BNF January 2026 Update

This update contains 15 significant changes, 3 dose changes, 4 new
monographs, 1 deleted monograph, and 1 deleted preparation.

Significant Changes:

• Azithromycin: updated indication and dose for uncomplicated gonorrhoea
  and new indication and dose for gonococcal conjunctivitis.
• Cefixime: updated indications and dose for uncomplicated gonorrhoea
  and disseminated gonococcal infection.
• Cefotaxime: deleted indication and dose for disseminated gonococcal
  infection.
• Ceftriaxone: updated indication for uncomplicated gonorrhoea and
  updated indications and dose for disseminated gonococcal infections.
• Cefuroxime: new indication and dose for gonococcal conjunctivitis.
• Ciprofloxacin: updated indication and dose for disseminated gonococcal
  infection.
• Fluorouracil: new indication and dose for actinic keratosis.
• Genital system infections, antibacterial therapy: updated guidance for
  management of gonorrhoea: uncomplicated.
• Herpesvirus infections: updated guidance for post-exposure prophylaxis
  against chickenpox or shingles.
• Immunoglobulins: updated guidance for uses of normal immunoglobulin
  and varicella-zoster immunoglobulin.
• Life support algorithm (image): adult advanced life support algorithm
  image updated.
• Normal immunoglobulin: new dosing for post-exposure prophylaxis of
  varicella-zoster infection.
• Ofloxacin: new indications and dose for gonococcal urethritis and
  gonococcal cervicitis, and deleted indications and dose for
  uncomplicated gonorrhoea and disseminated gonococcal infection.
• Prescribing in palliative care: updated guidance for opioid dose
  conversions.
• Varicella-zoster vaccines: updated guidance for pre-exposure prophylaxis
  against varicella (chickenpox) and immunisation against herpes zoster
  (shingles).

Dose Changes:

• Herpes-zoster vaccine (recombinant, adjuvanted) [update to age range for immunisation against herpes zoster (shingles) in patients with severe immunosuppression].
• Lidocaine hydrochloride [update to dose for ventricular fibrillation or pulseless ventricular tachycardia refractory to defibrillation [for cardiopulmonary resuscitation as an alternative to amiodarone]].
• Varicella-zoster vaccine [update to dose interval for immunisation against varicella infection (chickenpox) for adults and children aged 1 year and older].

New Monographs:

• Hetronifly® [serplulimab].
• Jaypirca® [pirtobrutinib].
• Skyclarys® [omaveloxolone].
• Tepezza® [teprotumumab].

Deleted Monographs: Varicella-zoster immunoglobulin

Deleted Preparations: Varicella-zoster immunoglobulin solution for injection (Bio Products Laboratory).