Page content

Page breadcrumb

3.2 Allergic conditions

First line drugs Second line drugs Specialist drugs Secondary care drugs

Traffic light status (TLS) explained:

  • Green: Routine prescribing within licensed indication
  • Amber 1: specialist recommendation followed by GP initiation and continuation
  • Amber 2: specialist or GP initiation in line with local guideline after 1st line failure followed by GP continuation
  • Amber 3: specialist initiation and stabilisation followed by GP continuation
  • Amber SCG: specialist initiation and stabilisation followed by GP continuation in line with an agreed shared care guideline
  • Red: Hospital or specialist prescribing only

 

 

Antihistamines

 

Non-sedating antihistamines

Cetirizine hydrochloride

  • Tablets 10mg
  • Oral solution 5mg/5mL

Notes: 

  • Sugar-free versions are available and can be ordered by specifying sugar-free on the prescription 
  • Should not be prescribed in Primary Care or at Discharge
  • Advise patient to purchase, unless prescription is for long-term regular use

 

Fexofenadine hydrochloride

  • Tablets 120mg, 180mg  

 

Loratadine 

  • Tablets 10mg
  • Oral solution 5mg in 5mL

Notes: 

  • Should not be prescribed in Primary Care or at Discharge
  • Advise patient to purchase, unless prescription is for long-term regular use

 

 

Sedating antihistamines

 

Chlorphenamine maleate

  • Tablets 4mg
  • Oral solution sugar-free 2mg in 5mL
  • Injection 10mg/mL

Notes: 

  • Patients aged over 6 should not be prescribed in Primary Care or at Discharge
  • Advise patient to purchase, unless prescription is for long-term regular use

 

Hydroxyzine hydrochloride

  • Tablets 10mg, 25mg

Note: 

 

Promethazine hydrochloride

  • Tablets 10mg, 25mg
  • Elixir 5mg/5mL
  • Injection 25mg/mL   

 

 

Vaccines (Allergen-type)

Pharmalgen® Bee Venom or Wasp Venom extract; Subcutaneous Injection

Notes:

 

 

Grazax allergy vaccine

  • Sublingual tablets for severe grass pollen allergy
  • Considered a LOW PRIORITY treatment due to lack of evidence of incremental clinical and cost effeectiveness when compared to existing therapies.
  • Our policy statement

 

 

Allergen Immunotherapy 

 

Benralizumab

Fasenra® Injection, 30mg/ml pre-filled syringe

Notes:

 

Mepolizumab

  • Nucala® Injection, 100mg powder for reconstitution

Notes:

 

Reslizumab

  • Cinqaero® Injection, 10mg/mL concentrate for solution for infusion vials 

Notes:

 

 

 

Anaphylaxis

Adrenaline / Epinephrine 

  • Injection 1 in 1000;        1mL amp;           IM or SC              (1mg/mL)
  • Injection 1 in 10,000;     10mL amp;          IV use                (100mcg/mL)
  • Minijet 1 in 1000;           1mL IM, 1mL SC disposable syringe  (1mg/mL)
  • Minijet 1 in 10,000;        10mL IV disposable syringe             (100mcg/mL) 

(Subcutaneous injection not generally recommended). 

Dose of intramuscular injection of adrenaline (epinephrine) for the emergency treatment of anaphylaxis by healthcare professionals

Age

Dose

Volume of adrenaline 

1 in 1000 (1mg/mL)

Child under 6 years

150 microgram

0.15mL

6-12 years

300 microgram

0.3mL

Adult & and child 12-18 years

500 microgram

0.5mL

 

 

 

Self-administration of adrenaline (epinephrine)

 

Guidance

 

  • People who have been prescribed an adrenaline auto-injector because of the risk of anaphylaxis should carry two with them at all times for emergency, on-the-spot use.

 

  • After every use of an adrenaline auto-injector, an ambulance should be called (even if symptoms are improving), the individual should lie down with their legs raised and, if at all possible, should not be left alone. 

 

Emerade®

  •  150 micrograms solution for injection in pre-filled pen 
  •  300 micrograms solution for injection in pre-filled pen 
  •  500 micrograms solution for injection in pre-filled pen  

 

Epipen® 

  • Auto-injector 300 microgram dose
  • Junior Auto-injector 150 microgram dose

Note:

  • It is advisable to prescribe adrenaline auto-injector by brand (Epipen) to avoid confusion.

 

 

Jext® (Amber 1)

  • 150 micrograms solution for injection in pre-filled pens
  • 300 micrograms solution for injection in pre-filled pens

 

 

 

 

Traffic light status (TLS) explained:

  • Green: Routine prescribing within licensed indication
  • Amber 1: specialist recommendation followed by GP initiation and continuation
  • Amber 2: specialist or GP initiation in line with local guideline after 1st line failure followed by GP continuation
  • Amber 3: specialist initiation and stabilisation followed by GP continuation
  • Amber SCG: specialist initiation and stabilisation followed by GP continuation in line with an agreed shared care guideline
  • Red: Hospital or specialist prescribing only

  

Return to Chapter: 3. Respiratory System

Last updated by: Dupe Fagbenro on 27-03-2019 17:05