West of Scotland Formulary

Prescribing Notes:

Antihistamines may be of value in the treatment of nasal allergies, especially hay fever, and vasomotor rhinitis. They reduce rhinorrhoea and sneezing but are usually less effective for nasal congestion.
Cetirizine and loratadine cause less sedation than chlorphenamine; they are all available over the counter. Drowsiness rarely occurs but patients should be advised that it is a possible side-effect and may affect performance of skilled tasks (e.g. driving); excess alcohol should be avoided.
Loratadine may be a suitable alternative for those who develop sedation with cetirizine.
Oral antihistamines are of value in preventing urticaria and are used to treat urticarial rashes, pruritus, and insect bites and stings; they are also used in drug allergies.
Liquid preparations should be reserved only when solid oral formulations are not appropriate, and the most cost-effective option should be chosen.

History Notes

15/04/2026

Regional formulary chapter launched.

Chlorphenamine is more liable to cause drowsiness in older patients.

Prescribing Notes:

Antihistamines may be of value in the treatment of nasal allergies, especially hay fever, and vasomotor rhinitis. They reduce rhinorrhoea and sneezing but are usually less effective for nasal congestion.
Oral antihistamines are of value in preventing urticaria and are used to treat urticarial rashes, pruritus, and insect bites and stings; they are also used in drug allergies.

History Notes

15/04/2026

Regional formulary chapter launched.

The Resuscitation Council UK advises that non-sedating oral antihistamines, in preference to chlorphenamine, may be given following initial stabilisation especially in patients with persisting skin symptoms (urticaria and/or angioedema).

Prescribing Notes:

Adrenaline should be given immediately for an anaphylactic reaction (rapidly progressive systemic reaction, with laryngeal oedema, bronchospasm and/or hypotension, for example).
Atopic individuals are particularly at risk of allergy. Risk assessment for future anaphylaxis should be completed by someone experienced in allergy care. Suspected anaphylaxis is an indication for prescribing adrenaline autoinjectors. Patients should usually be prescribed two adrenaline prefilled syringes and advised to always carry these.
Adrenaline for self-administration should be prescribed by brand name to ensure that the patient gets the device that they have been taught to use.
The MHRA provides specific advice for healthcare professionals on the safe and effective use of adrenaline auto-injectors.
Please see guidance from the Resuscitation Council UK on emergency treatment of anaphylactic reactions.

History Notes

15/04/2026

Regional formulary chapter launched.

For use in the symptomatic treatment of acute attacks of hereditary angioedema.

Prescribing Notes:

Berinert is a plasma-derived C1-esterase inhibitor. This is presented as powder for solution for IV injection. This is usually reconstituted and administered in a hospital setting but patients can be trained by specialist nurses to reconstitute and self-administer at home if appropriate.
Icatibant is a bradykinin B2 receptor antagonist that is available as a pre-filled syringe suitable for patient self-administration.
C1 esterase inhibitors can also be used as short-term prophylaxis prior to surgery. Icatibant can only be used in acute symptomatic treatment management.

History Notes

15/04/2026

Regional formulary chapter launched.

For short term prophylaxis of HAE prior to dental, medical or surgical procedures.

Prescribing Notes:

Berinert is a plasma-derived C1-esterase inhibitor. It is presented as powder for solution for IV injection. This is usually reconstituted and administered in a hospital setting.

History Notes

15/04/2026

Regional formulary chapter launched.

History Notes

15/04/2026

Regional formulary chapter launched.

Non-sedating.

Sedating.

Non-sedating.

Non-sedating. Supplied under PGD.

History Notes

15/04/2026

Regional formulary chapter launched.