BNF for Children 2011-2012

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400 7.3.1 Combined hormonal contraceptives BNFC 2011–20127 Obstetrics, gynaecology, and urinary-tract disordersday 4 of cycle or later, additional precautions(barrier methods) necessary during first 7 days;withdrawal bleeding occurs when inactive tabletsbeing taken; subsequent courses repeated withoutintervalPhasic preparations, see under individual preparationsbelowChanging to combined preparation containing differentprogestogen 21-day combined preparations: continuecurrent pack until last tablet and start first tablet ofnew brand the next day. If a 7-day break is taken beforestarting new brand, additional precautions (barriermethods) should be used during first 7 days (9 days forQlaira c ) of taking the new brandEvery Day (ED) combined preparations: start the newbrand (first tablet of a 21-day preparation or the firstactive tablet of an ED preparation) the day after takingthe last active tablet of previous brand (omitting theinactive tablets)Changing from progestogen-only tablet Start on day 1of menstruation or any day if amenorrhoea present andpregnancy has been excludedSecondary amenorrhoea (exclude pregnancy) Startany day, additional precautions (barrier methods)necessary during first 7 days (9 days for Qlaira c )After childbirth (not breast-feeding) Start 3 weeks afterbirth (increased risk of thrombosis if started earlier); laterthan 3 weeks postpartum additional precautions (barriermethods) necessary for first 7 days (9 days for Qlaira c )After abortion or miscarriage Start same day. By transdermal applicationApply first patch on day 1 of cycle, change patchon days 8 and 15; remove third patch on day 22and apply new patch after 7-day patch-free intervalto start subsequent contraceptive cycleNote If first patch applied later than day 1, additionalprecautions (barrier methods) should be used for the next7 daysChanging from combined oral contraception Applypatch on the first day of withdrawal bleeding; if nowithdrawal bleeding within 5 days of taking last activetablet, rule out pregnancy before applying first patch.Unless patch is applied on first day of withdrawalbleeding, additional precautions (barrier methods)should be used concurrently for first 7 daysChanging from progestogen-only method From animplant, apply first patch on the day implant removed;from an injection, apply first patch when next injectiondue; from oral progestogen, first patch may be started onany day after stopping pill. For all methods additionalprecautions (barrier methods) should be used concurrentlyfor first 7 daysAfter childbirth (not breast-feeding) Start 4 weeks afterbirth; if started later than 4 weeks after birth additionalprecautions (barrier methods) should be used for first 7daysAfter abortion or miscarriage Before 20 weeks’ gestationstart immediately; no additional contraceptionrequired if started immediately. After 20 weeks’ gestationstart on day 21 after abortion or on the first day of firstspontaneous menstruation; additional precautions (barriermethods) should be used for first 7 days afterapplying the patch. By vaginaInsert ring into vagina on day 1 of cycle and leavein for 3 weeks; remove ring on day 22; subsequentcourses repeated after 7-day ring-free interval(during which withdrawal bleeding occurs)Note If first ring inserted later than day 1, additionalprecautions (barrier methods) should be used for the next7 daysChanging from combined hormonal contraceptionInsert ring at the latest on the day after the usual tabletfree,patch-free, or placebo-tablet interval. If previouscontraceptive used correctly and pregnancy unlikely, canswitch to ring on any day of cycleChanging from progestogen-only method From animplant or intra-uterine progestogen-only device, insertring on the day implant or intra-uterine progestogen-onlydevice removed; from an injection, insert ring wheninjection next due; from oral preparation, first ring maybe inserted on any day after stopping pill. For all methodsadditional precautions (barrier methods) should be usedconcurrently for first 7 daysAfter first trimester abortion Start immediatelyAfter childbirth (not breast-feeding) or second trimesterabortion Start 4 weeks after birth or abortion; ifstarted later than 4 weeks after birth or abortion additionalprecautions (barrier methods) should be used forfirst 7 daysOral (low and standard strength)For information on these preparations, see CombinedOral Contraceptives table, p. 401Transdermal (standard strength)Ethinylestradiol with NorelgestrominSee Risk of Venous Thromboembolism (in notesabove) before prescribingEvra c (Janssen) APatches, self-adhesive (releasing ethinylestradiolapprox. 33.9 micrograms/24 hours and norelgestrominapprox. 203 micrograms/24 hours); net price 9-patch pack = £16.70. Counselling, administrationDose1 patch to be applied once weekly for three weeks,followed by a 7-day patch-free interval; subsequentcourses repeated after 7-day patch-free interval (duringwhich withdrawal bleeding occurs); for starting routinessee under Dose aboveNote Adhesives or bandages should not be used to holdpatch in place. If patch no longer sticky do not reapply butuse a new patch.The Scottish Medicines Consortium has advised (September2003) that Evra c patches should be restricted for use inwomen who are likely to comply poorly with combined oralcontraceptivesVaginal (low strength)Ethinylestradiol with EtonogestrelSee Risk of Venous Thromboembolism (in notesabove) before prescribingNuvaRing c (Organon) TAVaginal ring, releasing ethinylestradiol approx.15 micrograms/24 hours and etonogestrel approx.120 micrograms/24 hours, net price 3-ring pack =£27.00. Counselling, administrationDose1 ring to be inserted into the vagina for 3 weeks, removedon day 22; subsequent courses repeated after 7-day ringfreeinterval (during which withdrawal bleeding occurs);for starting routines see under Dose aboveCounselling The presence of the ring should be checkedregularly. In case of expulsion see Expulsion, DelayedInsertion or Removal, or Broken Vaginal Ring, p. 397
BNFC 2011–2012 7.3.1 Combined hormonal contraceptives 401Combined Oral ContraceptivesSee Risk of Venous Thromboembolism (in notes above) before prescribingType of preparation OestrogencontentProgestogencontentTabletsper cycleBrand Price, 3-cycle pack(unlessstated)1 Monophasic lowstrength (21-daypreparations)1 Monophasicstandard strength(21-daypreparations)3 Monophasicstandard strength(28-day ‘Every day’preparations)Ethinylestradiol20 microgramsEthinylestradiol30 microgramsEthinylestradiol35 microgramsMestranol50 microgramsEthinylestradiol30 microgramsEthinylestradiol30 microgramsDesogestrel150 microgramsGestodene75 microgramsNorethisteroneacetate 1 mgDesogestrel150 microgramsDrospirenone3 mgGestodene75 microgramsLevonorgestrel150 microgramsNorethisteroneacetate 1.5 mgNorgestimate250 microgramsNorethisterone500 microgramsNorethisterone1 mgNorethisterone1 mgGestodene75 microgramsLevonorgestrel150 microgramsManufacturer21 Gedarel c 20/150 £5.98 ConsilientMercilon c £7.97 Organon21 Femodette c £8.85 Bayer ScheringMillinette c 20/75 £6.37 ConsilientSunya 20/75 c £6.62 Stragen21 Loestrin 20 c £2.75 Galen21 Gedarel c 30/150 £4.93 ConsilientMarvelon c £6.45 Organon212 Yasmin c £14.70 Bayer Schering21 Femodene c £6.73 Bayer ScheringKatya 30/75 c £5.03 StragenMillinette c 30/75 £4.85 Consilient21 Levest c £2.55 MorningsideMicrogynon 30 c £2.82 Bayer ScheringOvranette c £2.20 WyethRigevidon c £1.89 Consilient21 Loestrin 30 c £3.95 Galen21 Cilest c 3-cyclepack =£2.87;6-cyclepack =£5.74Janssen21 Brevinor c £1.99 PharmaciaOvysmen c £1.49 Janssen21 Norimin c £2.28 Pharmacia21 Norinyl-1 c £2.19 Pharmacia21 active Femodene c ED £6.73 Bayer Schering7 inactive21 active Microgynon 30 £2.54 Bayer ScheringED c7 inactive7 Obstetrics, gynaecology, and urinary-tract disorders1. Dose 1 tablet daily for 21 days starting on day 1 of cycle; subsequent courses repeated after 7-day tablet-free interval (duringwhich withdrawal bleeding occurs); for starting routines see under Dose above2. Caution use with care if increased plasma-potassium concentration might be hazardous; renal impairment avoid if eGFR lessthan 30 mL/minute/1.73 m 23. Dose 1 tablet daily for 28 days, starting on day 1 of cycle with first active tablet (withdrawal bleeding occurs when inactivetablets being taken); subsequent courses repeated without interval; for starting routines see under Dose above
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Medicines information servicesInfor
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Published byBMJ GroupTavistock Squa
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iv BNFC 2011-2012PrefaceBNF for Chi
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vi BNFC 2011-2012BNF StaffDigital D
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viii BNFC 2011-2012Nurse Prescriber
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x BNFC 2011-2012. incorporating the
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xii BNFC 2011-2012prescribing notes
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Branded oral liquid preparations th
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xvi BNFC 2011-2012Finding significa
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xviii BNFC 2011-2012Epilim Chronosp
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xx BNFC 2011-2012Tears Naturale c S
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2 General guidance BNFC 2011-2012Ge
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4 Prescription writing BNFC 2011-20
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6 Supply of medicines BNFC 2011-201
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8 Emergency supply of medicines BNF
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10 Prescribing Controlled Drugs BNF
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Adverse reactions to drugs12 Advers
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Prescribing in hepatic impairment14
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Prescribing in pregnancy16 Prescrib
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18 Prescribing in palliative care B
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20 Prescribing in palliative care B
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22 Prescribing in dental practice B
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Emergency treatment of poisoning24
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26 Emergency treatment of poisoning
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36 1.1.1 Antacids and simeticone BN
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38 1.1.2 Compound alginate preparat
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40 1.2 Antispasmodics and other dru
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42 1.3 Antisecretory drugs and muco
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44 1.3.3 Chelates and complexes BNF
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46 1.4 Acute diarrhoea BNFC 2011-20
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48 1.5 Chronic bowel disorders BNFC
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50 1.5.1 Aminosalicylates BNFC 2011
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52 1.5.1 Aminosalicylates BNFC 2011
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54 1.5.3 Drugs affecting the immune
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56 1.5.4 Food allergy BNFC 2011-201
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58 1.6.1 Bulk-forming laxatives BNF
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60 1.6.2 Stimulant laxatives BNFC 2
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62 1.6.4 Osmotic laxatives BNFC 201
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64 1.6.5 Bowel cleansing preparatio
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66 1.7 Local preparations for anal
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68 1.8 Stoma and enteral feeding tu
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70 1.9.2 Bile acid sequestrants BNF
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72 1.9.4 Pancreatin BNFC 2011-20121
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74 2.1.1 Cardiac glycosides BNFC 20
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76 2.2 Diuretics BNFC 2011-20122 Ca
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78 2.2.2 Loop diuretics BNFC 2011-2
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BNFC 2011-2012 2.2.4 Potassium-spar
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BNFC 2011-2012 2.3.2 Drugs for arrh
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BNFC 2011-2012 2.3.2 Drugs for arrh
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BNFC 2011-2012 2.4 Beta-adrenocepto
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BNFC 2011-2012 2.5.1 Vasodilator an
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BNFC 2011-2012 2.5.4 Alpha-adrenoce
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BNFC 2011-2012 2.5.5 Drugs affectin
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BNFC 2011-2012 2.5.5 Drugs affectin
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BNFC 2011-2012 2.6.2 Calcium-channe
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BNFC 2011-2012 2.7.1 Inotropic symp
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BNFC 2011-2012 2.7.2 Vasoconstricto
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BNFC 2011-2012 2.8.1 Parenteral ant
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BNFC 2011-2012 2.8.1 Parenteral ant
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BNFC 2011-2012 2.8.2 Oral anticoagu
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BNFC 2011-2012 2.10 Myocardial infa
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BNFC 2011-2012 2.11 Antifibrinolyti
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BNFC 2011-2012 2.12 Lipid-regulatin
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BNFC 2011-2012 2.14 Drugs affecting
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BNFC 2011-2012 1333 Respiratory sys
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BNFC 2011-2012 3.1 Bronchodilators
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BNFC 2011-2012 3.1.1 Adrenoceptor a
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BNFC 2011-2012 3.1.1 Adrenoceptor a
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BNFC 2011-2012 3.1.2 Antimuscarinic
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BNFC 2011-2012 3.1.3 Theophylline 1
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BNFC 2011-2012 3.1.5 Peak flow mete
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BNFC 2011-2012 3.2 Corticosteroids
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BNFC 2011-2012 3.2 Corticosteroids
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BNFC 2011-2012 3.3 Cromoglicate and
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BNFC 2011-2012 3.4 Antihistamines,
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BNFC 2011-2012 3.4.1 Antihistamines
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BNFC 2011-2012 3.4.2 Allergen immun
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BNFC 2011-2012 3.4.3 Allergic emerg
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BNFC 2011-2012 3.4.3 Allergic emerg
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BNFC 2011-2012 3.6 Oxygen 163ment
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BNFC 2011-2012 3.7 Mucolytics 165HO
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BNFC 2011-2012 3.9 Cough preparatio
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BNFC 2011-2012 1694 Central nervous
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BNFC 2011-2012 4.1.2 Anxiolytics 17
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BNFC 2011-2012 4.2.1 Antipsychotic
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BNFC 2011-2012 4.3 Antidepressant d
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BNFC 2011-2012 4.3.1 Tricyclic anti
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BNFC 2011-2012 4.3.3 Selective sero
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BNFC 2011-2012 4.4 CNS stimulants a
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BNFC 2011-2012 4.5 Drugs used in th
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BNFC 2011-2012 4.6 Drugs used in na
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BNFC 2011-2012 4.7 Analgesics 199Sc
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BNFC 2011-2012 4.7.1 Non-opioid ana
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BNFC 2011-2012 4.7.2 Opioid analges
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BNFC 2011-2012 4.7.4 Antimigraine d
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BNFC 2011-2012 4.8 Antiepileptics 2
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BNFC 2011-2012 4.8.1 Control of the
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BNFC 2011-2012 4.8.2 Drugs used in
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BNFC 2011-2012 4.8.3 Febrile convul
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BNFC 2011-2012 4.9.2 Antimuscarinic
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BNFC 2011-2012 4.10.2 Nicotine depe
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BNFC 2011-2012 4.10.2 Nicotine depe
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BNFC 2011-2012 5.1 Antibacterial dr
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BNFC 2011-2012 5.1.1 Penicillins 25
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BNFC 2011-2012 5.1.2 Cephalosporins
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BNFC 2011-2012 5.1.3 Tetracyclines
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BNFC 2011-2012 5.1.4 Aminoglycoside
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BNFC 2011-2012 5.1.4 Aminoglycoside
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BNFC 2011-2012 5.1.5 Macrolides 281
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BNFC 2011-2012 5.1.6 Clindamycin 28
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BNFC 2011-2012 5.1.7 Some other ant
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BNFC 2011-2012 5.1.7 Some other ant
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BNFC 2011-2012 5.1.8 Sulfonamides a
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BNFC 2011-2012 5.1.9 Antituberculos
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BNFC 2011-2012 5.1.9 Antituberculos
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BNFC 2011-2012 5.1.11 Metronidazole
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BNFC 2011-2012 5.1.12 Quinolones 29
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BNFC 2011-2012 5.1.13 Urinary-tract
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BNFC 2011-2012 5.2.1 Triazole antif
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BNFC 2011-2012 5.2.1 Triazole antif
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BNFC 2011-2012 5.2.2 Imidazole anti
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BNFC 2011-2012 5.2.4 Echinocandin a
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BNFC 2011-2012 5.3 Antiviral drugs
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BNFC 2011-2012 5.3.1 HIV infection
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BNFC 2011-2012 5.3.2 Herpesvirus in
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BNFC 2011-2012 5.3.2 Herpesvirus in
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BNFC 2011-2012 5.3.3 Viral hepatiti
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BNFC 2011-2012 5.3.5 Respiratory sy
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BNFC 2011-2012 5.4 Antiprotozoal dr
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BNFC 2011-2012 5.4.1 Antimalarials
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BNFC 2011-2012 5.4.2 Amoebicides 33
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BNFC 2011-2012 5.4.6 Trypanocides 3
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BNFC 2011-2012 5.4.8 Drugs for pneu
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BNFC 2011-2012 5.5.2 Ascaricides 34
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BNFC 2011-2012 5.5.8 Drugs for stro
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BNFC 2011-2012 9.2.1 Oral preparati
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BNFC 2011-2012 9.2.1 Oral preparati
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BNFC 2011-2012 9.2.2 Parenteral pre
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BNFC 2011-2012 9.3 Intravenous nutr
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BNFC 2011-2012 9.4.2 Enteral nutrit
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BNFC 2011-2012 9.5 Minerals 471dren
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BNFC 2011-2012 9.5.1 Calcium and ma
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BNFC 2011-2012 9.5.2 Phosphorus 475
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BNFC 2011-2012 9.5.3 Fluoride 477Ch
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BNFC 2011-2012 9.6.2 Vitamin B grou
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BNFC 2011-2012 9.6.3 Vitamin C 481I
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BNFC 2011-2012 9.6.4 Vitamin D 483N
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BNFC 2011-2012 9.6.5 Vitamin E 4851
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BNFC 2011-2012 9.6.7 Multivitamin p
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BNFC 2011-2012 9.8.2 Acute porphyri
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BNFC 2011-2012 49910 Musculoskeleta
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BNFC 2011-2012 10.1.1 Non-steroidal
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BNFC 2011-2012 10.1.3 Drugs that su
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BNFC 2011-2012 10.1.3 Drugs that su
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BNFC 2011-2012 10.1.4 Gout and cyto
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BNFC 2011-2012 10.2.2 Skeletal musc
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BNFC 2011-2012 10.2.2 Skeletal musc
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BNFC 2011-2012 51711 Eye11.1 Admini
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BNFC 2011-2012 11.3.1 Antibacterial
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BNFC 2011-2012 11.4.2 Other anti-in
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BNFC 2011-2012 11.6 Treatment of gl
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BNFC 2011-2012 11.6 Treatment of gl
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BNFC 2011-2012 11.7 Local anaesthet
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BNFC 2011-2012 11.8.1 Tear deficien
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BNFC 2011-2012 11.9 Contact lenses
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BNFC 2011-2012 12.1.1 Otitis extern
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BNFC 2011-2012 12.1.2 Otitis media
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BNFC 2011-2012 12.2.2 Topical nasal
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BNFC 2011-2012 12.3 Drugs acting on
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BNFC 2011-2012 12.3.2 Oropharyngeal
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BNFC 2011-2012 12.3.5 Treatment of
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BNFC 2011-2012 13.1.1 Vehicles 551m
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BNFC 2011-2012 13.2.1 Emollients 55
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BNFC 2011-2012 13.3 Topical antipru
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BNFC 2011-2012 13.5.3 Drugs affecti
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BNFC 2011-2012 13.6.1 Topical prepa
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BNFC 2011-2012 13.6.1 Topical prepa
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BNFC 2011-2012 13.6.2 Oral preparat
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BNFC 2011-2012 13.7 Preparations fo
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BNFC 2011-2012 13.8.2 Camouflagers
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BNFC 2011-2012 13.10 Anti-infective
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BNFC 2011-2012 13.10.1 Antibacteria
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BNFC 2011-2012 13.10.2 Antifungal p
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BNFC 2011-2012 13.10.3 Antiviral pr
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BNFC 2011-2012 13.11.2 Chlorhexidin
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BNFC 2011-2012 13.12 Antiperspirant
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BNFC 2011-2012 59914 Immunological
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BNFC 2011-2012 14.1 Active immunity
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BNFC 2011-2012 14.5.1 Normal Immuno
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BNFC 2011-2012 14.6 International t
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BNFC 2011-2012 15.1.1 Intravenous a
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BNFC 2011-2012 15.1.1 Intravenous a
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BNFC 2011-2012 15.1.2 Inhalational
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BNFC 2011-2012 15.1.3 Antimuscarini
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BNFC 2011-2012 15.1.5 Neuromuscular
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BNFC 2011-2012 15.1.5 Neuromuscular
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BNFC 2011-2012 15.1.7 Antagonists f
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BNFC 2011-2012 655A1InteractionsTwo
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BNFC 2011-2012 Appendix 1: Interact
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BNFC 2011-2012 743A2Borderline subs
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Nutrison c(Nutricia Clinical)Nutris
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A2.1.2 Enteral feeds (non-disease s
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A2.1.2.2 Enteral feeds: Less than 1
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A2.1.3 Enteral feeds (non-disease s
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Infatrini c(Nutricia Clinical)Nutri
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Frebini c EnergyDrink(Fresenius Kab
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A2.2.1.2 Nutritional supplements: M
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Fortisip c Range(Nutricia Clinical)
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Forticreme cComplete(Nutricia Clini
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A2.3 Specialised formulasA2.3.1 Spe
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Nutramigen c Lipil 2(Mead Johnson)S
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Specialised formulas: Infant and ch
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KetoCal c(SHS)Standard dilution(20
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A2.4 Feed supplementsA2.4.1 High-en
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Medium-chainTriglyceride (MCT)Oil(S
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Calshake c(Fresenius Kabi)Powderper
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BNFC 2011-2012 A2.5 Feed additives
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BNFC 2011-2012 A2.6.1 Gluten-free f
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BNFC 2011-2012 A2.7 Nutritional sup
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BNFC 2011-2012 Appendix 3: Cautiona
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BNFC 2011-2012 791A4Intravenous inf
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BNFC 2011-2012 Appendix 4: Intraven
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BNFC 2011-2012 Dental Practitioners
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BNFC 2011-2012 Nurse Prescribers’
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BNFC 2011-2012 799Non-medical presc
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BNFC 2011-2012 Index of manufacture
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BNFC 2011-2012 809Special-orderManu
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BNFC 2011-2012 Abacavir—Alfacalci
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BNFC 2011-2012 Anthelios—Arthrofe
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BNFC 2011-2012 Benzodiazepines—Bu
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BNFC 2011-2012 Cetrimide—Cocaine
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BNFC 2011-2012 Coumarins—Dermatop
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BNFC 2011-2012 Disinfectants—Emer
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BNFC 2011-2012 Eye—Formaldehyde 8
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BNFC 2011-2012 Glycogen—Homatropi
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BNFC 2011-2012 Ibuprofen—Iodide 8
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BNFC 2011-2012 Laxatives—Magnesiu
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BNFC 2011-2012 Methylenedioxymetham
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BNFC 2011-2012 Nicardipine—Oftaqu
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BNFC 2011-2012 Paramax—Plaquenil
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BNFC 2011-2012 Procarbazine—Regul
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BNFC 2011-2012 Scottish—Sodium 83
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BNFC 2011-2012 Syringes—Tocophero
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BNFC 2011-2012 Ursofalk—Waxsol 84
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NEWBORN LIFE SUPPORTDry the babyRem
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PAEDIATRIC ADVANCED LIFE SUPPORTUnr
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BODY SURFACE AREA IN CHILDRENBody-w
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Croup(section 3.1)Dexamethasone ora
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Recommended wording of cautionaryan
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BNF for Children 2011-2012

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