​Intranasal

• Azelastine (Rhinolast) BD-QDS (adults and children aged ≥5 years)

First generation (sedating)

• Chlorphenamine 4mg every 4-6 hours, max 24mg daily (elderly max 12mg daily) (Piriton)

• Promethazine 25mg nocte (increased if necessary to 25mg 3-4 times daily)

Second generation (non-sedating)

• Cetirizine 10mg OD (Zirtek, Piriteze, BecoAllergy)

• Loratadine 10mg OD (Clarityn)

• Fexofenadine 120mg OD (adult seasonal allergic rhinitis dose)

Third generation (non-sedating)

• Levocetirizine 5mg OD (Xycal)

• Desloratidine 5mg OD (Neoclarityn)

Pregnancy / breastfeeding

• Loratidine

Children

• Chlorphenamine licensed from aged 1 month; Cetirizine and Loratadine licensed from age 2

Resources

• Antihistamines, allergen immunotherapy and allergic emergencies (BNF), Antihistamines (NHS Choices)