BNF April 2026 Update

This update contains 12 significant changes, 1 dose change, 1 classification change, 1 new monograph, and 3 deleted monographs. 

Significant Changes:  

• Chikungunya vaccine (live) (IXCHIQ®): updates to restrictions of use following safety review [MHRA/CHM advice]. 

• Chronic heart failure: updated guidance on management. 

• GLP-1 receptor agonists and dual GLP-1/GIP receptor agonists: strengthened warnings on acute pancreatitis, including necrotising and fatal cases [MHRA/CHM advice] (advice in dulaglutide, liraglutide, semaglutide, tirzepatide; see example in dulaglutide). 

• Immunisation schedule: updated guidance for immunisation against respiratory syncytial virus. 

• Improving information supplied with Gabapentinoids (pregabalin/gabapentin), Benzodiazepines and Z-drugs [MHRA/CHM advice] (advice in gabapentin, pregabalin, all benzodiazepines, eszopiclone, zolpidem tartrate, zopiclone; see example in diazepam). 

• Isotretinoin: changes to prescribing guidance and additional risk minimisation measures [MHRA/CHM advice]. 

• Omeprazole: new advice in cautions and renal impairment for oral suspension. 

• Respiratory syncytial virus immunisation: updated guidance. 

• Semaglutide (Wegovy®, Ozempic®, and Rybelsus®): risk of non-arteritic anterior ischaemic optic neuropathy (NAION) [MHRA/CHM advice]. 

• Semaglutide (Wegovy®): update to indications and dosing for weight management. 

• urea (13C): name change to urea (13C). 

• Vitamins: updated guidance for management of vitamin D deficiency. 

Dose Changes:  

• Respiratory syncytial virus (RSV) vaccine (Abrysvo®) [update to indications and dose]. 

Classification Changes:  

• Selexipag [primary classification changed to Prostaglandins and related substances]. 

New Monographs:  

• Lyfnua® [gefapixant]. 

Deleted Monographs: Exenatide; Insulin glargine with lixisenatide; Lixisenatide.