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BNF for Children July 2023 Update

This update contains 6 significant changes, 2 dose changes, and 1 deleted preparation.

Significant Changes:

  • Adrenaline/epinephrine: recall of Emerade® 500 micrograms and Emerade® 300 micrograms auto-injectors, due to the potential for device failure [National Patient Safety Alert advice].
  • Janus kinase (JAK) inhibitors: new measures to reduce risks of major cardiovascular events, malignancy, venous thromboembolism, serious infections and increased mortality [MHRA/CHM advice] (advice in abrocitinib, tofacitinib, upadacitinib; see example in tofacitinib).
  • Nitrofurantoin: reminder of the risks of pulmonary and hepatic adverse drug reactions [MHRA/CHM advice].
  • Rabies vaccine: updated guidance for immunisation.
  • Varicella-zoster vaccine: new indication for post-exposure prophylaxis against varicella infection (chickenpox) during co-circulating group A streptococcal infection (e.g. scarlet fever).
  • Varicella-zoster vaccines: updated guidance for varicella (chickenpox) immunisation.

Dose Changes:

  • Rabies vaccine [update to pre-exposure immunisation booster dose in patients who may have frequent, unrecognised exposures e.g. bat handlers].
  • Varicella-zoster vaccine [update to immunisation against varicella infection (chickenpox)].

Deleted Preparation:

  • Emerade® 150 micrograms [adrenaline/epinephrine].