11 June 2026
June BNF + BNFC Knowledge Updates
British National Formulary
This update contains 4 significant changes, 2 dose changes, 3 new monographs, 2 new preparations, and 1 deleted monograph.
Significant changes
Helminth infections: updated guidance for roundworm and hookworm infections.
Hepatitis B vaccine: updated guidance for post-exposure prophylaxis of neonates.
Prednisolone: new indications and doses for adrenal insufficiency and congenital adrenal hyperplasia.
Sepsis: updated guidance on intravenous fluids and vasopressors.
Dose changes
Dexamethasone [update to oral dose for congenital adrenal hyperplasia].
Fludrocortisone acetate [new indications for primary adrenal insufficiency and congenital adrenal hyperplasia replace previous indication for mineralocorticoid replacement in adrenocortical insufficiency; updates to structure of dosing].
New monographs
Akeega® [niraparib with abiraterone acetate] for Prostate cancer.
Nulibry® [fosdenopterin] for Molybdenum cofactor deficiency (MoCD) type A (under expert supervision.
Tivdak® [tisotumab vedotin] for Cervical cancer.
New preparations
EURneffy® [adrenaline] for Acute anaphylaxis (for self-administration at the first signs of anaphylaxis).
Fludrocortisone acetate 0.1mg/mL oral solution for Primary adrenal insufficiency [if mineralocorticoid replacement needed alongside glucocorticoid replacement], Congenital adrenal hyperplasia [if mineralocorticoid replacement needed alongside glucocorticoid replacement]; for Adrenocortical insufficiency resulting from septic shock (in combination with hydrocortisone).
Deleted monographs
Levamisole.
BNF for Children
This update contains 4 significant changes, 3 dose changes, 1 classification change, 1 new monograph, and 2 new preparations.
Significant changes
Helminth infections: updated guidance for roundworm and hookworm infections.
Hepatitis B vaccine: updated guidance for post-exposure prophylaxis of neonates.
Levamisole: indications and dosing for roundworm infections and hookworm infections removed, and important safety information updated.
Sepsis: updated guidance on intravenous fluids and vasopressors.
Dose changes
Dexamethasone [new indication and dose for congenital adrenal hyperplasia replaces previous indication and dose for physiological replacement].
Fludrocortisone acetate [new indications for primary adrenal insufficiency and congenital adrenal hyperplasia replace previous indication for mineralocorticoid replacement in adrenocortical insufficiency; updates to structure of dosing].
Prednisolone [new indications and doses for adrenal insufficiency and congenital adrenal hyperplasia replace previous indication and dose for corticosteroid replacement therapy].
Classification changes
Levamisole [primary classification changed to Immunosuppressants] for Nephrotic syndrome (initiated under specialist supervision).
New monographs
Nulibry® [fosdenopterin] for Molybdenum cofactor deficiency (MoCD) type A [gestational age less than 37 weeks] (under expert supervision); for Molybdenum cofactor deficiency (MoCD) type A [gestational age 37 weeks and above] (under expert supervision); for Molybdenum cofactor deficiency (MoCD) type A (under expert supervision).
