3.4.1 Antihistamines
Of some value in treatment of nasal allergies, urticarial rashes, pruritus, insect bites and drug allergies. Non-sedating preparations are usually longer acting.
Non-sedating antihistamines |
Although drowsiness is rare, nevertheless patients should be advised that it can occur and may affect performance of skilled tasks (e.g. driving); excess alcohol should be avoided. |
|
Non-sedating antihistamines should be offered first line to all patients, especially children and adolescents. |
|
|
Sedating antihistamines |
|
AMBER Alimemazine 7.5mg/5mL SF oral solution [Second line use after promethazine when initiated by tertiary centre for |
indications that include insomnia/sedation]. Use restricted to paediatrics only. |
3.4.2 Allergen Immunotherapy |
Treatment of severe persistent allergic asthma (NICE TAG278) |
(recommended as an option by NICE in people aged 6 years and older) |
RED Omalizumab injection 150mg/mL |
|
For previously treated chronic spontaneous urticaria - recommended as an option by NICE TAG 339 |
RED Omalizumab injection 150mg/mL |
|
3.4.3 Allergic emergenciesIn anaphylactic shock adrenaline 1 in 1000 should be give by intramuscular injection at the doses below. |
NOTE: 1. When administering adrenaline in an emergency the Health Care Professional should base the dose on age. | | | |
By intramuscular injection |
Child under 6 years 150 micrograms (0.15 mL), repeated every 5 minutes if necessary |
Child 6–12 years 300 micrograms (0.3 mL), repeated every 5 minutes if necessary |
Child 12–18 years 500 micrograms (0.5 mL), repeated every 5 minutes if necessary |
Adult 500 micrograms (0.5 mL), repeated every 5 minutes if necessary |
|
GREEN Adrenaline injection 1 in 1000, 1mL
Hereditary Angioedema |
RED Lanadelumab [Takhzyro] NHS England Commissioned |
NICE TA606 Lanadelumab is recommended as an option for preventing recurrent attacks of hereditary angioedema in people |
aged 12 and older, only if: |
> they are eligible for preventive C1-esterase inhibitor (C1-INH) treatment in line with NHS England's |
commissioning policy, that is, they are having 2 or more clinically significant attacks (as defined in the |
policy) per week over 8 weeks despite oral preventive therapy, or oral therapy is contraindicated or not tolerated |
> the lowest dosing frequency of lanadelumab is used in line with the summary of product characteristics, that is, |
when the condition is in a stable, attack-free phase (see section 2) and |
> the company provides lanadelumab according to the commercial arrangement. |
|
RED Berotralstat [Orladeyo] NHS England Commissioned |
NICE TA738 Berotralstat is recommended as an option for preventing recurrent attacks of hereditary angioedema in people |
12 years and older, only if: |
> they have at least 2 attacks per month, and |
> it is stopped if the number of attacks per month does not reduce by at least 50% after 3 months. |
It is only recommended if the company provides berotralstat according to the commercial arrangement. |
|
|
|
Adrenaline pre-filled syringes
Jext® - [Note 18 month expiry] | GREEN Adrenaline (epinephrine) (Jext®) single dose pre-loaded syringe | 150micrograms (body weight up to 15 Kg for self administration) 300micrograms (body weight 30Kg and above for self administration) | Jext Website - information for Patients includes the 'How to use' videos | Jext Patient Information Leaflet - view here | The following link provide training materials for the Jext devices: | Jext® devices | Jext® 150 Training Video | Jext® 300 Training Video | | |
Emerade® | GREEN Adrenaline (epinephrine) (Emerade®) single dose pre-loaded syringe | 500micrograms (for issue to patients at risk of severe anaphylaxis) | 300micrograms (body weight 30Kg and above for self administration) | 150micrograms (body weight up to 15 Kg for self administration) | See latest MHRA Emerade® recall information here | |
|
Epipen® | Adrenaline (epinephrine) (EpiPen Auto-injector®) single dose pre-loaded syringe [for issue to patients at risk of anaphylaxis] | GREEN Epipen150micrograms, [19 month expiry see SPC] | Epipen 300micrograms [24 month expiry - see SPC] | |
EpiPen Website - information for Patients |
EpiPen Patient information Leaflet - view here |
The following links provide training materials for the Epipen devices: |
EpiPen® devices |
EpiPen® 0.15mg |
EpiPen® 0.3mg |
|
|
|
All material in this section is aimed at health care professionals, but is information currently held in the public domain, members of the |
public seeking advice on medicine-related matters are advised to speak with their GP, pharmacist, nurse or contact NHS111 Service. |
Email: info.elmmb@nhs.net |
Copyright© 2016 - 2020 East Lancashire Medicines Management Board. |
All rights reserved. Disclaimer/Terms and conditions |