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British National Formulary November 2023 Update

This update contains 9 significant changes, 2 dose changes, 4 new monographs, 4 new preparations and 1 deleted monograph.

Significant Changes:

  • Methotrexate: advise patients to take precautions in the sun to avoid photosensitivity reactions [MHRA/CHM advice].
  • Prednisolone: update to treatment duration for acute exacerbation of COPD.
  • Quinolones: reminder of the risk of disabling and potentially long-lasting or irreversible side effects [MHRA/CHM advice] (see example in ciprofloxacin).
  • Quinolones: suicidal thoughts and behaviour [MHRA/CHM advice] (see example in ciprofloxacin).
  • Stroke: updated guidance for management.
  • Ticagrelor: update to include dosing for ischaemic stroke and transient ischaemic attack (BNF only).
  • Valproate: full pack dispensing [MHRA/CHM advice] (advice in sodium valproate, valproic acid; see example in sodium valproate).
  • Valproate: re-analysis of study on risks in children of men taking valproate [MHRA/CHM advice] (advice in sodium valproate, valproic acid; see example in sodium valproate).
  • Valproate: reminder of current Pregnancy Prevention Programme requirements; information on new safety measures to be introduced in the coming months [MHRA/CHM advice] (advice in sodium valproate, valproic acid; see example in sodium valproate).

Dose Changes:

  • Aspirin [update to dosing for ischaemic stroke and transient ischaemic attack].
  • Clopidogrel [update to dosing for ischaemic stroke and transient ischaemic attack].

New Monographs:

  • Camzyos® [mavacamten].
  • Pombiliti® [cipaglucosidase alfa].
  • Quviviq® [daridorexant].
  • Sotyktu® [deucravacitinib].

New Preparations:

Demovo® [desmopressin]; Desmopressin sublingual tablets; Opfolda® [miglustat]; Wegovy® [semaglutide].

Deleted Monographs:

Nandrolone.