BNF 81 pdf free download (British National Formulary March - September 2021)

The BNF is designed as a digest for rapid reference and it may not always include all the information necessary for prescribing and dispensing. Also, less detail is given on areas such as obstetrics, malignant disease, and anaesthesia since it is expected that those undertaking treatment will have specialist knowledge and access to specialist literature. BNF for Children should be consulted for detailed information on the use of medicines in children. The BNF should be interpreted in the light of professional knowledge and supplemented as necessary by specialised publications and by reference to the product literature. Information is also available from Medicines Information Services.


BNF 81 pdf free download


The BNF aims to provide prescribers, pharmacists, and other healthcare professionals with sound up-to-date information about the use of medicines.

The BNF includes key information on the selection, prescribing, dispensing and administration of medicines. Medicines generally prescribed in the UK are covered and those considered less suitable for prescribing are clearly identified. Little or no information is included on medicines promoted for purchase by the public.

Please refer to digital versions of BNF for the most up-todate content. BNF is published in print but interim updates are issued and published in the digital versions of BNF. The publishers work to ensure that the information is as accurate and up-to-date as possible at the date of publication, but knowledge and best practice in this field change regularly. BNF’s accuracy and currency cannot be guaranteed and neither the publishers nor the authors accept any responsibility for errors or omissions. While considerable efforts have been made to check the material in this publication, it should be treated as a guide only. Prescribers, pharmacists and other healthcare professionals are advised.

Information on drugs is drawn from the manufacturers’ product literature, medical and pharmaceutical literature, UK health departments, regulatory authorities, and professional bodies. Advice is constructed from clinical literature and reflects, as far as possible, an evaluation of the evidence from diverse sources. The BNF also takes account of authoritative national guidelines and emerging safety concerns. In addition, the editorial team receives advice on all therapeutic areas from expert clinicians; this ensures that the BNF’s recommendations are relevant to practice.
The BNF is designed as a digest for rapid reference and it may not always include all the information necessary for prescribing and dispensing. Also, less detail is given on areas such as obstetrics, malignant disease, and anesthesia since it is expected that those undertaking treatment will have specialist knowledge and access to specialist literature. Similarly, little or no information is included on medicines for very rare conditions. BNF for Children should be consulted for detailed information on the use of medicines in children. The BNF should be interpreted in the light of professional knowledge and supplemented as necessary by specialized publications and by reference to the product literature. Information is also available from medicines information services, see Medicines Information Services (see inside front cover).

It is important to use the most recent BNF information for making clinical decisions. The print edition of the BNF is updated in March and September each year. Monthly updates are provided online via Medicines Complete and the NHS Evidence portal. The more important changes are listed under Changes; changes listed online are cumulative (from one print edition to the next), and can be printed off each month to show the main changes since the last print edition as an aide memoire for those using print copies.

UPDATE

Monthly updates are provided online via Medicines Complete and the NHS Evidence portal. The changes listed below are cumulative (from one print edition to the next).

Significant changes

Significant changes that appear in the print edition of BNF 81 (March — September 2021):
. Aflibercept p. 1054: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection [MHRA/CHM advice].
. Amisulpride p. 414: Clozapine and other antipsychotics: monitoring blood concentrations for toxicity [MHRA/CHM advice].
. Amphotericin: name change to amphotericin B p. 632.
. Amphotericin B p. 632: Liposomal and lipid-complex formulations: name change to reduce medication errors [MHRA/CHM advice].
. Andexanet alfa p. 131 for adults treated with apixaban or  rivaroxaban when reversal of anticoagulation is needed  due to life-threatening or uncontrolled bleeding [SMC guidance].
. Andexanet alfa p. 131 (Ondexxya ®): Commercial anti-FXa activity assays are unsuitable for measuring anti-FXa activity following administration of andexanet alfa [MHRA/CHM advice].
. Antibacterials, use for prophylaxis p. 529: updated guidance for the prevention of secondary Haemophilus influenzaetype b disease.
. Apixaban p. 136: Direct-acting oral anticoagulants (DOACs): reminder of bleeding risk, availability of reversal agents [MHRA/CHM advice].
. Aripiprazole p. 415: Clozapine and other antipsychotics: monitoring blood concentrations for toxicity [MHRA/CHM advice].
. Atezolizumab p. 907 (Tecentriq ®) in combination with arboplatin and etoposide, is indicated for the first-line treatment of adult patients with extensive-stage small cell lung cancer [SMC guidance].
. Atezolizumab p. 907 (Tecentriq ®) in combination with nab-paclitaxel for the treatment of adult patients with unresectable locally advanced or metastatic triplenegative breast cancer whose tumours have PD-L1 expression at a level of 1 % or more and who have not received prior chemotherapy for metastatic disease [SMC guidance].
. Atezolizumab p. 907 (Tecentriq ®) with carboplatin and etoposide for untreated extensive-stage small-cell lung cancer [NICE guidance].
. Atezolizumab p. 907 (Tecentriq ®) with nab-paclitaxel for untreated PD-L1-positive, locally advanced or metastatic, triple-negative breast cancer [NICE guidance].
. Avatrombopag p. 1079 for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure [NICE guidance].
. Avelumab p. 908 (Bavencio ®) in combination with axitinib for the first-line treatment of adult patients with advanced renal cell carcinoma [SMC guidance].
. Avelumab p. 908 with axitinib p. 1013 for untreated advanced renal cell carcinoma [NICE guidance].
. Axitinib p. 1013: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection [MHRA/CHM advice].
. Baricitinib p. 1152 (Olumiant ® A): increased risk of diverticulitis, particularly in patients with risk factors [MHRA/CHM advice].
. Bedaquiline p. 622 in combination regimen for multipledrug resistant pulmonary tuberculosis [AWMSG guidance].
. Bevacizumab p. 909: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection [MHRA/CHM advice].
. Bisacodyl p. 65: Stimulant laxatives (bisacodyl, senna and sennosides, sodium picosulfate) available over-thecounter: new measures to support safe use [MHRA/CHM advice].
. BNF updates for Community Practitioner Nurse Prescribers: For BNF app and online versions of the BNF- list of medicinal preparations (renamed as Approved list for prescribing by Community Practitioner Nurse Prescribers (NPF) p. 1685) updated with indications for use by Community Practitioner Nurse Prescribers and links to BNF monographs; general guidance and treatment summaries for use by Community Practitioner Nurse Prescribers have also been added. For BNF print editionslist of medicinal preparations (Nurse Prescribers’ Formulary (NPF)) updated with indications for use by Community Practitioner Nurse Prescribers and crossreferences to BNF monographs. For further information, see How to use the NPF above the list of medicinal preparations.
. Brentuximab vedotin p. 911 in combination for untreated systemic anaplastic large cell lymphoma [NICE guidance].
. Brolucizumab p. 1234 for the treatment of adults with neovascular (wet) age-related macular degeneration [SMC guidance].
. Budesonide p. 48 (Jorveza ®) for the treatment of eosinophilic oesophagitis in adults [SMC guidance].
. Bupropion hydrochloride p. 520 (Zyban ®): risk of serotonin syndrome with use with other serotonergic drugs [MHRA/CHM advice].
. Cabozantinib p. 1016: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection [MHRA/CHM advice].
. Cannabidiol p. 326 with clobazam for therapy of seizures associated with Dravet syndrome [SMC guidance].
. Cannabidiol p. 326 with clobazam for therapy of seizures associated with Lennox-Gastaut syndrome [SMC guidance].
. Capecitabine p. 950: Fluorouracil (i.v.), capecitabine and tegafur containing products: Pre-treatment testing to identify DPD-deficient patients at increased risk of severe and fatal toxicity [MHRA/CHM advice].
. Caplacizumab p. 1080 for the treatment of adults with acquired thrombotic thrombocytopenic purpura [SMC guidance].
. Carfilzomib p. 1007 for previously treated multiple myeloma [NICE guidance].
. Carfilzomib p. 1007 (Kyprolis ®) in combination with lenalidomide and dexamethasone for the treatment of adult patients with multiple myeloma who have received at least one prior therapy [for patients who have received only one prior therapy] [SMC guidance].
. Cariprazine p. 416 for the treatment of schizophrenia [AWMSG guidance].
. Clozapine p. 417: Clozapine and other antipsychotics: monitoring blood concentrations for toxicity [MHRA/CHM advice].
. Cyproterone acetate p. 812: new advice to minimise risk of meningioma [MHRA/CHM advice].
. Cyproterone acetate p. 812: Restrictions in use of cyproterone acetate due to risk of meningioma (letter) [MHRA/CHM advice].
. Cytarabine p. 953: Liposomal and lipid-complex formulations: name change to reduce medication errors [MHRA/CHM advice]. 
. Dabigatran etexilate p. 148: Direct-acting oral anticoagulants (DOACs): reminder of bleeding risk,  availability of reversal agents [MHRA/CHM advice].
. Daratumumab p. 913 (Darzalex ®) subcutaneous injection as monotherapy, for the treatment of adult patients with
Monthly updates are provided online via Medicines
Complete and the NHS Evidence portal. The changes listed
below are cumulative (from one print edition to the next).

Significant changes

Significant changes that appear in the print edition of BNF 81 (March — September 2021):
. Aflibercept p. 1054: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection [MHRA/CHM advice].
. Amisulpride p. 414: Clozapine and other antipsychotics: monitoring blood concentrations for toxicity [MHRA/CHM advice].
. Amphotericin: name change to amphotericin B p. 632.
. Amphotericin B p. 632: Liposomal and lipid-complex formulations: name change to reduce medication errors [MHRA/CHM advice].
. Andexanet alfa p. 131 for adults treated with apixaban or  rivaroxaban when reversal of anticoagulation is needed  due to life-threatening or uncontrolled bleeding [SMC guidance].
. Andexanet alfa p. 131 (Ondexxya ®): Commercial anti-FXa activity assays are unsuitable for measuring anti-FXa activity following administration of andexanet alfa [MHRA/CHM advice].
. Antibacterials, use for prophylaxis p. 529: updated guidance for the prevention of secondary Haemophilus influenzaetype b disease.
. Apixaban p. 136: Direct-acting oral anticoagulants (DOACs): reminder of bleeding risk, availability of reversal agents [MHRA/CHM advice].
. Aripiprazole p. 415: Clozapine and other antipsychotics: monitoring blood concentrations for toxicity [MHRA/CHM advice].
. Atezolizumab p. 907 (Tecentriq ®) in combination with arboplatin and etoposide, is indicated for the first-line treatment of adult patients with extensive-stage small cell lung cancer [SMC guidance].
. Atezolizumab p. 907 (Tecentriq ®) in combination with nab-paclitaxel for the treatment of adult patients with unresectable locally advanced or metastatic triplenegative breast cancer whose tumours have PD-L1 expression at a level of 1 % or more and who have not received prior chemotherapy for metastatic disease [SMC guidance].
. Atezolizumab p. 907 (Tecentriq ®) with carboplatin and etoposide for untreated extensive-stage small-cell lung cancer [NICE guidance].
. Atezolizumab p. 907 (Tecentriq ®) with nab-paclitaxel for untreated PD-L1-positive, locally advanced or metastatic, triple-negative breast cancer [NICE guidance].
. Avatrombopag p. 1079 for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure [NICE guidance].
. Avelumab p. 908 (Bavencio ®) in combination with axitinib for the first-line treatment of adult patients with advanced renal cell carcinoma [SMC guidance].
. Avelumab p. 908 with axitinib p. 1013 for untreated advanced renal cell carcinoma [NICE guidance].
. Axitinib p. 1013: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection [MHRA/CHM advice].
. Baricitinib p. 1152 (Olumiant ® A): increased risk of diverticulitis, particularly in patients with risk factors [MHRA/CHM advice].
. Bedaquiline p. 622 in combination regimen for multipledrug resistant pulmonary tuberculosis [AWMSG guidance].
. Bevacizumab p. 909: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection [MHRA/CHM advice].
. Bisacodyl p. 65: Stimulant laxatives (bisacodyl, senna and sennosides, sodium picosulfate) available over-thecounter: new measures to support safe use [MHRA/CHM advice].
. BNF updates for Community Practitioner Nurse Prescribers: For BNF app and online versions of the BNF- list of medicinal preparations (renamed as Approved list for prescribing by Community Practitioner Nurse Prescribers (NPF) p. 1685) updated with indications for use by Community Practitioner Nurse Prescribers and links to BNF monographs; general guidance and treatment summaries for use by Community Practitioner Nurse Prescribers have also been added. For BNF print editionslist of medicinal preparations (Nurse Prescribers’ Formulary (NPF)) updated with indications for use by Community Practitioner Nurse Prescribers and crossreferences to BNF monographs. For further information, see How to use the NPF above the list of medicinal preparations.
. Brentuximab vedotin p. 911 in combination for untreated systemic anaplastic large cell lymphoma [NICE guidance].
. Brolucizumab p. 1234 for the treatment of adults with neovascular (wet) age-related macular degeneration [SMC guidance].
. Budesonide p. 48 (Jorveza ®) for the treatment of eosinophilic oesophagitis in adults [SMC guidance].
. Bupropion hydrochloride p. 520 (Zyban ®): risk of serotonin syndrome with use with other serotonergic drugs [MHRA/CHM advice].
. Cabozantinib p. 1016: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection [MHRA/CHM advice].
. Cannabidiol p. 326 with clobazam for therapy of seizures associated with Dravet syndrome [SMC guidance].
. Cannabidiol p. 326 with clobazam for therapy of seizures associated with Lennox-Gastaut syndrome [SMC guidance].
. Capecitabine p. 950: Fluorouracil (i.v.), capecitabine and tegafur containing products: Pre-treatment testing to identify DPD-deficient patients at increased risk of severe and fatal toxicity [MHRA/CHM advice].
. Caplacizumab p. 1080 for the treatment of adults with acquired thrombotic thrombocytopenic purpura [SMC guidance].
. Carfilzomib p. 1007 for previously treated multiple myeloma [NICE guidance].
. Carfilzomib p. 1007 (Kyprolis ®) in combination with lenalidomide and dexamethasone for the treatment of adult patients with multiple myeloma who have received at least one prior therapy [for patients who have received only one prior therapy] [SMC guidance].
. Cariprazine p. 416 for the treatment of schizophrenia [AWMSG guidance].
. Clozapine p. 417: Clozapine and other antipsychotics: monitoring blood concentrations for toxicity [MHRA/CHM advice].
. Cyproterone acetate p. 812: new advice to minimise risk of meningioma [MHRA/CHM advice].
. Cyproterone acetate p. 812: Restrictions in use of cyproterone acetate due to risk of meningioma (letter) [MHRA/CHM advice].
. Cytarabine p. 953: Liposomal and lipid-complex formulations: name change to reduce medication errors [MHRA/CHM advice]. 
. Dabigatran etexilate p. 148: Direct-acting oral anticoagulants (DOACs): reminder of bleeding risk,  availability of reversal agents [MHRA/CHM advice].
. Daratumumab p. 913 (Darzalex ®) subcutaneous injection as monotherapy, for the treatment of adult patients. 

  

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