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British National Formulary June 2023 Update

This update contains 14 significant changes, 5 dose changes, 1 new monograph, 4 new preparations, 2 deleted monographs and 1 deleted preparation.

Significant Changes:

  • Aminoglycosides: pre-treatment screening advice on genetic testing for aminoglycoside exposure posing risk to hearing (advice in relevant monographs; see example in gentamicin).
  • Anaemia, iron deficiency: updated guidance for oral iron.
  • Camouflagers: title changed to Camouflages.
  • COVID-19 vaccines: updated guidance for immunisation.
  • Guidance on prescribing: information on national genomic testing directory.
  • Metabolic disorders: new guidance on management.
  • Oral iron: updated dosing and monitoring advice for iron-deficiency anaemia based on British Society of Gastroenterology guidelines (advice in ferrous sulfate, ferrous sulfate with ascorbic acid, ferrous fumarate, ferrous gluconate, ferric maltol, sodium feredetate; see example in ferrous sulfate).
  • Paliperidone: update to once-monthly intramuscular dosing.
  • Prescribing in palliative care: updated guidance.
  • Respiratory system, drug delivery: title changed to Respiratory system, inhaled drug delivery.
  • Respiratory system, inhaled drug delivery: updated guidance.
  • “Specialist drug” monographs within BNF Publications: identification and reduced level of detail, see How to use BNF Publications online.
  • Terlipressin acetate: new indication for type 1 hepatorenal syndrome.
  • Terlipressin acetate: new recommendations to reduce risks of respiratory failure and septic shock in patients with type 1 hepatorenal syndrome [MHRA/CHM advice].

Dose Changes:

  • Clarithromycin [update to include dosing for prevention of invasive group A streptococcal infection in children from 6 months old and adults].
  • Fentanyl [update to indications and dose for transdermal patches].
  • Morphine [update to palliative care indications and dosing for pain, cough, and breathlessness at rest].
  • Oxycodone hydrochloride [update to dosing for moderate to severe pain in palliative care].
  • Secukinumab [update to dosing for plaque psoriasis].

New Monographs:

  • Amvuttra® [vutrisiran].

New Preparations:

  • Byannli® [paliperidone].
  • Onureg® [azacitidine].
  • Testogel® 40.5 mg/2.5 g [testosterone].
  • VidPrevtyn Beta® [COVID-19 vaccine].

Deleted Monographs: Atenolol with nifedipine; Tazarotene.

Deleted Preparation: Feospan® [ferrous sulfate].