page5
Preface
The BNF is a joint
publication of
the British Medical
Association and the Royal Pharmaceutical Society.
It is
published biannually under
the authority of
a Joint
Formulary Committee which comprises representatives
of
the two professional
bodies and of
the UK Health
Departments. The Dental Advisory Group oversees the
preparation of advice on the drug management of dental
and oral conditions; the Group includes representatives
of the British Dental Association. The Nurse Prescribers’
Advisory Group advises
on the content
relevant
to
nurses.
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.
Information on drugs is drawn from the manufacturers’
product
literature,
medical
and pharmaceutical
litera-
ture, 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 emer-
ging 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
anaesthesia since it is expected that those undertaking
treatment will have specialist knowledge and access to
specialist
literature.
BNF for Children
should be con-
sulted 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 (see inside front cover).
It is vital to use the most recent edition of the BNF for
making clinical decisions. The more important changes
for this edition are listed on p.
xvi.
The website (bnf.org) includes additional information of
relevance to healthcare professionals.
Other digital
for-
mats of
the BNF—including intranet
and versions for
mobile
devices—are
produced in parallel
with the
printed version.
The BNF welcomes comments from healthcare pro-
fessionals.
Comments
and constructive
criticism
should be sent to:
British National Formulary,
Royal Pharmaceutical Society,
1 Lambeth High Street,
London SE1 7JN.
editor@bnf.org
Contents
Preface
iii
Acknowledgements
iv
How the BNF is constructed
viii
How to use the BNF
x
Changes for this edition
xvi
Significant changes
xvi
Dose changes
xvii
Classification changes
xvii
New names
xvii
Deleted preparations
xvii
New preparations included in this edition
xviii
Guidance on prescribing
1
General guidance
1
Prescription writing
5
Emergency supply of medicines
7
Controlled Drugs and drug dependence
8
Adverse reactions to drugs
12
Prescribing for children
15
Prescribing in hepatic impairment
17
Prescribing in renal impairment
17
Prescribing in pregnancy
19
Prescribing in breast-feeding
19
Prescribing in palliative care
20
Prescribing for the elderly
24
Prescribing in dental practice
26
Drugs and sport
31
Emergency treatment of poisoning
32
Notes on drugs and Preparations
1:
Gastro-intestinal system
43
2:
Cardiovascular system
81
3:
Respiratory system
170
4:
Central nervous system
207
5:
Infections
320
6:
Endocrine system
418
7:
Obstetrics, gynaecology, and
urinary-tract disorders
485
8:
Malignant disease and immunosup-
pression
518
9:
Nutrition and blood
576
10:
Musculoskeletal and joint diseases
629
11:
Eye
666
12:
Ear, nose, and oropharynx
685
13:
Skin
700
14:
Immunological products and vac-
cines
746
15:
Anaesthesia
775
Appendices and indices
Appendix 1:
Interactions
800
Appendix 2:
Liver disease
17
Appendix 3:
Renal impairment
17
Appendix 4:
Pregnancy
19
Appendix 5:
Breast-feeding
19
Appendix 6:
Intravenous additives
892
Appendix 7:
Borderline substances
903
Appendix 8:
Wound management products
and elasticated garments
935
Appendix 9:
Cautionary and advisory labels
for dispensed medicines
957
Dental Practitioners’ Formulary
972
Nurse Prescribers’ Formulary
974
Non-medical prescribing
978
Index of manufacturers
979
Index
990
BNF 61
iii