Related guidance:

Anaphylaxis: assessment and referral after emergency treatment Clinical guideline (CG134 December 2011, updated August 2020)

Food allergy in under 19s: assessment and diagnosis Clinical guideline (CG116 February 2011)

Drug allergy: diagnosis and management Clinical guideline (CG183 September 2014)

Hayfever or allergic rhinitis: treatment during pregnancy (SPS January 2022)

For nasal allergy see NHS Somerset Formulary Ear, Nose and Oropharynx.

The use of first generation antihistamines in older people is potentially inappropriate. See STOPP/START criteria for potentially inappropriate prescribing in older people: version 2 (Age and Aging 2015)

Therapeutic AreaFormulary ChoicesCost for 28
(unless otherwise stated)
Rationale for decision / comments
Antihistamines: non-sedatingGreen crossLoratadine
- suitable for self-care
10mg tablet: £0.86 (30)
5mg/5ml sugar free solution: £2.85(100ml)
First line

Green crossCetirizine
- suitable for self-care
10mg tablet: £0.82 (30)
5mg/5ml sugar free solution: £17.16 (200ml)
Desloratadine 5mg tablet: £5.33 (30)
2.5mg/5ml sugar free solution: £21.17 (150ml)
Second line
Antihistamines: sedating

Green crossChlorphenamine
- suitable for self-care
4mg tablets: £3.61
2mg/5ml sugar free solution: £2.21 (150ml)
See our Allergies webpage for information, resources and guidance including NHS Somerset ICB: Adrenaline Auto-Injector advice on use for GPs and patients

Adrenaline auto-injectors: reminder for prescribers to support safe and effective use. See MHRA Drug Safety Update (November 2021)

It is recommended that patients are prescribed two pens which they should carry at all times.

Patients asked to return Emerade 300 and 500 microgram adrenaline pens for replacement. See MHRA Press release (May 2023)
as EpiPen Jr®Solution for injection auto-injector
150micrograms/0.3ml (1 in 2,000): £34.30
Children 7.5-25 kg
as EpiPen®Solution for injection auto-injector
300micrograms/0.3ml (1 in 1,000): £34.30
as Jext®Solution for injection auto-injector
150micrograms/0.15ml (1 in 1,000): £34.30
300micrograms/0.3ml (1 in 1,000): £34.30
The usual dose is 150 micrograms for children 15-30 kg.
Children and adolescents over 30 kg should be prescribed 300 micrograms.
The usual dose is 300 micrograms for adults over 30 kg.