Content overview

14 July 2026

Palliative Care Formulary

This update contains 3 revised monographs.

The following monograph has been fully revised: Nefopam

The following monographs have been partially revised: Denosumab; Strong opioid

14 July 2026

BNF for Children

This update contains 4 significant changes.

Significant Changes:

• Antibacterials, principles of therapy: updated guidance on notifiable diseases.
• Ceftriaxone: new indication and dose for sepsis.
• Xylometazoline hydrochloride: Nasal decongestant sprays and drops containing xylometazoline hydrochloride/oxymetazoline hydrochloride: increased risk of rebound congestion, rhinitis medicamentosa, and tachyphylaxis with overuse [MHRA/CHM advice].
• Xylometazoline hydrochloride: update to maximum duration of use for nasal congestion.

14 July 2026

British National Formulary

This update contains 7 significant changes and 2 new monographs.

Significant Changes:

• Antibacterials, principles of therapy: updated guidance on notifiable diseases.
• Dutasteride: updated safety warnings for psychiatric side effects and sexual dysfunction [MHRA/CHM advice].
• Fenofibrate: new indication and dose for non-proliferative diabetic retinopathy in type 2 diabetes mellitus.
• Finasteride: updated safety warnings for psychiatric side effects and sexual dysfunction [MHRA/CHM advice].
• Hyperkalaemia: updated guidance on management of mild to moderate hyperkalaemia.
• Xylometazoline hydrochloride: Nasal decongestant sprays and drops containing xylometazoline hydrochloride/oxymetazoline hydrochloride: increased risk of rebound congestion, rhinitis medicamentosa, and tachyphylaxis with overuse [MHRA/CHM advice].
• Xylometazoline hydrochloride: update to maximum duration of use for nasal congestion.

New Monographs:

• Loqtorzi® [toripalimab].
• Lynkuet® [elinzanetant].

14 July 2026

Agilio: Diagnosis and Treatment Guidance

This update contains 5 significant changes and 16 minor changes.

Significant Changes:

• Gingivitis and periodontitis — reviewed. A literature search was conducted in May 2026 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. Minor alterations and structural changes have been applied to the topic, including updates to the prevalence section, the addition of further details about mouth cancer (to support decision-making around when to consider an urgent suspected cancer pathway referral), and the addition of pregnancy/breastfeeding details to the prescribing information sections. The term acute necrotizing ulcerative gingivitis (ANUG) has been updated to necrotizing gingivitis (NG) throughout the topic, aligning with the internationally adopted terminology used in the classification of periodontal and peri-implant diseases and conditions.
• Immunizations – seasonal influenza — reviewed. The management section has been updated to align with the NHS immunisation programme 2026 to 2027.
• Insect bites and stings — reviewed. A literature search was conducted in April 2026 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomised controlled trials (RCTs)  published since the last revision of this topic. No major changes to the recommendations have been made, but the topic has been restructured to improve flow and usability.
• Olecranon bursitis — reviewed. A literature search was conducted in June 2026 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomised controlled trials published since the last revision of the topic. No major changes to the recommendations have been made.
• Sciatica (lumbar radiculopathy) — reviewed. A literature search was conducted in June 2026 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomised controlled trials published since the last revision of this topic. Information has been expanded on the definition to reflect the recognition in recent literature that the term ‘sciatica’ is not used consistently, which hampers understanding of the evidence on the topic. A section on referral has been added, and the section on differential diagnosis has been reorganised. No significant changes to recommendations for management have been made.

Minor Changes:

• Burns and scalds — minor update. First aid advice made consistent with BBA recommendations.
• Carpal tunnel syndrome— minor update. Information regarding the Tinnel sign updated to reflect a recent systematic review.
• Depression – antenatal and postnatal — minor update. Figures regarding the background risk of congenital cardiac malformation and the increased risk with SSRIs have been amended.
• Ectopic pregnancy — minor update. The section on Follow up after an ectopic pregnancy has been updated in line with NICE’s Ectopic pregnancy and miscarriage: diagnosis and initial management.
• Eczema — minor update. Text removed related to comparisons between differing emollients.
• Hypercalcaemia — minor update. A minor typographical error was corrected.
• Hypertension— minor update. Typo corrected.
• Insomnia — minor update. The following changes have been made: all usage of the term ‘long-term insomnia’ has been corrected to ‘chronic insomnia’; wording has been changed to clarify the use of hypnotic drugs in the management of chronic insomnia; and reasoning as to why over-the-counter medication treatments for insomnia should not be recommended has been added to the relevant basis-for-recommendation sections.
• Insulin therapy in type 2 diabetes — minor update. Aligned with the 2026 update to NICE guidance Type 2 diabetes in adults: management and removed reference to individual products, to reflect the recent withdrawal of a significant number of insulin products and known insulin brand shortages.
• Itch – widespread — minor update. Wording has been changed to note that myeloma is rarely associated with generalised pruritus.
• Leg ulcer venous — minor update. ABPI thresholds and use of compression hosiery made consistent with the updated compression stockings topic and associated guidance.
• Parkinsons — minor update. Updated prevalence data.
• Peripheral arterial disease — minor update. ABPI thresholds made consistent with updated compression stockings topic and associated guidance.
• Prostate cancer — minor update. Added UK NSC screening announcement (and relevant research and references) to screening for prostate cancer section. Minor typographical error corrected.
• Sensory neuropathy — minor update. Statistics regarding paraproteinaemias ammended/removed.
• Urinary tract infection (lower) – women — minor update. Changed order of headings of section on treatment of recurrent UTI. The sense of the advice remains unchanged.

14 July 2026

Stockley’s Herbal Medicines Interactions

Minor updates to the content on St John’s wort have been made.

Pharmacopoeial information has also been updated.

14 July 2026

Stockley’s Interactions Checker

For July, 331 new interactions have been added, and 395 existing interactions have been updated.