British National Formulary (BNF) 91

Practical and evidence based, British National Formulary (BNF) is the only drug formulary in the world that is both independent and has rigorous, accredited content creation processes. Edited by the Joint Formulary Committee, BNF 91 is relied on by health professionals who prescribe, dispense, and administer medicines globally, supporting safe decision-making at the point of care.

Extensive content updates in the BNF 91 edition include:

New monographs for:

• Abrysvo and Arexvy (respiratory syncytial virus (RSV) vaccine) for immunisation against respiratory syncytial virus
• Filspari (sparsentan) for primary immunoglobulin A (IgA) nephropathy
• IXCHIQ (chikungunya vaccine, live) for immunisation against chikungunya
• Livdelzi (seladelpar) for primary biliary cholangitis
• Nemluvio (nemolizumab) for moderate-to-severe atopic eczema and moderate-to-severe prurigo nodularis
• Piperaquine phosphate with artenimol for treatment of falciparum malaria
• Suvexx (sumatriptan with naproxen) for treatment of acute migraine
• Tzield (teplizumab) for type 1 diabetes mellitus
• Vimkunya (chikungunya vaccine, inactivated) for immunisation against chikungunya

MHRA advice on:

• Isotretinoin: updated prescribing guidance
• Ivacaftor with tezacaftor and elexacaftor (Kaftrio): risk of psychological side effects
• Paracetamol: safe to use during pregnancy
• RSV vaccine (Abrysvo and Arexvy): small risk of Guillain-Barre syndrome in older adults
• Short-acting beta2-agonists (salbutamol and terbutaline): risk from overuse in asthma
• Thiopurines: risk of intrahepatic cholestasis of pregnancy
• Valproate: updated safety materials on reproductive risks

Other significant changes include updated guidance on:

• Amoxicillin, cefalexin, nitrofurantoin, and trimethoprim: updated dosing for prophylaxis of recurrent urinary-tract infection
• Benralizumab, guselkumab, and mirikizumab: new indications including Crohns disease, ulcerative colitis, and eosinophilic granulomatosis with polyangiitis
• Citalopram and escitalopram: new dosing for known CYP2C19 poor metabolisers
• COVID-19 and malaria treatment: updated guidance
• Posaconazole and semaglutide (Ozempic and Rybelsus): updated dosing and safety information
• Prescribing in palliative care: updated opioid dose conversion guidance
• Rasburicase: National Patient Safety Alert on delayed administration for tumour lysis syndrome

BNF is published jointly by BMJ Group and Pharmaceutical Press.