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In an increasingly paper‐free healthcare system, you may not have access to paper copies of the BNFc. The BNFc has an online platform accessed via the National Institute for Health and Care Excellence (NICE), or via Medicines Complete (https://about.medicinescomplete.com/) as well as an offline app that can be used on smart phones and tablets. The BNF for Children (https://bnfc.nice.org.uk/) and BNF online (https://bnf.nice.org.uk/) are updated monthly and as such is more up‐to‐date than the print version and does not require a specific log in. The app is automatically updated monthly (when connected to Wi‐Fi).

When you visit the home page of the BNFc online (via NICE) you are presented with clear options for navigation. All the same information is held online as in print – but navigation is different. Drugs (as drug monographs), interactions and treatment summaries can be searched for by browsing an alphabetised list or the search bar at the top of the web page. The home page also has a ‘type’ organisation where quick access to areas such as wound management, borderline substances and nurse prescribers’ formularies can be found.

Searching for atenolol (for example) and opening its page displays information under the atenolol drug monograph. A table of contents is provided for rapid navigation of the subsections available. On scrolling down the opening page, indications and dose are clearly presented alongside routes of administration. Next, licensing information, safety information and contraindications are displayed.

Cautionary and advisory labels are indicated when medicinal form is selected both by label number and the associated text. In addition, the schedule of any controlled drug is clearly documented in its medicinal form information.

Associated class monograph information are integrated throughout the chosen drug monograph and are indicated by the phrasing ‘for all … ’ . An example of this can be seen in the contraindications for atenolol (Figure 2.2)

Searching for interactions is managed within a dedicated interactions section by an initial drug search and then matching to a subsequent alphabetical list. The associated interaction is discussed in terms of potential effects of the interaction, signposting to relevant additional sections of the BNFc such as ‘safety in the home’ in ‘Guidance on prescribing’ and have associated hyperlinks for ease. Severity of interactions are defined using terms of severe, moderate, mild and unknown to support decision making alongside the type of evidence underpinning the interaction information.

Figure 2.2 Contraindication and class monograph.

Key to safe and accountable practice is the recognition and reporting of suspected adverse reactions or effects of medication. The BNF and BNFc support active reporting of adverse reactions by both healthcare professionals and patients themselves or their carers. Using the Yellow Card Scheme, the MHRA collects information on medications, vaccines, herbal treatments, medical devices, defective medications and from 2016 counterfeit or fake healthcare products. The print copy of the BNF and BNFc have a small supply of yellow cards in the back matter. Alternatively, concerns can be raised using the UK Medicines and Healthcare Products Regulatory Agency (MHRA) Yellow card webpage (https://yellowcard.mhra.gov.uk/). Chapter 19 provides more details of this.