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British National Formulary October 2023 Update

This update contains 12 significant changes, 4 dose changes, 1 classification change, 5 new monographs, 1 new preparation, 1 deleted monograph and 1 deleted preparation.

Significant Changes:

  • Erythromycin: updated pregnancy advice for patients with early syphilis.
  • Genital system infections, antibacterial therapy: updated guidance for the management of syphilis.
  • Hyoscine hydrobromide patches (Scopoderm® 1.5 mg patch or Scopoderm® TTS patch): risk of anticholinergic side effects, including hyperthermia [MHRA/CHM advice].
  • Mifepristone: updated to include dosing for missed miscarriage.
  • Obstetrics: updated guidance on miscarriage.
  • Selective serotonin re-uptake inhibitors: breast-feeding advice for all drugs in class and individual drug monographs updated (see examples in fluoxetine and sertraline).
  • Selective serotonin re-uptake inhibitors: pregnancy advice updated (see example in citalopram).
  • Tranexamic acid: new indication for prevention and treatment of haemorrhage following head injury.
  • Vaccination, general principles: updated guidance on vaccination during pregnancy and breast-feeding.
  • Vaccines update: restructure of Influenza vaccine monograph—creation of monographs for influenza vaccine (live) and influenza vaccine (inactivated).
  • Vaccines update: restructure of monograph content—creation of two class monographs, Vaccines, general (information common to all vaccines) and Vaccines, live (information relevant to live vaccines only); see examples in yellow fever vaccine or hepatitis A vaccine.
  • Vaccines update: restructure of Typhoid vaccine monograph—creation of monographs for typhoid vaccine (live) and typhoid vaccine (inactivated).

Dose Changes:

  • Azithromycin [update to dosing for uncomplicated non-gonococcal urethritis in children aged 12 to 17 years old].
  • Cefotaxime [update to dosing for uncomplicated gonorrhoea].
  • Misoprostol [update to dosing for missed miscarriage and incomplete miscarriage].
  • Tranexamic acid [update to dosing for prevention and treatment of significant haemorrhage following major trauma].

Classification Changes:

  • Vaccines update [classifications changed to Vaccines, live or Vaccines, inactivated and non-replicating].

New Monographs:

  • Bleomycin.
  • Qdenga® [dengue vaccine].
  • Sodium benzoate.
  • Tibsovo® [ivosidenib].
  • Vaxchora® [cholera vaccine (live)].

New Preparations: Sertraline 100 mg/5 mL concentrate for oral solution.

Deleted Monographs: Lamivudine with tenofovir disoproxil.

Deleted Preparations: Percutol® [glyceryl trinitrate]