3.4.3 Allergic emergencies

Adrenaline / Epinephrine
  • Injection 1 in 1000 - 0.5ml, 1ml (£0.60 = 1ml amp)
  • Emerade® auto-injector 150 microgram dose, 300 microgram dose, 500 microgram dose (£28.94 = 500 microgram)
  • Epipen®auto-injector 300 microgram dose (£26.45)
  • Epipen® Junior Auto-injector 150 microgram dose (£26.45)

Indications

  • Emergency treatment of acute anaphylaxis

Notes

  1. It is advisable to prescribe adrenaline auto-injector by brand (Emerade® or Epipen®) to avoid confusion, as more than one brand is now available.
  2. MHRA Drug Safety Update (October 2019): recent action taken to support safety - all adrenaline auto-injectors:
    1. Patients should continue to follow existing advice to carry 2 in-date pens with them at all times
    2. Different brands of adrenaline auto-injector are not used in exactly the same way so specific training and advice for patients and carers is required before using each of the devices

Angioedema

C1-Esterase inhibitor
  • Injection powder for reconstitution, 500 unit vial
Icatibant
  • Injection 10mg/ml - 3ml pre-filled syringe

Notes

  1. NHS England Clinical Commissioning Policy: Treatment of Acute Attacks in Hereditary Angioedema (April 2013)
Lanadelumab
  • Solution for injection 300mg

Notes

  1. NICE TA606: Lanadelumab (Takhzyro) is recommended as an option for preventing recurrent attacks of hereditary angioedema in people aged 12 and older, only when the criteria of the NICE TA are met (October 2019)

 

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