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Preface iii
Acknowledgements iv
How to use the BNF ix
Changes for this edition xi
Significant changes xi
Dose changes xi
Classification changes xii
Deleted preparations xii
New preparations included in this edition xiii
Late additions xiii
Name changes xiv
Guidance on prescribing 1
General guidance 1
Prescription writing 4
Emergency supply of medicines 6
Controlled Drugs and drug dependence 7
Adverse reactions to drugs 11
Prescribing for children 13
For detailed advice on medicines used for children
consult BNF for Children
Prescribing in palliative care 15
Prescribing for the elderly 19
Prescribing in dental practice 21
Drugs and sport 26
Emergency treatment of poisoning 27
Notes on drugs and Preparations
1: Gastro-intestinal system 37
2: Cardiovascular system 72
3: Respiratory system 150
4: Central nervous system 185
5: Infections 288
6: Endocrine system 372
7: Obstetrics, gynaecology, and
urinary-tract disorders 434
8: Malignant disease and immunosuppression
465
9: Nutrition and blood 512
10: Musculoskeletal and joint diseases 559
11: Eye 590
12: Ear, nose, and oropharynx 608
13: Skin 624
14: Immunological products and vaccines
669
15: Anaesthesia 697
Appendixes and indices
Appendix 1: Interactions 720
Appendix 2: Liver disease 804
Appendix 3: Renal impairment 815
Appendix 4: Pregnancy 831
Appendix 5: Breast-feeding 852
Appendix 6: Intravenous additives 867
Appendix 7: Borderline substances 880
Appendix 8: Wound management products
and elasticated garments 911
Appendix 9: Cautionary and advisory labels
for dispensed medicines 932
Dental Practitioners’ Formulary 947
Nurse Prescribers’ Formulary 950
Non-medical prescribing 954
Index of manufacturers 955
Index 971
The BNF is a joint publication of the British Medical
Association and the Royal Pharmaceutical Society of
Great Britain. 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 literature,
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 emerging
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 consulted
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. xi.
The BNF on the internet (bnf.org) includes additional
information of relevance to healthcare professionals
dealing with medicines. Other digital versions of the
BNF—including intranet and personal digital assistant
(PDA) versions—are produced in parallel with the paper
version.