British National Formulary

The British National Formulary (BNF) is a United Kingdom (UK) pharmaceutical reference book that contains a wide spectrum of information and advice on prescribing and pharmacology, along with specific facts and details about many medicines available on the UK National Health Service (NHS). Information within the BNF includes indication(s), contraindications, side effects, doses, legal classification, names and prices of available proprietary and generic formulations, and any other notable points.[1] Though it is a national formulary, it nevertheless also includes entries for some medicines which are not available under the NHS, and must be prescribed and/or purchased privately. A symbol clearly denotes such drugs in their entry.

British National Formulary (BNF)
The cover of BNF 73 (March 2017)
AuthorPharmaceutical Press, the Royal Pharmaceutical Society's knowledge business
LanguageBritish English
SubjectMedicine, Pharmacy
GenreMedicines Information
PublisherBMJ and
Pharmaceutical Press
Publication date
September 2022 (84th edition)
Publication placeUnited Kingdom
Media typePaperback print, digital online, smartphone app
Pages1,844
ISBN978-0-85711-432-7
OCLC1338666044
Websitewww.bnf.org

It is used by pharmacists and doctors (both general practitioners (GPs) and generalist hospital practitioners, and by other prescribing healthcare professionals (such as nurses, pharmacy technicians, paramedics, and dentists)); as a reference for correct dosage, indication, interactions and side effects of drugs. It is also used as a reassurance by those administering drugs, for example a nurse on a hospital ward, and even for patients and others seeking an authoritative source of advice on any aspect of pharmacotherapy.

Development

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Many individuals and organisations contribute towards the preparation of the BNF. It is authored by Pharmaceutical Press, the Royal Pharmaceutical Society's (RPS) knowledge business; and is jointly published by the BMJ (owned by the BMA), and Pharmaceutical Press (owned by the RPS). It is published under the authority of a Joint Formulary Committee (JFC),[2] which comprises pharmacy, medical, nursing, and lay representatives; there are also representatives from the Medicines and Healthcare products Regulatory Agency (MHRA), the UK Health Departments, and a national guideline producer.

Information on drugs is drawn from the manufacturers' product literature, medical and pharmaceutical literature, 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 Joint Formulary Committee takes advice on all therapeutic areas from advisers from expert groups; this ensures that the BNF's recommendations are relevant to practice. In September 2016, the National Institute for Health and Care Excellence (NICE) in the UK gave NICE accreditation to the processes to produce BNF publications; a further review in 2021 resulted in the successful renewal of accreditation.[3]

History

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It was first published in 1949,[2] as the National Formulary, with updated versions appearing every three years until 1976. The fifth version in 1957 saw its name change to The British National Formulary.[4][5] A new-look version, under the auspices of Owen Wade, was released in 1981.[2][6] A study in Northern Ireland, looking at prescribing in 1965, reported that the BNF was likely able to serve the requirements of prescribers in general practice, while also achieving a cost saving.[7] By 2003, issue 46 of the BNF contained 3000 interactions or groups of interactions, with about 900 of these marked by a bullet.[8][9][10][11][12]

Editions

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A new edition of the BNF book is published twice-yearly, in March and September.[1] The current edition is 87, which was published in March 2024. It is a tradition that the colour of each new edition is radically different from the previous.[2]

Availability

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The BNF is presently available as a book, a website, and mobile applications - the latter for use on smartphones and tablets.[2] The book is available for purchase, and the September edition is distributed to healthcare professionals in the UK at no direct cost to them.[1][13] NHS workers and healthcare professionals in the HINARI group of developing nations are entitled to free access via MedicinesComplete following registration (requires provision of a name, an address, an email address, and a phone number). Other visitors can subscribe to the BNF on MedicinesComplete.[14] Healthcare organisations can also subscribe to a customisable BNF via their corporate online intranet.[15] In 2017, BNF Publications released applications for offline access to the BNF on iOS and Android devices. Monthly content updates are available, over an internet connection.[16] NICE provides a website providing the content of the BNF to the public, including non-NHS users.[17]

The BNF also includes the Nurse Prescribers' Formulary (NPF) and other NPF content for use by District Nurses and Specialist Community Public Health Nurses (including Health Visitors), who have received training to become nurse prescribers.[18]

Sister publications

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The British National Formulary for Children (BNFC)[1][19][20] book, first published September 2005,[2] is published yearly,[2] and details the doses and uses of medicines in children from neonates to adolescents.[1]

BNF sections

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The British National Formulary is divided into various sections; with the main sections on drugs and preparations being organised by body system.

Table of Contents
  • Preface
  • Acknowledgements
  • How BNF publications are constructed
  • How to use the BNF
  • Changes
  • Guidance on prescribing
  • Prescription writing
  • Emergency supply of medicines
  • Controlled drugs and drug dependence
  • Adverse reactions to drugs
  • Guidance on intravenous infusions
  • Medicines optimisation
  • Antimicrobial stewardship
  • Prescribing for children
  • Prescribing in hepatic impairment
  • Prescribing in renal impairment
  • Prescribing in pregnancy
  • Prescribing in breast-feeding
  • Prescribing in palliative care
  • Prescribing for the elderly
  • Drugs and sport
  • Prescribing in dental practice
Notes on drugs and preparations
  1. Gastro-intestinal system
  2. Cardiovascular system
  3. Respiratory system
  4. Nervous system
  5. Infection
  6. Endocrine system
  7. Genito-urinary system
  8. Malignant disease
  9. Blood and nutrition
  10. Musculoskeletal system
  11. Eye
  12. Ear, nose, and oropharynx
  13. Skin
  14. Vaccines
  15. Anaesthesia
  16. Emergency treatment of poisoning
Appendices and indices
  • Appendix 1 Interactions
  • Appendix 2 Borderline substances
  • Appendix 3 Cautionary and advisory labels for dispensed medicines
  • Appendix 4 Wound management products and elasticated garments
  • Dental Practitioners' Formulary
  • Nurse Prescribers' Formulary
  • Non-medical prescribing
  • Index of proprietary manufacturers
  • Special-order manufacturers

See also

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References

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  1. ^ a b c d e "BNF Publications - Books". www.bnf.org. BMJ Group and Royal Pharmaceutical Society. Archived from the original on 17 August 2016. Retrieved 16 August 2016.
  2. ^ a b c d e f g "BNF Publications - About - Our organisation". www.bnf.org. BMJ Group and Royal Pharmaceutical Society. Archived from the original on 17 August 2016. Retrieved 16 August 2016.
  3. ^ "Accreditation decisions". NICE. September 2021. Retrieved 9 January 2023.
  4. ^ Anon (1957). "The British National Formulary". British Medical Journal. 2 (5047): 758–759. PMC 1962234. PMID 13460381.
  5. ^ Wade, O. L. (1993). "British National Formulary: Its birth, death, and rebirth". BMJ (Clinical Research Ed.). 306 (6884): 1051–1054. doi:10.1136/bmj.306.6884.1051. PMC 1676980. PMID 8490505.
  6. ^ Anon (1978). "British National Formulary 1976-8". British Medical Journal. 2 (6136): 580–581. doi:10.1136/bmj.2.6136.580-b. PMC 1606955. PMID 20792725.
  7. ^ Wade, O. L.; McDevitt, G. D. (1966). "Prescribing and the British National Formulary". British Medical Journal. 2 (5514): 635–637. doi:10.1136/bmj.2.5514.635. PMC 1943465. PMID 20791099.
  8. ^ Aronson, J. K. (2004). "Drug interactions-information, education, and the British National Formulary". British Journal of Clinical Pharmacology. 57 (4): 371–372. doi:10.1111/j.1365-2125.2004.02125.x. PMC 1884473. PMID 15025733.
  9. ^ VNRAS.com, BNF 73. "BNF 73" (PDF). Archived (PDF) from the original on 21 October 2021.{{cite web}}: CS1 maint: numeric names: authors list (link)
  10. ^ VNRAS.com. "BNF for Children BNFC 2019-2020" (PDF). Archived from the original (PDF) on 11 October 2021. Retrieved 1 May 2022.
  11. ^ "BNF 78" (PDF).
  12. ^ "BNF for Children BNFC 2019-2020" (PDF). Archived from the original (PDF) on 11 October 2021. Retrieved 1 May 2022.
  13. ^ "BNF - NHS Evidence - Search Engine for Evidence in Health and Social Care". Archived from the original on 1 October 2012. Retrieved 2012-06-14.
  14. ^ "Digital Medicines Information Suite". Archived from the original on 19 December 2008. Retrieved 22 December 2008. MedicinesComplete
  15. ^ "BNF FormularyComplete". Archived from the original on 25 September 2011. BNF on FormularyComplete
  16. ^ "NICE apps for smartphones and tablets". www.nice.org.uk. National Institute for Health and Care Excellence. April 2014. Archived from the original on 13 August 2014. Retrieved 19 July 2014.
  17. ^ "BNF (British National Formulary". nice.org.uk. Retrieved 4 August 2023.
  18. ^ "BNF is only available in the UK". NICE. Retrieved 9 November 2023.
  19. ^ Elias-Jones, A.; Rylance, G. (2005). "The launch of the British National Formulary for Children". Archives of Disease in Childhood. 90 (10): 997–998. doi:10.1136/adc.2005.080366. PMC 1720111. PMID 16177154.
  20. ^ "BNFC.org". Archived from the original on 20 December 2007. Retrieved 2006-09-07. British National Formulary for Children
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