BNF for Children

11th June 2024

BNF for Children

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

Significant Changes:

• Borderline substances: products suitable for conditions requiring a ketogenic diet have been moved to a new section called Ketogenic diet.
• Diabetic hyperglycaemic emergencies: updated guidance for management of individuals aged 16-18 years.
• Gentamicin : removal of indication and dose for treatment of Pseudomonal lung infection in cystic fibrosis.
• Meningococcal vaccines: updated guidance for immunisation.

Dose Changes:

• Amikacin [update to dosing for pulmonary infection with Pseudomonas aeruginosa in cystic fibrosis].
• Bexsero® ( meningococcal group B vaccine (rDNA, component, adsorbed) ) [update to dosing].
• Cyanocobalamin [update to dosing].
• Haemophilus influenzae type b with meningococcal group C vaccine [update to dosing].
• Meningococcal groups A with C and W135 and Y vaccine [update to dosing].

New Monographs:

• Adacel® [diphtheria with tetanus and pertussis vaccine].
• Entresto® [sacubitril with valsartan].
• Opdivo® [nivolumab].
• Opdualag® [nivolumab with relatlimab].
• Velsipity® [etrasimod].

Deleted Monographs:

• Artenimol with piperaquine phosphate.”

14th May 2024

BNF for Children

This update contains 8 significant changes, 3 dose changes, 3 new monographs, 1 new preparation and 2 deleted monographs.

Significant Changes:

• Budesonide: update to dosing for modified-release capsules.
• Codeine phosphate linctus (codeine oral solutions): reclassification to prescription-only medicine [MHRA/CHM advice].
• Hydrocortisone: updated indication oral and perioral lesions to aphthous ulcers.
• Hyoscine butylbromide: update to important safety information.
• Malaria, prophylaxis: updated guidance.
• Pneumococcal vaccine: updated guidance for immunisation.
• Pseudoephedrine hydrochloride: very rare risk of posterior reversible encephalopathy syndrome (PRES) and reversible cerebral vasoconstriction syndrome (RCVS) [MHRA/CHM advice].
• Vaccination, general principles: updated guidance for immunisation of individuals with asplenia, splenic dysfunction, or complement disorders.

Dose Changes:

• Acetylcysteine [update to dosing for paracetamol overdosage].
• Paracetamol [update to upper weight range for intravenous paracetamol].
• Pneumococcal polysaccharide conjugate vaccine (adsorbed) [update to dosing].

New Monographs:

• Enspryng® [satralizumab].
• Evkeeza® [evinacumab].
• Eylea® [aflibercept].

New Preparations: Otinova® [aluminium acetate].

Deleted Monographs: Chloroquine with proguanil; Proguanil hydrochloride.

9th April 2024

BNF for Children

This update contains 4 significant changes, 2 new monographs, 1 new preparation, 1 deleted monograph and 1 deleted preparation.

Significant Changes:

• Ceftriaxone: update to structure of indications and dose section.
• Clindamycin: update to structure of indications and dose section.
• Contraceptives, non-hormonal: updated guidance in-line with Faculty of Sexual & Reproductive Healthcare recommendations on intra-uterine contraception.
• Valproate (Belvo®, Convulex®, Depakote®, Dyzantil®, Epilim®, Epilim Chrono® or Chronosphere®, Episenta®, Epival®, and Syonell®): new safety and educational materials to support regulatory measures in men and women under 55 years of age [MHRA/CHM advice] (advice in sodium valproate, valproic acid; see example in sodium valproate).

New Monographs:

• Ebglyss® [lebrikizumab].
• Kanuma® [sebelipase alfa].

New Preparations: Etacortilen® eye drops [dexamethasone].

Deleted Monographs: Benzoin tincture, compound.

Deleted Preparations: Hibitane® Plus 5% concentrate solution [chlorhexidine].

12th March 2024

BNF for Children

This update contains 4 significant changes, 1 new monograph and 1 deleted monograph.

Significant Changes:

• Aripiprazole (Abilify® and generic brands): risk of pathological gambling [MHRA/CHM advice].
• Quinolones: must now only be prescribed when other commonly recommended antibiotics are inappropriate [MHRA/CHM advice] (see example in ciprofloxacin).
• Type 2 diabetes: updated guidance for management.
• Vitamin B₁₂: advise patients with known cobalt allergy to be vigilant for sensitivity reactions [MHRA/CHM advice] (advice in cyanocobalamin, hydroxocobalamin; see example in hydroxocobalamin).

New Monographs:

• Litfulo® [ritlecitinib].
• Livmarli® [maralixibat].

Deleted Monographs: Cinchocaine hydrochloride with fluocortolone caproate and fluocortolone pivalate.

13th February 2024

BNF for Children

This update contains 6 significant changes, 1 dose change, 1 new monograph, and 3 deleted monographs.

Significant Changes:

• Baclofen: update to expression of doses for chronic severe spasticity of voluntary muscle.
• Controlled drugs and drug dependence: control of nitrous oxide.
• Insulin degludec (Tresiba®): potential for inappropriate dosing of insulin when switching Tresiba® products [National Patient Safety Alert advice].
• Liraglutide (Saxenda®): vigilance required due to potentially harmful falsified products [MHRA/CHM advice].
• Semaglutide (Ozempic®): vigilance required due to potentially harmful falsified products [MHRA/CHM advice].
• Valproate: organisations to prepare for new regulatory measures for oversight of prescribing to new patients and existing female patients [National Patient Safety Alert advice] (advice in sodium valproate, valproic acid; see example in sodium valproate).

Dose Changes:

• Octasa® MR 400 mg and 800 mg tablets (mesalazine).

New Monographs:

• Slynd® [drospirenone].

Deleted Monographs: Diflucortolone valerate; Fluocinolone acetonide with clioquinol; Fluocinolone acetonide with neomycin.

9th January 2024

BNF for Children

This update contains 4 significant changes and 2 new monographs.

Significant Changes:

• Budesonide with formoterol (Symbicort 200/6 Turbohaler®): updated to include dosing as reliever therapy for mild asthma.
• Co-cyprindiol: update to contra-indications and cautions for use.
• Factor IX fraction, dried: name change to factor IX .
• Isotretinoin (Roaccutane®): introduction of new safety measures, including additional oversight of the initiation of treatment for patients under 18 years of age [MHRA/CHM advice].

New Monographs:

• Trulicity® [dulaglutide].
• Voraxaze® [glucarpidase].