Symptomatic relief of allergic rhinitis and urticaria
▶ Child 12–17 years: 10 mg once daily
l CAUTIONS Elderly—limited information available . history
of QT-interval prolongation . predisposition to arrhythmia . uncorrected hypokalaemia
l INTERACTIONS → Appendix 1: antihistamines, nonsedating
▶ Common or very common Asthenia . dizziness . drowsiness . dry mouth . headache
▶ Rare or very rare Palpitations .tachycardia
SIDE-EFFECTS, FURTHER INFORMATION Non-sedating
antihistamines such as rupatadine cause less sedation and
psychomotor impairment than the older antihistamines,
but can still occur; sedation is generally minimal. This is
because non-sedating antihistamines penetrate the blood
brain barrier to a much lesser extent.
l PREGNANCY Most manufacturers of antihistamines advise
avoiding their use during pregnancy; however, there is no
l BREAST FEEDING Most antihistamines are present in
breast milk in varying amounts; although not known to be
harmful, most manufacturers advise avoiding their use in
mothers who are breast-feeding.
l HEPATIC IMPAIRMENT Manufacturer advises avoid (no
l RENAL IMPAIRMENT Manufacturer advises avoid—no
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
▶ Rupatadine (Non-proprietary)
Rupatadine (as Rupatadine fumarate) 10 mg Rupatadine 10mg
tablets | 30 tablet P £30.00 DT = £30.00
ANTIHISTAMINES › SEDATING ANTIHISTAMINES
Alimemazine tartrate 11-Sep-2018
▶ Child 2–4 years: 2.5 mg 3–4 times a day
282 Allergic conditions BNF 78
▶ Child 5–11 years: 5 mg 3–4 times a day
▶ Child 12–17 years: 10 mg 2–3 times a day, in severe cases
up to maximum daily dose has been used; maximum
▶ Adult: 10 mg 2–3 times a day, in severe cases up to
maximum daily dose has been used; maximum 100 mg
▶ Elderly: 10 mg 1–2 times a day
l CONTRA-INDICATIONS Children under 2 years except on
specialist advice (safety of such use has not been
established). epilepsy . hepatic dysfunction . history of
narrow angle glaucoma . hypothyroidism . myasthenia
susceptible to orthostatic hypotension
l INTERACTIONS → Appendix 1: antihistamines, sedating
common in the elderly or in volume depletion). QT
long term high doses).tremor. ventricular fibrillation
SIDE-EFFECTS, FURTHER INFORMATION Drowsiness may
Patients on high dosage may develop photosensitivity
and should avoid exposure to direct sunlight.
Children and elderly patients are more susceptible to
l PREGNANCY Most manufacturers of antihistamines advise
avoiding their use during pregnancy; however, there is no
evidence of teratogenicity. Use in the latter part of the
third trimester may cause adverse effects in neonates such
as irritability, paradoxical excitability, and tremor.
l BREAST FEEDING Most antihistamines are present in
breast milk in varying amounts; although not known to be
harmful, most manufacturers advise avoiding their use in
mothers who are breast-feeding.
l HEPATIC IMPAIRMENT Manufacturer advises avoid—no
Driving and skilled tasks Drowsiness may affect
performance of skilled tasks (e.g. cycling or driving);
sedating effects enhanced by alcohol.
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug. Forms available
from special-order manufacturers include: oral solution
CAUTIONARY AND ADVISORY LABELS 2
▶ Alimemazine tartrate (Non-proprietary)
Alimemazine tartrate 1.5 mg per 1 ml Alimemazine 7.5mg/5ml oral
solution | 100 ml P £179.55 DT = £179.55
Alimemazine tartrate 6 mg per 1 ml Alimemazine 30mg/5ml oral
solution | 100 ml P £243.51 DT = £243.51
CAUTIONARY AND ADVISORY LABELS 2
▶ Alimemazine tartrate (Non-proprietary)
Alimemazine tartrate 10 mg Alimemazine 10mg tablets | 28 tablet P £112.85 DT = £112.85
Chlorphenamine maleate 09-Jul-2018
Symptomatic relief of allergy such as hay fever, urticaria,
food allergy, drug reactions | Relief of itch associated
▶ Child 1–23 months: 1 mg twice daily
▶ Child 2–5 years: 1 mg every 4–6 hours; maximum 6 mg
▶ Child 6–11 years: 2 mg every 4–6 hours; maximum
▶ Child 12–17 years: 4 mg every 4–6 hours; maximum
▶ Adult: 4 mg every 4–6 hours; maximum 24 mg per day
▶ Elderly: 4 mg every 4–6 hours; maximum 12 mg per day
▶ BY INTRAMUSCULAR INJECTION, OR BY INTRAVENOUS
▶ Child 1–5 months: 250 micrograms/kg (max. per dose
2.5 mg), repeated if necessary; maximum 4 doses per
▶ Child 6 months–5 years: 2.5 mg, repeated if necessary;
▶ Child 6–11 years: 5 mg, repeated if necessary; maximum
▶ Child 12–17 years: 10 mg, repeated if necessary;
▶ Adult: 10 mg, repeated if necessary; maximum 4 doses
Emergency treatment of anaphylactic reactions
▶ BY INTRAMUSCULAR INJECTION, OR BY INTRAVENOUS
▶ Child 1–5 months: 250 micrograms/kg (max. per dose
2.5 mg), repeated if necessary; maximum 4 doses per
▶ Child 6 months–5 years: 2.5 mg, repeated if necessary;
▶ Child 6–11 years: 5 mg, repeated if necessary; maximum
▶ Child 12–17 years: 10 mg, repeated if necessary;
▶ Adult: 10 mg, repeated if necessary; maximum 4 doses
l UNLICENSED USE Tablets not licensed for use in children
under 6 years. Syrup not licensed for use in children under
MHRA/CHM ADVICE (MARCH 2008 AND FEBRUARY 2009) OVERTHE-COUNTER COUGH AND COLD MEDICINES FOR CHILDREN
Children under 6 years should not be given over-thecounter cough and cold medicines containing
l INTERACTIONS → Appendix 1: antihistamines, sedating
BNF 78 Allergic conditions 283
▶ Frequency not known Agitation . appetite decreased . blood
reactions .tinnitus . urinary retention . vomiting
SIDE-EFFECTS, FURTHER INFORMATION Children and
elderly patients are more susceptible to side-effects.
l PREGNANCY Most manufacturers of antihistamines advise
avoiding their use during pregnancy; however, there is no
evidence of teratogenicity. Use in the latter part of the
third trimester may cause adverse effects in neonates such
as irritability, paradoxical excitability, and tremor.
l BREAST FEEDING Most antihistamines are present in
breast milk in varying amounts; although not known to be
harmful, most manufacturers advise avoiding their use in
mothers who are breast-feeding.
l HEPATIC IMPAIRMENT Manufacturer advises caution.
l DIRECTIONS FOR ADMINISTRATION For intravenous
injection, give over 1 minute; if small dose required, dilute
Medicines for Children leaflet: Chlorphenamine maleate for allergy
symptoms www.medicinesforchildren.org.uk/chlorphenaminemaleate-allergy-symptoms-0
Driving and skilled tasks Drowsiness may affect
performance of skilled tasks (e.g. cycling or driving);
sedating effects enhanced by alcohol.
l PROFESSION SPECIFIC INFORMATION
Dental practitioners’ formulary
▶ With oral use Chlorphenamine tablets may be prescribed.
Chlorphenamine oral solution may be prescribed.
l EXCEPTIONS TO LEGAL CATEGORY
▶ With intramuscular use or intravenous use Prescription only
medicine restriction does not apply to chlorphenamine
injection where administration is for saving life in
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug. Forms available
from special-order manufacturers include: oral solution
▶ Chlorphenamine maleate (Non-proprietary)
Chlorphenamine maleate 10 mg per 1 ml Chlorphenamine
10mg/1ml solution for injection ampoules | 5 ampoule P £22.48–
CAUTIONARY AND ADVISORY LABELS 2
▶ Chlorphenamine maleate (Non-proprietary)
Chlorphenamine maleate 400 microgram per
1 ml Chlorphenamine 2mg/5ml oral solution sugar free sugar-free |
▶ Allerief (Crescent Pharma Ltd)
Chlorphenamine maleate 400 microgram per 1 ml Allerief
2mg/5ml oral solution sugar-free | 150 ml p £2.21 DT = £2.21
▶ Piriton (GlaxoSmithKline Consumer Healthcare)
Chlorphenamine maleate 400 microgram per 1 ml Piriton
2mg/5ml syrup | 150 ml p £2.78 DT = £2.78
CAUTIONARY AND ADVISORY LABELS 2
▶ Chlorphenamine maleate (Non-proprietary)
Chlorphenamine maleate 4 mg Chlorphenamine 4mg tablets | 28 tablet p £1.00 DT = £0.76
▶ Allerief (Crescent Pharma Ltd)
Chlorphenamine maleate 4 mg Allerief 4mg tablets | 28 tablet p
▶ Hayleve (Genesis Pharmaceuticals Ltd)
Chlorphenamine maleate 4 mg Hayleve 4mg tablets | 28 tablet p
▶ Piriton (GlaxoSmithKline Consumer Healthcare)
Chlorphenamine maleate 4 mg Piriton 4mg tablets | 500 tablet p
Piriton Allergy 4mg tablets | 30 tablet p £2.06 | 60 tablet p £3.73
▶ Pollenase (chlorphenamine) (E M Pharma)
Chlorphenamine maleate 4 mg Pollenase Antihistamine 4mg
Symptomatic relief of allergy such as hay fever, urticaria
▶ Adult: 1 mg twice daily, increased if necessary up to
l CONTRA-INDICATIONS Avoid in Acute porphyrias p. 1058
l INTERACTIONS → Appendix 1: antihistamines, sedating
▶ Common or very common Asthenia . sedation
l PREGNANCY Most manufacturers of antihistamines advise
avoiding their use during pregnancy; however, there is no
evidence of teratogenicity. Use in the latter part of the
third trimester may cause adverse effects in neonates such
as irritability, paradoxical excitability, and tremor.
l BREAST FEEDING Most antihistamines are present in
breast milk in varying amounts; although not known to be
harmful, most manufacturers advise avoiding their use in
mothers who are breast-feeding.
Driving and skilled tasks Drowsiness may affect
performance of skilled tasks (e.g. driving); sedating effects
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
CAUTIONARY AND ADVISORY LABELS 2
▶ Tavegil (GlaxoSmithKline Consumer Healthcare)
Clemastine (as Clemastine hydrogen fumarate) 1 mg Tavegil 1mg
tablets | 60 tablet p £6.66 DT = £6.66
Cyproheptadine hydrochloride 30-Jun-2018
Symptomatic relief of allergy such as hay fever, urticaria |
▶ Adult: 4 mg 3 times a day, usual dose 4–20 mg daily;
l CONTRA-INDICATIONS Avoid in Acute porphyrias p. 1058
l INTERACTIONS → Appendix 1: antihistamines, sedating
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