|Therapeutic Area||Formulary Choices||Cost for 28|
(unless otherwise stated)
|Rationale for decision / comments|
|Non-sedating antihistamines||For nasal allergy and treatment with corticosteroid nasal sprays, please see Chapter 15.|
|First- line:||Loratadine - suitable for self-care||10mg tablets: £0.87 (30)|
5mg/5ml solution: £1.89 (100ml)
|Loratadine is first line on basis of low rate of motor impairment and cost-effectiveness. Loratadine is available OTC.
|Second-line:||Cetirizine - suitable for self-care||10mg tablets: £0.83 (30)|
5mg/5ml solution: £1.52 (200ml)
|Cetirizine is second line as more likely to impair motor function than Loratadine. Cetirizine is available OTC.
|Third-line:||Desloratadine tablets||5mg tablets: £0.96 (30)||As an option if first- and second-line choices are not tolerated or contra indicated.
|Sedating antihistamines||Chlorphenamine - suitable for self-care||4mg tablets: £0.76|
2mg/5ml SF solution: £2.62 (150ml)
|Chlorphenamine is available OTC.
|Adrenaline||Adrenaline solution for injection in prefilled pen (Emerade®) ||150 mcg: £26.74|
300 mcg: £26.94
500 mcg: £26.94
|• Emerade® has an 18 months shelf life.
• 300mcg device has a longer needle than Epipen®.
The 150mcg and 300mcg devices are suitable for patients to self-administer.
The 500mcg device should only be used by health professionals although generally most practices use vials to administer doses of 500mcg.
The extended shelf life is a significant advantage as most patients replace their device when it expires rather than because it has been used.
Approved PAMM Feb 16