British National Formulary January 2025 Update
This update contains 15 significant changes, 4 dose changes, 4 new monographs, 3 new preparations and 3 deleted monographs.
Significant Changes:
Cefotaxime: removal of indication and dose for emergency treatment of suspected bacterial meningitis or meningococcal disease, before urgent transfer to hospital, in patients who cannot be given benzylpenicillin.
Ceftriaxone: update to indications and dosing for pre-hospital treatment of suspected bacterial meningitis and meningococcal disease.
Central nervous system infections, antibacterial therapy: updated guidance on management.
Chloramphenicol: updated monitoring advice.
Dexamethasone: update to dose advice for adjunctive treatment of suspected bacterial meningitis.
Diabetic foot infections, antibacterial therapy: updated guidance on fluoroquinolones.
Gastro-intestinal system infections, antibacterial therapy: updated guidance on fluoroquinolones.
Glatiramer acetate: anaphylactic reactions may occur months to years after treatment initiation [MHRA/CHM advice].
GLP-1 receptor agonists: reminder of the potential side effects and to be aware of the potential for misuse [MHRA/CHM advice] (advice in dulaglutide, exenatide, liraglutide, lixisenatide, semaglutide and tirzepatide; see example in liraglutide).
Mavacamten: pre-treatment screening advice on genetic testing for treating symptomatic obstructive hypertrophic cardiomyopathy.
Medical emergencies in the community: update to antibacterials for suspected bacterial meningitis and meningococcal disease.
Medroxyprogesterone acetate: risk of meningioma and measures to minimise this risk [MHRA/CHM advice].
Respiratory system infections, antibacterial therapy: updated guidance on fluoroquinolones.
Urinary-tract infections: updated guidance on fluoroquinolones.
Urinary-tract infections: updated guidance on treatment of lower urinary-tract infections.
Dose Changes:
Cefotaxime [removal of intramuscular route for severe susceptible infections due to sensitive Gram-positive and Gram-negative bacteria, and meningitis].
Ceftriaxone [removal of intramuscular route for meningitis].
Ceftriaxone [update to indications and dosing for meningitis and meningococcal disease].
Fluconazole [update to indications and dosing].
New Monographs:
Iqirvo® [elafibranor].
Piasky® [crovalimab].
Sogroya® [somapacitan].
Voydeya® [danicopan].
New Preparations: Alutard SQ Bee® [bee venom extract]; Alutard SQ Wasp® [wasp venom extract]; Itulazax 12 SQ-Bet® [tree pollen extract].
Deleted Monographs: Belantamab mafodotin; Crizanlizumab; Voxelotor.