BNF February 2026 Update

This update contains 12 significant changes, 3 dose changes and 2 new monographs.

Significant Changes:

• Birch bark extract: name change to birch bark extracts.
• Diarrhoea (acute): updated guidance on the use of antibacterial drugs for acute diarrhoea.
• Epilepsy: updated guidance on management.
• Givinostat: new important safety information.
• Mesalazine and idiopathic intracranial hypertension [MHRA/CHM advice].
• Penicillamine: harm from incorrect recording of a penicillin allergy as a penicillamine allergy [National Patient Safety Alert advice].
• Penicillins: harm from incorrect recording of a penicillin allergy as a penicillamine allergy [National Patient Safety Alert advice] (advice in all penicillins; see example in amoxicillin).
• Respiratory system infections, antibacterial therapy: updated guidance on community-acquired pneumonia.
• Respiratory system infections, antibacterial therapy: updated guidance on hospital-acquired pneumonia.
• Semaglutide (Rybelsus®): transition to new formulation and risk of medication error [MHRA/CHM advice].
• Vaccination, general principles: updated guidance on vaccination in pregnancy.
• Vutrisiran: new indications and dose for treatment of wild-type and hereditary transthyretin amyloidosis in patients with cardiomyopathy.

Dose Changes:

• Amoxicillin [update to age ranges and duration of treatment for community-acquired pneumonia in children].
• Clarithromycin [update to age ranges and duration of treatment for community-acquired pneumonia in children].
• Erythromycin [update to age ranges and duration of treatment for community-acquired pneumonia in children].

New Monographs:

• Beyonttra® [acoramidis] for Wild-type transthyretin amyloidosis in patients with cardiomyopathy (wtATTR-CM) (initiated under specialist supervision); Hereditary transthyretin amyloidosis in patients with cardiomyopathy (hATTR-CM) (initiated under specialist supervision).
• Voranigo® [vorasidenib] for Astrocytoma; Oligodendroglioma.