Therapeutic AreaFormulary ChoicesCost for 28
(unless otherwise stated)
Rationale for decision / comments
3.4.1 Antihistamines
Non-sedating antihistaminesFor nasal allergy and treatment with corticosteroid nasal sprays, please see Chapter 12.
First- line:

Green crossLoratadine - 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.

Green crossCetirizine - 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.
Desloratadine tablets

5mg tablets: £0.96 (30)

As an option if first- and second-line choices are not tolerated or contra indicated.
Sedating antihistamines

Green crossChlorphenamine - suitable for self-care
4mg tablets: £0.76
2mg/5ml SF solution: £2.62 (150ml)
Chlorphenamine is available OTC.
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