10th June 2025

Clarke’s Analysis of Drugs and Poisons

This update contains 4 major and 5 minor revisions to monographs.

This update contains:

• 4 fully revised NPS monographs.
• 5 minor updates.

10th June 2025

Critical Illness

This update contains 1 minor update.

Minor update: Fentanyl.

10th June 2025

BNF for Children

This update contains 7 significant changes, 3 dose changes and 2 new monographs.

Significant Changes:

• Hydroxychloroquine sulfate: updated pregnancy and breast-feeding advice.
• Malaria, prophylaxis: updated guidance.
• Neonatal infection, antibacterial therapy: updated guidance Sepsis: updated guidance on management.
• Parenteral anticoagulants: updated guidance for use of heparin flushes.
• Sepsis: updated guidance on management.
• Sympathomimetics: updated guidance for septic shock.
• Tuberculosis: updated guidance for multi-drug resistant tuberculosis.

Dose Changes:

• Rilpivirine [update to dosing for HIV-1 infection].
• Sodium hyaluronate with trehalose [update to dosing for dry eye conditions].
• Vocabria® (cabotegravir) [update to dosing for HIV-1 infection].

New Monographs:

• Apretude® [cabotegravir].
• Duvyzat® [givinostat].

10th June 2025

Martindale: The Complete Drug Reference

This update contains 25 new monographs and 14 existing monographs have been updated. Preparations have also been updated for 4 countries.

New Monographs

• 11β-Methyl-19-nortestosterone is reported to be an anabolic androgenic steroid. It may be subject to abuse in sport.
• 17α-Methylepitiostanol is reported to be an anabolic androgenic steroid that is a precursor of desoxymethyltestosterone. It may be subject to abuse in sport.
• 2-Phenylpropylamine is an isomer of amfetamine that may be included in dietary supplements promoted for weight loss and athletic performance. The FDA do not consider it to be a dietary ingredient. It may be subject to abuse in sport.
• 4-Fluoromethylphenidate is an analogue of methylphenidate. It may be subject to abuse in sport.
• 9-Hydroxyfluorene is reported to be a stimulant that may be subject to abuse in sport.
• Adrenosterone is reported to be an anabolic androgenic steroid that may be subject to abuse in sport.
• BPC-157 is a 15-amino acid peptide that may be subject to abuse in sport.
• Dimethandrolone is reported to be an anabolic androgenic steroid that may be subject to abuse in sport.
• Elacestrant is an oestrogen antagonist that degrades the oestrogen receptor-α, and is used for the treatment of locally advanced or metastatic breast cancer in males and postmenopausal females.
• Ethylphenidate is an analogue of methylphenidate. It may be subject to abuse in sport.
• Fruquintinib is a tyrosine kinase inhibitor used in the treatment of metastatic colorectal cancer.
• Lebrikizumab is a recombinant monoclonal antibody that is used for the treatment of moderate to severe atopic eczema.
• Lecanemab is a recombinant humanised immunoglobulin G1 monoclonal antibody that binds to aggregated amyloid-beta. It is used in the treatment of mild cognitive impairment and mild dementia in Alzheimer’s disease.
• Methylnaphthidate is an analogue of methylphenidate. It may be subject to abuse in sport.
• MOTS-c is an AMP-activated protein kinase (AMPK) activator. It may be subject to abuse in sport.
• Quizartinib is a tyrosine kinase inhibitor that targets FMS-like tyrosine kinase 3 (FLT3). It is used in the treatment of acute myeloid leukaemia with a FLT3 internal tandem duplication (ITD) mutation.
• Ractopamine is reported to be a beta-adrenoceptor agonist used in some countries as an animal-feed additive to promote growth. It may be subject to abuse in sport.
• Ryanodine receptor-1-calstabin complex stabilisers reduce calcium leakage from the sarcoplasmic reticulum of skeletal muscle cells, thereby improving muscle function. They may be subject to abuse in sport.
• S-23 is reported to be a selective androgen receptor modulator (SARM). It may be subject to abuse in sport.
• S-519 is reported to be an insulin mimetic that may be subject to abuse in sport.
• S-597 is reported to be an insulin mimetic that may be subject to abuse in sport.
• SR-9011 is reported to be a Rev-erbα agonist and may be subject to abuse in sport.
• Trestolone is reported to be an anabolic androgenic steroid that may be subject to abuse in sport.
• Troponin activators selectively activate the troponin complex, increasing the calcium sensitivity of troponin C and thereby increasing muscle contraction. They may be subject to abuse in sport.
• YK-11 is reported to be a selective androgen receptor modulator (SARM). It may be subject to abuse in sport.

Selective Updates – some new, re-validated or changed information

Monographs

• Aducanumab
• Broom (formerly Scoparium)
• Colchicine
• Dandelion (formerly Taraxacum)
• Elder (formerly Sambucus)
• Flavonoids (formerly Flavonoid Compounds)
• Hawthorn (formerly Crataegus)
• Methenamine
• Nettle (formerly Urtica)
• Pelargonium (formerly Pelargonium Sidoides)
• Pygeum (formerly Pygeum Africanum)
• Rhodiola (formerly Rhodiola Rosea)
• Sirolimus
• Willow (formerly Salix)

Updated names, synonyms and codes; official standards; official preparations

• Ph. Eur. 11.4

Proprietary Preparations and Manufacturers updated for the following countries and regions:

• Portugal
• Sweden
• UK^†
• USA^†

† Countries updated on an ongoing basis

10th June 2025

Palliative Care Formulary

This update contains 1 revised monograph.

The following monograph has been fully revised: The use of medicinal products beyond (off-label) and without (unauthorized) marketing authorization.

10th June 2025

British National Formulary

This update contains 8 significant changes, 4 dose changes, 2 new monographs and 4 new preparations.

Significant Changes:

• Bimekizumab: new indication and dose for hidradenitis suppurativa.
• Chloroquine: updated pregnancy and breast-feeding advice when used for rheumatic disease.
• Contraceptives, hormonal: inclusion of guidance for use of combined oral contraceptives for preventive treatment of ovarian cancer in at-risk females.
• Hydroxychloroquine sulfate: updated pregnancy and breast-feeding advice.
• Malaria, prophylaxis: updated guidance.
• Sepsis: updated guidance on management.
• Sympathomimetics: updated guidance for septic shock.
• Tuberculosis: updated guidance for multi-drug resistant tuberculosis.

Dose Changes:

• Colchicine [update to dosing for prophylaxis of familial Mediterranean fever].
• Rilpivirine [update to dosing for HIV-1 infection].
• Sodium hyaluronate with trehalose [update to dosing for dry eye conditions].
• Vocabria® (cabotegravir) [update to dosing for HIV-1 infection].

New Monographs:

• Briumvi® [ublituximab]
• Duvyzat® [givinostat].

New Preparations: Apretude® 30 mg film-coated tablets [cabotegravir]; Apretude® 600 mg prolonged-release suspension for injection [cabotegravir]; Budenofalk® suppositories [budesonide]; Netildex® eye gel [dexamethasone with netilmicin]