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BNSSG Paediatric Joint Formulary

3.2 Allergic conditions

Last edited: 15-04-2024

3.2 Allergic conditions

First line drugs Second line drugs Specialist drugs Secondary care drugs



Cetirizine (TLS Green)

Chlorphenamine (TLS Green)

Loratadine (TLS Green)


Fexofenadine (TLS Blue)

Specific indications:

Promethazine (TLS Blue)

Hydroxyzine (TLS Green)


Allergen Immunotherapy

Refer to Immunology


Bee and Wasp Allergen Extracts

Alutard® (TLS Red)

  • Hypersensitivity to wasp or bee venom only 


Grass and Tree Pollen Extracts

Specific Indications: (TLS Red)

Pollinex Quattro® (TLS Red)

  • Immunology only

Grazax® (TLS Red)

  • Immunology only


Grass, Tree Pollen and House Dust mite Extracts

OralVac® (TLS Red)

  • Immunology only

Acarizax (oral) (TLS Red)

  • For adolescents and adults with severe rhinitis or house dust mite allergic asthma


Birch Pollen Extract

Itulazax (Standardised allergen extract of pollen from white birch [Betula verrucosa]) (TLS Red)

  • For treatment of moderate-to-severe allergic rhinitis and/or conjunctivitis induced by pollen from the birch homologous group for use by the specialist allergy team.


Peanut Allergy

Palforzia (TLS Red)

  • NICE TA769 Palforzia for treating peanut allergy in children and young people


Allergic Emergencies

See  BNSSG Remedy Adrenaline Auto-Injectors page for further information from UHBW Children's hospital



Recommended: (TLS Green)

Adrenaline (epinephrine) 1 in 1000 (1mg/mL) (TLS Green)

  • Intramuscular

  • For self-administration using pre-filled adrenaline auto-injectors (pens), brands include Epipen®, Jext® and Emerade® (note: in May 2023 a National Patient Safety Alert (NatPSA) Class 1 Medicines Recall Notification was published recalling Emerade 500 micrograms and Emerade 300 micrograms auto-injectors, due to the potential for device failure, NatPSA/2023/004/MHRA)

Adrenaline (epinephrine) 1 in 10,000 (100micrograms/mL) (TLS Green) IV

  • Intravenous

Chlorphenamine (parenteral) (TLS Green)

Hydrocortisone sodium succinate (parenteral) (TLS Green)


3.2.1 Angioedema


C1-esterase inhibitor (Berinert®) (TLS Red)


Respiratory Stimulants

Doxapram (TLS Red)