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 82 (September 2021- March 2022):
. 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 82 (September 2021 - March 2022):
. 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.