Antihistamines, Hyposensitisation and Allergic Emergencies

Preferred list (P)

CETIRIZINE

• Capsules are non-formulary

LORATADINE

Preferred list (P)

ADRENALINE

For Auto-Injector Device:

• Ensure device training is provided
• Always brand prescribe
• Advise patients to carry two devices at all times

Prescribing notes:

• It is the duty of the prescriber to ensure training is provided before prescribing an adrenaline auto-injector device.
• Technique varies between devices.
• Adrenaline for self-administration should always be prescribed by brand name to ensure the patient receives the device they are trained to use.
• Trainer devices are available free of charge from manufacturers’. Expiry alert services, demonstration videos and support materials are also available. Please see individual links below:
  • JEXT^®
  • EPIPEN^®

• Patients should be advised to carry two auto-injectors at all times:
  MHRA Guidance August 2017 / MHRA Key Messages for Patients (August 2018).

**All unexpired EMERADE^® 300 and 500 micrograms adrenaline auto-injectors are subject to a Class 1 Medicines recall due to the potential for device failure. Further information, including what action to be taken, is available at the link below: 

National Patient Safety Alert: Class 1 Medicines Recall Notification: Recall of Emerade 500 micrograms and Emerade 300 micrograms auto-injectors, due to the potential for device failure

Patients should obtain a prescription and be supplied with an alternative brand.

EMERADE^® 150 microgram auto-injector will not be returning to market at this time.

CHLORPHENAMINE Injection

• Preferred list – hospital

• Chlorphenamine injection is a useful adjunctive treatment given after adrenaline injection and continued for 24-48 hours to prevent relapse.

HYDROCORTISONE Injection

• Preferred list – hospital

• Hydrocortisone should be given to prevent further deterioration in patients with a severe anaphylactic reaction. Its onset of action is delayed for several hours.