netFormulary South East London Joint Medicines Formulary NHS
Guy's and St Thomas' NHS Foundation Trust
Kings College Hospital NHS Foundation Trust
Lewisham and Greenwich NHS Trust
 
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 Formulary Chapter 3: Respiratory system - Full Chapter
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03.04.01  Expand sub section  Antihistamines
03.04.01  Expand sub section  Non-sedating antihistamines
03.04.01  Expand sub section  Sedating antihistamines
Alimemazine tabs, oral solution

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Formulary
   
Chlorphenamine tabs, oral solution, injection

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Cyproheptadine tabs

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Hydroxyzine tabs, oral solution

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Formulary Max dose 100mg for adults, 50mg for elderly.

Refer to MHRA for recent advice re risks of QT interval prolongation

Link  MHRA Drug Safety Update April 2015: Hydroxyzine - risk of QT prolongation    
Ketotifen tabs, liquid

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Formulary
Amber 2
Approved for:
Food protein gastrointestinal allergies in adults and children aged ≥3 years
Allergy clinic initiation only

Link  SE London APC Recommendation: Ketotifen for food protein allergy    
Promethazine tabs, oral solution, injection

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Cyproheptadine tablets

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Formulary Approved off-label indication:
  • Treatment of serotonin syndrome
  • Loading dose of 12 mg, further doses may be given following clinical review
    Prescribing must be initiated under the supervision of the Clinical Toxicology team at the GSTFT Poisons Unit
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    Cytotoxic Drug
    Cytotoxic Drug
    Restricted Drug
    Restricted Drug
    CD
    Controlled Drug
    Unlicensed Drug
    Unlicensed
    High Cost Medicine
    High Cost Medicine
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    Cancer Drugs Fund
    Cancer Drugs Fund
       

     

    Traffic Light Status Information

    Status Description
      Red   Specialist Prescribing only. The responsibility for prescribing, monitoring, dose adjustment and review should remain with the specialist. In very exceptional circumstances a specialist may discuss individual patient need for a RED drug to be prescribed by a GP and the GP should consider informing the Medicines Management team before a decision is made to prescribe for individual patients.   
      Amber 1   Treatment can be initiated in primary care after a recommendation from an appropriate specialist  
      Amber 2   Specialist initiation followed by maintenance prescribing in primary care  
      Amber 3   Specialist initiation with ongoing monitoring required. After dose stabilisation GPs can be requested to take over prescribing responsibilities using the approved APC shared care documentation  
      Green   Specialist and non-specialist initiation  
      Grey   Not recommended for prescribing  

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