The NZF and NZFC are resources available free of charge for all healthcare professionals prescribing, dispensing and administering medicines across community and hospital care. The NZF and NZFC address the need for general purpose, point-of-care information about the use of medicines in New Zealand. These resources aid decision making and contribute to best practice through standardised and evidence-based information about medicines.
The editorial team are unable to comment on individual cases and cannot enter into correspondence with patients (or their relatives). These matters are best dealt with by health professionals who are familiar with all the circumstances surrounding the case.
We encourage patients to talk to their healthcare provider if they have any queries about their medicines.
Healthcare professionals should contact an appropriate medicines information centre for patient-specific information not included in the NZF or NZFC.
The NZF and NZFC receive many comments which we are very grateful for. Readers of the NZF and NZFC should note that these publications are an aide memoire for use by practitioners with a high level of background knowledge about medicines, and are not exhaustive in their coverage. Supplementary information is available from the Medicine Data Sheets.
If you want to contact the NZF or NZFC, please comment via the feedback button at the top right-hand side of the webpage.
Alternatively you may email the team at firstname.lastname@example.org.
The style for referencing the NZF is as follows:
New Zealand Formulary (NZF). NZF v[Number]. [Year]. Available from: www.nzf.org.nz (Accessed [Month], [Year]).
The style for referencing the NZFC is as follows:
New Zealand Formulary for Children (NZFC). NZFC v[Number]. [Year]. Available from: www.nzfchildren.org.nz (Accessed [Month], [Year]).
The NZF team are currently investigating the development of an iPhone/iPad and android portable application. Until this is produced, the website and pdf's can be used on mobile devices. To download the pdf, go to Download
Yes, the NZF icon can be attached to the Medtech32 toolbar to allow easy access to the website. Full instructions about how to install the icon on the Medtech32 toolbar are available here: NZF or NZFC.
In recent years, the naming of medicines has moved towards using recommended International Nonproprietary Names (rINNs) instead of British Approved Names (BANs). This follows the World Health Organisation’s recommendations for the nomenclature of drugs, to reduce medication error arising from two different names. The NZF may include the BAN in the monograph, written underneath the monograph title as a synonym (either spelling is searchable within the NZF).
We appreciate that such an expansion of the NZF and NZFC would simplify practitioners’ access to various treatment options. However, it is outside the scope of the NZF and NZFC to include information about complementary and alternative medicines.
Owing to the large number of frequently changing products that are available for purchase, it is difficult to maintain lists of preparations on sale to the public accurately, and the NZF considers that incomplete or out of date information is potentially dangerous. To identify the active ingredients in preparations on sale to the public, it is safer to consult the product literature, the retailer, or the manufacturer.
The NZF and NZFC include information on the available medicine products listed on the New Zealand Universal List of Medicines (NZULM) and Medsafe websites. If a medicine is discontinued, the monograph is retained in the NZF and NZFC for at least 6 months and then archived. The NZF and NZFC do not include information on availability due to supply issues—for this information, contact a pharmacist or medicines wholesaler.
The NZF and NZFC are updated each month and significant changes such as new monographs are listed in the Changes for this release section. However due to the editorial processes, monographs may not be available when a new medicine is listed on the NZULM. If a medicine is listed as “Not available” on the Medsafe website, the NZF will not usually include a monograph for this medicine unless it is subsidised for use by PHARMAC.
In the preparation group at the bottom of a drug monograph there is a list of available preparations for that medicine. A green symbol beside the medicine pack size indicates if it is fully () or partially () subsidised. Clicking on the Show Hospital Medicines List Status button (above the key) displays whether a medicine is on the Hospital Medicine List by showing the symbol beside the listed pack.
If PHARMAC restrictions exists for a particular preparation, the word ‘restrictions’ appears next to it with a dotted underline. This can be clicked on to hold open a box outlining the PHARMAC restrictions. Links to any relevant special authority forms will also appear in this restrictions box.
In the preparation group at the bottom of a drug monograph there is a list of available preparations for that medicine. If PHARMAC restrictions exists for a particular preparation, it is indicated by the word ‘restrictions’ with the dotted underline. This can be clicked on to hold open a box outlining the PHARMAC restrictions. Links to any relevant special authority form (as a printable PDF) will appear in this restrictions box.
In the preparation group at the bottom of a drug monograph there is a list of available preparations for that medicine. If a medicine datasheet is available it is indicated by a document icon () after the product brand name. This can be clicked on to open a link to the Medicine Data Sheet held on the Medsafe website.
The NZF hosts the Pharmaceutical Society of New Zealand Cautionary and Advisory Labels (CALs), which are additional instructions or advice added to the medicine container or dispensing label at the time of dispensing. They are intended to prompt further discussion between patients and health providers. A medicine's CAL can be found in the product information at the bottom of the drug monograph. The information can be displayed by clicking on the yellow CALs icon. The Pharmaceutical Society of New Zealand is responsible for CALs and should be contacted for any related queries.
It is recognised that there may be occasions when pharmacists will use their knowledge and professional discretion and decide to omit one or more of the recommended labels for a particular patient. In this case patient counselling takes on even greater importance.
There is no drug pricing information included on the NZF website because the cost of drugs can vary between different wholesalers and pharmacies. This can be confusing and inaccurate for consumers and health professionals. For current drug pricing information, the NZF recommends contacting a pharmacist. The PHARMAC Schedule also contains pharmacy acquisition cost for subsidised medicines.
Occasionally where a particular clinical need has been identified, the NZF gives information on the use of section 29 unapproved medicines, or the use of approved medicines in an unapproved way (‘off-label' use). Such information is included on the basis of evidence of safety and efficacy, and advice from clinical experts.
The manufacturer’s Medicine Data Sheet is an important source of information used when creating content for the NZF and NZFC; however, the NZF and NZFC are not simply abridged versions of Medicine Data Sheets. The NZF and NZFC provide independent, general and concise advice about a medicine, derived from numerous resources including the Medicine Data Sheets, the BNF, and expert advice. This means that the NZF and NZFC entries may not be entirely consistent with the manufacturers' literature.
Information from other New Zealand sources (such as journal articles, Prescriber Update issued by Medsafe) are also incorporated into the NZF and NZFC.
The peanut oil used in medicines is highly refined and the majority, if not all, of the peanut protein is removed during manufacturing. However, as life-threatening allergic reactions can occur with minimal exposure to peanut, caution is recommended with the use of medicines containing peanut oil in patients with a known peanut allergy. See Beware - Peanut Oil is Present in Some Medicines, Prescriber Update June 2012.
The malignant disease section of the NZF includes information about the indications of Cytotoxic drugs as well as some of the principle adverse effects associated with them. Because oncology is an area that is likely to be managed by specialists, the NZF does not include detail of chemotherapy regimens. Such information is best obtained from up-to-date local treatment protocols. In addition, many cancer treatments take place within the context of clinical trials and it is not possible to include the necessary information in the NZF.
An association between the use of chloramphenicol eye drops and aplastic anaemia has been suggested. Case-control studies involving a population of 40 million people found no evidence of an increased risk (Wiholm B-E et al. Relation of aplastic anaemia to use of chloramphenicol eye drops in two international case-control studies. BMJ 1998; 316: 666). Another study (Lancaster T et al. Risk of serious haematological toxicity with use of chloramphenicol eye drops in a British general practice database. BMJ 1998; 316: 667), using a UK general practice database, identified 442 543 patients who received 674 148 prescriptions for chloramphenicol eye drops, 3 individuals experienced serious haematological toxicity.
Recommendations to avoid use of chloramphenicol eye drops therefore appear to be not well founded and the NZF considers it the drug of choice for superficial eye infections.
The NZF and NZFC includes information on food substitutes and formulas that are used for special medical purposes, which doctors and some dietitians can prescribe for people with diagnosed food conditions and metabolic disorders. Some of these may be obtained on a prescription from pharmacies; some are also sold in supermarkets and pharmacies.
The NZF presents two options for obtaining information about drug interactions: Stockley’s Interaction Alerts and BNF interaction summaries (synonymous with Appendix 1 in the BNF).
In the clinical notes of the NZF (notes on conditions and drug groups) there are links to BNF interaction summaries (see below). This gives a summary of the interactions of the associated drug group or class. This is a good option for an overview or for general reference.
In the individual drug monographs, there is a link to the relevant section of Stockley’s Interaction Alerts, which rates information according to three categories (see below). The Alerts give additional information to assist in the management of an interaction. The Stockley’s Interaction Alerts database is also used for drug/drug interaction checking and decision support. There is also a link to the relevant BNF interaction summary in each individual drug monograph as this gives a more general overview.
Interactions shown in bold and against a pink background are potentially serious; concomitant administration of the drugs involved should be avoided (or only undertaken with caution and appropriate monitoring). Interactions that are not in bold type do not usually have serious consequences.
The Alerts are rated using three separate categories:
For more information, see Drug Interactions.
NZFC contains information on the use of drugs for neonates, children, and adolescents up to 18 years of age. Whereas the NZF deals with the use of medicines for adults, NZFC is able to focus on the use of medicines in children. This allows the NZFC to deal with the drug management of childhood conditions more extensively and also provides a greater discussion of the unapproved use of medicines. NZFC includes advice on drugs used for rare metabolic disorders and on specialist neonatal and paediatric interventions.
Entries on individual drugs give an indication of the approval status of the drug and if specialist expertise is required for use in children. Recognising that ’adult’ conditions may also be relevant to younger patients, NZFC includes advice on the use of medicines during pregnancy and when breast-feeding.
NZFC does not include information on the drug management of conditions such as dementia, which affect older people and are dealt with by the NZF.
If prescribing notes or a drug monograph are available in both publications, a button appears at the top of the webpage: View in the NZFC or View in the NZF. Clicking on these buttons allows you to move to the corresponding page between publications.
The use of age bands in the presentation of doses can be confusing. In NZFC, a dose for, say, ‘Child 1–8 years’ means that the dose may be used from the child’s 1st birthday to the 8th birthday and the next band, say, ‘Child 8–12 years’ applies between a child’s 8th and 12th birthdays.
The age bands apply to children of average size and, in practice, the clinician will use the age bands in conjunction with other factors such as the severity of the condition being treated and the child’s size in relation to the average size of children of the same age.
Many drugs used in children are used outside their approval and they may not have been studied in adequate detail in children. NZFC includes information on drugs when there is sufficient evidence for the drug to be considered relatively safe and effective in children.
For some drugs information is very scarce and their use may be limited to specialist centres and by clinicians with specialist expertise and knowledge of these drugs. In such cases, until the evidence is better established, NZFC does not include information about these drugs.
Updates to the online and pdf versions of the NZF are published on the 1st working day of each calendar month. It is vital to use the most recent release of the NZF for making clinical decisions.