BNF December 2025 Update

This update contains 15 significant changes,1 dose change, 2 new preparations
and 11 deleted monographs.

Significant Changes:

• Amoxicillin: updated indications and dose for prophylaxis of recurrent
  urinary-tract infection.
• Benralizumab: new indication and dose for eosinophilic granulomatosis
  with polyangiitis.
• Bismuth potassium with metronidazole and tetracycline hydrochloride: name change to bismuth subcitrate potassium with metronidazole and
  tetracycline hydrochloride.
• Cefalexin: updated indications and dose for prophylaxis of recurrent urinary-tract infection.
• Citalopram: new indications and dosing for known CYP2C19 poor metabolisers, and update to structure of dosing for depressive illness and
  panic disorder.
• Escitalopram: new indications and dosing for known CYP2C19 poor metabolisers.
• Human alpha1-proteinase inhibitor: name change to alpha1-proteinase inhibitor.
• Isotretinoin: updates to prescribing guidance and survey of services [MHRA/CHM advice].
• Nitrofurantoin: updated indications and dose for prophylaxis of recurrent urinary-tract infection.
• Rasburicase: harm from delayed administration of rasburicase for tumour lysis syndrome [National Patient Safety Alert advice.
• Semaglutide (Ozempic®): updated dose equivalence and conversion statement.
•  Semaglutide (Rybelsus®): updated indications and dose for type 2 diabetes mellitus, and important safety information.
• Sodium clodronate: name change to clodronate disodium.
• Trimethoprim: updated indications and dose for prophylaxis of recurrent urinary-tract infection.
• Ulipristal acetate: updated breast-feeding advice.

Dose Changes:

• Infliximab [update to dosing for active ulcerative colitis, active Crohn’s disease and fistulating Crohn’s disease].

New Preparations: Enalto® [escitalopram]; Rybelsus® 1.5 mg, 4 mg, and 9 mg round tablets [semaglutide].

Deleted Monographs: Adefovir dipivoxil; Aspirin with codeine; Bezlotoxumab;
Castor oil with collodion and colophony; Colestipol hydrochloride; Diclofenac;
Macrogol 3350 with anhydrous sodium sulfate, potassium chloride, sodium.