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.
Second-line:

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.
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

Green crossChlorphenamine - 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.

• 16mm needle in 300mcg and 23mm in 300/500.

The 150mcg and 300mcg devices are suitable for patients to self-administer. Dose is normally 5-10mg per kg of body weight, though more may be necessary

The 500mcg device should only be used by health professionals or in patients at risk of severe anaphylaxis.

It is recommended that patients carry two pens with them in case of failure or a top up is needed.

Approved PAMM Feb 16