British National Formulary July 2025 Update

This update contains 12 significant changes and 6 new monographs.

Significant Changes:

Antibacterials, principles of therapy: updated guidance on notifiable diseases.
Asthma, acute: update to criteria for severity of acute asthma attacks.
Immunisation schedule: updated guidance for immunisation against respiratory syncytial virus.
Ivacaftor with tezacaftor and elexacaftor (Kaftrio®): risk of psychological side effects [MHRA/CHM advice].
Obstetrics: update to treatment of postpartum haemorrhage.
Ocular corticosteroids: cautions updated (advice in betamethasone, dexamethasone, fluorometholone, hydrocortisone, loteprednol etabonate, prednisolone; see example in fluorometholone).
Ocular NSAIDs: cautions updated (advice in bromfenac, diclofenac sodium, flurbiprofen, ketorolac trometamol, nepafenac; see example in bromfenac).
Posaconazole: update to indications and dose, and important safety information.
Respiratory syncytial virus immunisation: updated guidance.
Salbutamol: reminder of the risks from overuse in asthma and to be aware of changes in the SABA prescribing guidelines [MHRA/CHM advice].
Terbutaline sulfate: reminder of the risks from overuse in asthma and to be aware of changes in the SABA prescribing guidelines [MHRA/CHM advice].
Thiopurines and intrahepatic cholestasis of pregnancy [MHRA/CHM advice] (advice in azathioprine, mercaptopurine, tioguanine; see example in azathioprine).

New Monographs: