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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
 note 

Chlorphenamine is the 1st line formulary choice of sedating antihistamine.

Consider Self care if clinically appropriate.

At all hospital trusts-  review indication and check whether continued use is needed during inpatient hospital stay before ordering from pharmacy.


Chlorphenamine
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First Choice
Green
  • Consider Self care if clinically appropriate.
  • At all hospital trusts- review indication and check whether continued use is needed during inpatient hospital stay before ordering from pharmacy.
  • Chlorphenamine use in pregnancy - Where use of chlorphenamine in pregnancy is being considered, the available pregnancy safety data and its limitations should be discussed with the patient. See link below for further information. 
 
Alimemazine
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Restricted Drug Restricted
Red Hospital
  • Not to be prescribed in primary care. 
  •    
    Hydroxyzine
    (Tablet, syrup)
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    Restricted Drug Restricted
    Advice

    • CUHFT: Approved for urticaria only.

    • NWAFT: Restricted to use in dermatology

    • All other trusts and Primary Care: non-formulary

     
    Link  MHRA April 2015: Hydroxyzine - risk of QT interval prolongation and Torsade de Pointes
       
    Promethazine
    (Injection, oral solution, tablet)
    View adult BNF View SPC online View childrens BNF  Track Changes
    Restricted Drug Restricted
    Advice

     



    • CUHFT: When used for other indication than urticaria/allergy or nausea/vomiting, then this should be on advice from Mental Health only.

    • CPFT: Formulary

    • NWAFT: Formulary

    • Non formulary at RPH and in Primary Care

     
    Link  CPFT guideline for the pharmacological management of acute behavioural disturbance in inpatient wards
    Link  NICE Evidence summary: Promethazine for rapid tranquillisation in mental health settings
       
     ....
     Non Formulary Items
    Clemastine

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    Non Formulary
    Non Formulary
     
    Cyproheptadine

    View adult BNF View SPC online View childrens BNF Track Changes
    Non Formulary
    Non Formulary
     
      
    Key
    note Notes
    Section Title Section Title (top level)
    Section Title Section Title (sub level)
    First Choice Item First Choice item
    Non Formulary Item Non Formulary section
    Restricted Drug
    Restricted Drug
    Unlicensed Drug
    Unlicensed
    Track Changes
    Display tracking information
    click to search medicines.org.uk
    Link to adult BNF
    click to search medicines.org.uk
    Link to children's BNF
    click to search medicines.org.uk
    Link to SPCs
    SMC
    Scottish Medicines Consortium
    Cytotoxic Drug
    Cytotoxic Drug
    CD
    Controlled Drug
    High Cost Medicine
    High Cost Medicine
    Cancer Drugs Fund
    Cancer Drugs Fund
    NHSE
    NHS England
    Homecare
    Homecare
    CCG
    CCG

    Traffic Light Status Information

    Status Description

    OTC

    Available Over the Counter. Consider Self Care   

    Green

    Formulary - Can be prescribed in both secondary and primary care.   

    Advice

    Formulary - Specialist Advice, secondary care advice provided for primary care initiation.  

    Amber No SCG

    Formulary - Specialist initiation without shared care guidance.  

    Amber SCG

    Formulary - Specialist initiation with shared care guidance.  

    Red Hospital

    Restricted - Hospital only, not to be prescribed in primary care.  

    Switch

    Not recommended for prescribing. Switch to alternative cost-effective option.   

    Black

    Not recommended for prescribing in primary or secondary care.  

    Grey

    Not recommended as no formal application made for addition to the formulary. Contact relevant pharmacy team for further information.   

    Non Formulary

    Non-Formulary (category under review).  

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