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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.