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BNF 84 (British National Formulary) September 2022-March 2023: 84: September 2022 - March 2023

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Expert advisers The BNF uses representatives from expert groups (professional societies and advisory bodies) to provide expert advice on clinical content. Grade B: Moderate strength Guidelines, assessed using AGREE II, that meet the grade B threshold; or a body of evidence including studies rated as 2++, directly applicable to the target population, and demonstrating overall consistency of results; or extrapolated evidence from studies rated as 1++ or 1+. Dental Advisory Group The Dental Advisory Group oversees the preparation of advice on the drug management of dental and oral conditions; the group includes representatives from the British Dental Association and a representative from the UK Health Departments. An oral syringe is supplied when oral liquid medicines are prescribed in doses other than multiples of 5 mL.

Liverpool: (0151) 794 8206 Driver and Vehicle Licensing Agency (DVLA) Information on the national medical guidelines of fitness to drive is available from: www.In some monographs, immediately below the nomenclature or drug action, there are a number of cross references or flags used to signpost the user to any additional information they need to consider about a drug.

Biological medicines Biological medicines are medicines that are made by or derived from a biological source using biotechnology processes, such as recombinant DNA technology. The BP direction that a preparation must be freshly prepared indicates that it must be made not more than 24 hours before it is issued for use.The legal status is shown for prescription-only medicines and controlled drugs, as well as pharmacy medicines and medicines on the general sales list. Extemporaneous preparation A product should be dispensed extemporaneously only when no product with a marketing authorisation is available. Ivacaftor, tezacaftor, elexacaftor (Kaftrio ® A ) in combination with ivacaftor (Kalydeco ®): risk of serious liver injury; updated advice on liver function testing [MHRA/CHM advice]. 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.

Once on a page, visual cues aid navigation: treatment summary information is in black type, with therapeutic use titles similarly styled in black, whereas the use of colour indicates drug-related information, including drug classification titles, drug class monographs, and drug monographs. Patients receiving medicines containing cariogenic sugars should be advised of appropriate dental hygiene measures to prevent caries.National funding/access decisions The Department of Health has confirmed that, in England, NICE can decide to apply the same remit, and the resulting technology appraisal guidance, to relevant biosimilar medicines which appear on the market subsequent to their originator biological medicine. Drug monographs – where possible, all information that relates to a single drug is contained within its drug monograph, moving information previously contained in the prescribing notes. 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.

Nurse Prescribers’ Advisory Group The Nurse Prescribers’ Advisory Group oversees the list of drugs approved for inclusion in the Nurse Prescribers’ Formulary; the group includes representatives from a range of nursing disciplines and stakeholder organisations. It is important to report suspected adverse reactions using the Yellow Card Scheme (see Adverse reactions to drugs p. Labelling of prescribed medicines There is a legal requirement for the following to appear on the label of any prescribed medicine: .The presence of benzyl alcohol and polyoxyl castor oil (polyethoxylated castor oil) in injections is indicated in the BNF. Joint Formulary Committee The Joint Formulary Committee (JFC) is responsible for the content of the BNF. Quick reference guides for life support and key drug doses in medical emergencies are also included, for ease of access. Cautionary and advisory labels that pharmacists are recommended to add when dispensing are included in the medicinal forms section.

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