Antihistamines, Hyposensitisation and Allergic Emergencies

Warning

Non-Sedating Antihistamines

Preferred list (P)

CETIRIZINE

  • Capsules are non-formulary

LORATADINE

Prescribing Notes:

Allergic Emergencies

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:

**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.

Prescribing Notes:

NHSL Joint Adult Formulary Key

To indicate the category of a formulary medicine, updated sections adopt the following key:

Preferred list (P): First-line formulary choices.

Total list (T): Alternative choices when preferred list options not effective/not tolerated, or not indicated.

Specialist initiation (S1): Specialist initiation, or on the advice of a Consultant or Specialist Practitioner in this therapeutic area. Continuation in primary care is acceptable.

Specialist use only (S2): Supply via hospital, Homecare Service or a hospital based prescription (HBP) for dispensing by community pharmacy. Not prescribed in primary care setting.

Editorial Information

Last reviewed: 31/01/2022

Next review date: 31/01/2025

Author(s): NHSL.

Version: Please refer to the introduction section for an explanation of the review dates above.

Approved By: ADTC

Reviewer name(s): ADTC.