Specialist drug monographs within BNF Publications

From June 2023, BNF Publications will be more clearly and consistently identifying specialist drug monographs within content, by including the words “Specialist drug” alongside the monograph title. This feature will be applied to existing monographs, and to monographs moving forward, that are used within specialist settings (such as drugs used for malignancy, and those given via intravitreal injection). These “specialist drug” monographs will contain less detail than a regular monograph within BNF Publications. A “specialist drug” monograph will continue to include information to support patient safety and non-specialist patient care (such as important safety information, interactions, side-effects, and contra-indications), but it will not contain information which is within the remit of specialist care (such as doses, and directions for administration).

Why are these changes being made?

Based on the primary use case of BNF Publications, supporting non-specialist clinical practice, the preface of the BNF sets out that less detail is given for specialist areas such as malignant disease. However, there has been no consistent style used within BNF monographs to highlight to users that a drug is used in these specialist areas.

Over the last year, we have undertaken research to understand how we could ensure that specialist drug content in BNF Publications is aligned with the stated scope within the preface, and with the primary use case of the BNF. Analytics around the use of BNF Publications’ content confirmed that specialist drug content is accessed much less frequently than drug content for non-specialist use. User research supported the analytics, and showed that those users who did access specialist content were most commonly looking at safety information, such as contra-indications, interactions, and side-effects.

The results of this research have enabled us to critically review the information that should be included within specialist drug monographs. “Specialist drug” monographs will contain less detail than a regular monograph within BNF Publications, in a consistent format. A “specialist” monograph will continue to include information to support patient safety and non-specialist patient care (such as important safety information, interactions, side-effects, and contra-indications), but it will not contain information which is within the remit of specialist care (such as doses, and directions for administration). The current level of additional prescribing information has been retained for drug monographs that have a mix of specialist and non-specialist uses (such as methotrexate that is used for both malignancy and rheumatological conditions).

This new feature will appear within the June 2023 monthly digital update and the BNF app, and will be present within the September 2023 print editions of BNF and BNF for Children.

Remember to check the information for all components of combination drugs

In drug monographs that contain two or more drugs, the BNF includes cross references to the single ingredient monographs to help the user locate all information about the drugs contained in the combination product. 

Currently the cross references from combination monographs to constituent drugs are not appearing on the Android app in a small number of cases. We are working to reinstate these signposting statements.

Note: This issue is now resolved.

BNF app login brings new Favourites functionality

With the latest update, you now have access to the new features on the BNF app, providing you with an improved experience.

Favourite records
Our research has shown many users want quick access to BNF records they visit frequently. By introducing registration, we are now able to give you a more personalised experience with the new ‘Favourites’ feature. Favourites will allow you to bookmark drug monographs, treatment summaries, and other records you refer to frequently or need to find quickly and access them across multiple devices.


Registration
To enable the Favourites functionality, and to support future app development, you will now be asked to register for access to the BNF app. It is quick and easy to do — just enter your email address and job role, then choose a password. Once you log in to the BNF app, you will remain logged in on your device.


All users are now required to register and log in to access the BNF app. The BNF app remains fully functional both online and offline, providing access to the latest drug information quickly, and on-the-go.

Why register for an account?

  • Quick and easy registration process, at no cost to you
  • Access your favourite records quickly, across multiple devices
  • Help us improve the app based on usage and needs

The BNF app remains fully functional both online and offline, providing access to the latest drug information quickly, and on-the-go.

NHS registered user access extended

NHS registered user access to BNF content through MedicinesComplete has been automatically extended.  If you have received an email asking you to re-register as an NHS user, you can safely ignore it and your access will not be affected. 

If you have re-registered as an NHS user, thank you, your access to BNF content through MedicinesComplete is also confirmed. 

If you have any questions, please get in touch. 

BNF 84 and BNF for Children 2022-23: Yellow Cards and Quick Reference Guides

In the upcoming print editions, BNF 84 and BNF for Children 2022–23, you will notice that the pages inserted after the index have been updated as follows:

  • Yellow Card inserts have been removed — information on when and how to submit Yellow Cards and links to online reporting sites remain available in the Adverse reactions to drugs section; signposting to this section and a link to the MHRA’s Yellow Card website is included on the back cover of print editions
  • Quick reference guides are now printed on standard paper stock instead of glossy paper — all content that was previously on these pages remains present (e.g. life support algorithms and key drug doses in medical emergencies)
  • Quick reference guides have been re-ordered to facilitate rapid reference — the advanced life support algorithm is now easily accessible on the inside back cover and listed in the Contents page

Correction of side-effect content in BNF monographs for cetuximab, lenvatinib and regorafenib

Omissions of side-effects within three BNF monographs have been identified, as follows:

  • Cetuximab — hypersensitivity (severe, sometimes fatal and may be delayed)
  • Regorafenib — haemorrhage (sometimes fatal)
  • Lenvatinib — haemorrhage (sometimes fatal)

These omissions have been corrected and the side-effects will be present in digital versions of BNF for the July 2022 monthly update and the forthcoming print edition, BNF 84 (September 2022).

Correction of valganciclovir information in BNF for Children

The valganciclovir drug monograph in BNF for Children has incorrectly included the following equivalence statement since the monograph was added for the July 2018 monthly digital update and the print edition BNF for Children 2018-2019.

Dose equivalence and conversion
Oral valganciclovir 900 mg twice daily is equivalent to intravenous ganciclovir 5 mg/kg twice daily.

This statement applies to dosing in adults only.

It will be removed from digital versions of BNF for Children for the August 2021 monthly update and the forthcoming print edition BNF for Children 2021-2022.

Interactions for combination drugs: check interactions for the individual component drugs

On MedicinesComplete, the interactions checker is currently not displaying interactions for co-drugs (e.g. co-codamol, co-trimoxazole) correctly. The results state that there are no interaction results for co-drugs, when this is not the case. Users are reminded to always check the interactions of all individual components of co-drugs to get the complete clinical information.

This issue applies to the interactions checkers for BNF and BNF for Children and the Stockley’s Interactions Checker on MedicinesComplete. In BNF and BNF for Children on MedicinesComplete, when using the navigation panel to filter search results of co-drugs by Interactions, the same issue also occurs.

The interactions are displaying correctly when the interactions information is accessed directly via links from the Interactions section of the co-drug monographs in BNF and BNF for Children.

This issue only affects interactions content on MedicinesComplete.

Please contact editor@bnf.org with any questions.

Note: This issue is now resolved.

BNF hosts antimicrobial summary guidance on behalf of NICE and PHE

BNF Publications will now host the Summary of antimicrobial prescribing guidance – managing common infections on behalf of the National Institute for Health and Care Excellence (NICE) and Public Health England (PHE). The hosting on BNF.org is an interim measure, whilst a long-term solution for the governance and hosting is established.

The Summary is a rapid reference containing recommendations around antimicrobial prescribing from NICE and PHE. The Summary will be updated at least quarterly and is available as a PDF and Word Document (updated February 2023).

The current version was updated February 2023, with changes made to recommendations for Acute sore throat and Scarlet fever (GAS).

From June 2023, NICE will resume responsibility for hosting this resource and, as such, it will no longer be hosted on www.bnf.org. Please email nice@nice.org.uk for further information.