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8th July 2025

AHFS Drug Information

This update contains 4 new monographs and 36 revised monographs.

New monographs: Antihemophilic Factor (Recombinant), Single Chain; Nipocalimab-aahu; Penpulimab-kcqx; Prademagene zamikeracel.

Revised monographs: Ambrisentan; Aprocitentan; ARIPiprazole; Asfotase Alfa; Atogepant; Axatilimab-csfr; Azithromycin (EENT); cloBAZam; Diclofenac; Dupilumab; Durvalumab; Erenumab-aooe; Filgrastim; Fremanezumab-vfrm; Galcanezumab-gnlm; Letermovir; Macitentan; Macitentan and Tadalafil; Mirikizumab-mrkz; Mirvetuximab soravtansine; Naltrexone; Nusinersen Sodium; Odevixibat; Omadacycline Tosylate; Patiromer Sorbitex Calcium; Pembrolizumab; Phenylephrine Hydrochloride (Systemic); Rimegepant Sulfate; Risdiplam; Seladelpar Lysine; Sotorasib; Sutimlimab-jome; Ubrogepant; Venlafaxine; Xanomeline and trospium chloride; Zavegepant Hydrochloride.

8th July 2025

British National Formulary

This update contains 12 significant changes and 6 new monographs.

Significant Changes:

• Antibacterials, principles of therapy: updated guidance on notifiable diseases.
• Asthma, acute: update to criteria for severity of acute asthma attacks.
• Immunisation schedule: updated guidance for immunisation against respiratory syncytial virus.
• Ivacaftor with tezacaftor and elexacaftor (Kaftrio®): risk of psychological side effects [MHRA/CHM advice].
• Obstetrics: update to treatment of postpartum haemorrhage.
• Ocular corticosteroids: cautions updated (advice in betamethasone, dexamethasone, fluorometholone, hydrocortisone, loteprednol etabonate, prednisolone; see example in fluorometholone).
• Ocular NSAIDs: cautions updated (advice in bromfenac, diclofenac sodium, flurbiprofen, ketorolac trometamol, nepafenac; see example in bromfenac).
• Posaconazole: update to indications and dose, and important safety information.
• Respiratory syncytial virus immunisation: updated guidance.
• Salbutamol: reminder of the risks from overuse in asthma and to be aware of changes in the SABA prescribing guidelines [MHRA/CHM advice].
• Terbutaline sulfate: reminder of the risks from overuse in asthma and to be aware of changes in the SABA prescribing guidelines [MHRA/CHM advice].
• Thiopurines and intrahepatic cholestasis of pregnancy [MHRA/CHM advice] (advice in azathioprine, mercaptopurine, tioguanine; see example in azathioprine).

New Monographs:

• Abrysvo® [respiratory syncytial virus (RSV) vaccine].
• Andembry® [garadacimab].
• Arexvy® [respiratory syncytial virus (RSV) vaccine].
• Artesunate.
• Lytgobi® [futibatinib].
• Suvexx® [sumatriptan with naproxen].

8th July 2025

Palliative Care Formulary

This update contains 1 revised monograph.

The following monograph has been partially updated: Appendix 3: Compatibility charts 1-7 and text fully updated

8th July 2025

Electronic Medicines Compendium (emc)

For July, 161 new medicines have been added, and numerous medicines have been amended.

8th July 2025

Agilio: Diagnosis and Treatment Guidance

This update contains 5 significant changes, 7 minor changes and 1 new topic.

Significant Changes:

• Corticosteroids – oral — reviewed. A literature search was conducted in May 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last version of this topic. No major changes to recommendations have been made.
• Hand foot and mouth disease — reviewed.  A literature search was conducted in April 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. There have been minor structural changes to the topic, and changes to the recommendations have been updated in line with updated literature. A recommendation to consider the use of topical oromucosal antiseptics or anaesthetics has been added to the management advice section.
• Hepatitis C — reviewed. A literature search was conducted in May 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic.
• Immunizations – seasonal influenza — reviewed. The management section has been updated to align with the NHS immunisation programme 2025 to 2026.
• Jaundice in the newborn — reviewed. A literature search was conducted in April to May 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of this topic. The topic has undergone minor restructuring. No major changes to the recommendations have been made.

Minor Changes:

• Constipation in children — minor update. Further information on macrogols available for the treatment of constipation added.
• Gonorrhoea — minor update. Information on diagnosis and treatment of gonorrhoea has been updated in line with updates to the BASHH national guideline for the Management of Infection with Neisseria gonorrhoea BASHH, 2025. This includes the recommendation that pharyngeal testing is recommended for all individuals with urogenital gonorrhoea, first line antibiotic choice, cefixime dosing, and that routine test of cure is not necessary for anogenital infections treated with ceftriaxone1g if the infection is susceptible to ceftriaxone.
• LUTS in men — minor update. Added information about the potential treatment option of vibegron for voiding or storage symptoms if antimuscarinic medicines are unsuitable, ineffective, or not tolerated. This is based on the National Institute for Health and Care Excellence (NICE) technology appraisal Vibegron for treating symptoms of overactive bladder syndrome NICE, 2024.
• Neuropathic pain — minor update. Added addiction as a potential adverse effect of pregabalin and gabapentin.
• Pre-conception – advice and management — minor update. Added information relating to GLP-1 agonists and pre-conception advice.
• Prostate cancer — minor update. Typographical error in PSA table corrected and a broken link replaced.
• Restless legs syndrome — minor update. Text about vitamin C has been removed from this topic.

New Topic:

• Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)

8th July 2025

BNF for Children

This update contains 10 significant changes, 2 dose changes and 4 new monographs.

Significant Changes:

• Antibacterials, principles of therapy: updated guidance on notifiable diseases.
• Asthma, acute: update to criteria for severity of acute asthma attacks.
• Immunisation schedule: updated guidance for immunisation against respiratory syncytial virus.
• Ivacaftor with tezacaftor and elexacaftor (Kaftrio®): risk of psychological side effects [MHRA/CHM advice].
• Ocular corticosteroids: cautions updated (advice in betamethasone, dexamethasone, fluorometholone, prednisolone; see example in fluorometholone).
• Ocular NSAIDs: cautions updated (advice in diclofenac sodium, ketorolac trometamol; see example in diclofenac sodium).
• Respiratory syncytial virus immunisation: updated guidance.
• Salbutamol: reminder of the risks from overuse in asthma and to be aware of changes in the SABA prescribing guidelines [MHRA/CHM advice].
• Terbutaline sulfate: reminder of the risks from overuse in asthma and to be aware of changes in the SABA prescribing guidelines [MHRA/CHM advice].
• Thiopurines and intrahepatic cholestasis of pregnancy [MHRA/CHM advice] (advice in azathioprine, mercaptopurine, tioguanine; see example in azathioprine).

Dose Changes:

• Palivizumab [update to indications and dose].
• Pimecrolimus [update to dosing for short-term treatment of mild to moderate atopic eczema (including flares) when topical corticosteroids cannot be used].

New Monographs:

• Abrysvo® [respiratory syncytial virus (RSV) vaccine].
• Andembry® [garadacimab].
• Artesunate.
• Noxafil® [posaconazole].