaemic emergencies
• Management of acute otitis media
• Emergency contraception
• Management of Clostridioides difficile infection
• Immunisation schedule updated guidance in-line with Public Health England/UK Health Security Agency recommendations, including Bacillus Calmette-Guérin, human papillomavirus, and influenza vaccines and immunisation of neonates
• Levetiracetam dosing added for convulsive status epilepticus in children
• Malaria prophylaxis in-line with Public Health England recommendations
• Miconazole oral gel no longer licensed for treatment of intestinal candidiasis
• Preventative migraine treatment
• Management of nausea and vomiting during pregnancy
• New guidance on management of neonatal bacterial infection
• Oral anticoagulants
• Paediatric Steroid Treatment Card to support early recognition and treatment of adrenal crisis in children with adrenal insufficiency [British Society for Paediatric Endocrinology and Diabetes]
• Chronic pain
• Phenobarbital oral solutions and advice from the RCPCH/NPPG
• Phosphate imbalance
• Potassium permanganate: inadvertent oral administration of potassium permanganate [National Patient Safety Alert advice]
• Prescribing in renal impairment
• Rabies vaccine and post-exposure management
• Remdesivir treatment duration
• Management of secondary bacterial infection of common skin conditions, including eczema
• Smoking cessation
• Tetanus vaccine and the use of immunoglobulin for tetanus infection and prophylaxis in-line with Public Health England recommendations
• Trientine dihydrochloride: name change to Trientine, and update to dosing for Wilson’s disease
• Recommended insulin regimens in type 1 diabetes
• Vitamin D

BNF for Children 2022-2023 is an essential publication, it provides you with:

• Up-to-date information on prescribing, dispensing, and administering medicines
• Authoritative, independent guidance on best practice enabling you to select safe and effective medicines
• Information you know you can trust for quality, reliability, and independence
• Everything you need at your fingertips, all in one book

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