British National Formulary December 2023 Update

This update contains 9 significant changes, 2 dose changes and 1 new monograph.

Significant Changes:

Adverse reactions to drugs: updated information on MHRA Yellow Card scheme (including interactive Drug Analysis Profiles and the Yellow Card biobank) and medication error reporting.
Antibacterials, use for prophylaxis: updated guidance for the prevention of secondary cases of diphtheria.
Benzathine benzylpenicillin: important safety information updated to highlight difference with benzylpenicillin sodium.
Benzylpenicillin sodium: important safety information updated to highlight difference with benzathine benzylpenicillin.
Carvedilol: updated to include dosing for primary prevention of decompensated cirrhosis, and prevention of bleeding from medium or large oesophageal varices.
Contraceptives, interactions: updated guidance for drug interactions between HIV antiretroviral therapy and contraceptives.
Ear: updated guidance for the management of otitis media with effusion.
Propranolol hydrochloride: updated to include dosing for primary prevention of decompensated cirrhosis.
Statins: very infrequent reports of myasthenia gravis [MHRA/CHM advice] (see example in simvastatin).

Dose Changes:

Haloperidol [update to palliative care indications and dosing].
Morphine [update to starting dose for pain in palliative care in patients being switched from a regular weak opioid].

New Monographs: