Q&A 403.3

Which oral antihistamines are available in lactose-free formulations?

Prepared by UK Medicines Information (UKMi) pharmacists for NHS healthcare professionals

Before using this Q&A, read the disclaimer at

Date prepared:14th July 2016

Background

In adults with lactose intolerance, ingestion of lactose may cause gastrointestinal symptoms. Symptoms vary according to the quantity of lactose ingested, the patient’s ability to digest lactose and the amount and type of colonic flora. Lactose is widely used in pharmaceutical formulations as a diluent or carrier. The dose of lactose in most pharmaceuticals is usually less than 2g per day and is unlikely to cause symptoms except in cases of severe lactose intolerance [1].

For patients with severe lactose intolerance, the lactose content of medications should be determined before prescribing. For further information about lactose intolerance and medicines see Medicines Q&A 131 ‘What factors need to be considered when prescribing for lactose intolerant adults?’[1].

Answer

The table below gives details of lactose free formulationsof oralantihistamine, single active constituentpreparations that are used for allergic conditionsand are listed in the electronic Medicines Compendium (eMC).

Antihistamine / Lactose-free formulation / Manufacturer / Ref
Sedating antihistamines
Alimemazine tartrate / Alimemazine Tartrate Syrup 30mg/5ml / Zentiva / [2]
Alimemazine Tartrate Syrup 7.5mg/5ml / Zentiva / [3]
Chlorphenamine maleate / Boots Allergy Relief 1 year Plus Antihistamine 2mg/5ml Syrup / The Boots Company PLC / [4]
Chlorphenamine Maleate 2mg/5ml Oral Solution / The Boots Company PLC / [4]
Chlorphenamine Elixir BP / Sandoz Ltd / [5]
Chlorphenamine Elixir 2mg/5ml / Sandoz Ltd / [5]
Lloydspharmacy Allergy Relief Syrup / Sandoz Ltd / [5]
Piriton Syrup / GlaxoSmithKline Consumer Healthcare / [6]
Promethazine hydrochloride / Phenergan Elixir / SANOFI / [7]
Phenergan Elixir 5mg/5ml Oral Solution / SANOFI / [7]
Antihistamine / Lactose-free formulation / Manufacturer / Ref
Non-sedating antihistamines
Cetirizine dihydrochloride / Benadryl Allergy Liquid Release 10mg Capsules / McNeil Products Ltd / [8]
Benadryl Allergy Oral Syrup / McNeil Products Ltd / [9]
Benadryl Allergy Children’s 1mg/ml Oral Solution / McNeil Products Ltd / [9]
Benadryl for Children Allergy Solution / McNeil Products Ltd / [10]
Benadryl Allergy Children’s 6+ 1mg/ml Oral Solution / McNeil Products Ltd / [10]
Zirtek Allergy Solution 1mg/ml Oral Solution / UCB Pharma Ltd / [11]
Zirtek Allergy Relief for Children 1mg/ml Oral Solution / UCB Pharma Ltd / [12]
Cetirizine hydrochloride / ASDA 6 Year + Allergy Relief Liquid / The Boots Company PLC / [13]
Boots Hayfever and Allergy Relief Syrup / The Boots Company PLC / [13]
Care Hayfever and Allergy 1mg/ml Solution / Thornton & Ross Ltd / [14]
Cetirizine Hydrochloride 1mg/ml Oral Solution / The Boots Company PLC / [13]
Cetirizine Hydrochloride 5mg/5ml Oral Solution / Pinewood Healthcare / [15]
Cetirizine Hydrochloride 5mg/5ml Solution / Fannin (UK) Ltd / [16]
Galpharm Hayfever and Allergy Relief Syrup / The Boots Company PLC / [13]
Piriteze Allergy Syrup
Piriteze Allergy 1mg/ml Syrup / The Boots Company PLC
GlaxoSmithKline Consumer Healthcare / [13]
[17]
Sainsbury’s Family Hayfever and Allergy Relief Liquid / The Boots Company PLC / [13]
Superdrug Family Hayfever and Allergy Relief Liquid / The Boots Company PLC / [13]
Tesco Family Allergy Relief Syrup / The Boots Company PLC / [13]
Wilko Hayfever & Allergy Relief Syrup / The Boots Company PLC / [13]
Antihistamine / Lactose-free formulation / Manufacturer / Ref
Desloratadine / Desloratadine Actavis 5mg
film-coated tablets / Actavis UK Ltd / [18]
Desloratadine 0.5mg/ml Oral Solution / Rosemont Pharmaceuticals Ltd / [19]
Desloratadine 0.5mg/ml Oral Solution (Caduceus) / Actavis UK Ltd / [20]
NeoClarityn Oral Solution / Merck Sharp & Dohme Ltd / [21]
Fexofenadine hydrochloride / Fexofenadine Hydrochloride 120mg Film-Coated Tablets / Dr. Reddy’s Laboratories (UK) Ltd / [22]
Fexofenadine Hydrochloride 120mg Film-Coated Tablets / Fannin (UK) Ltd / [23]
Fexofenadine Hydrochloride 180mg Film-Coated Tablets / Dr. Reddy’s Laboratories (UK) Ltd / [24]
Fexofenadine 180mg Film-Coated Tablets / Fannin (UK) Ltd / [25]
Telfast 30mg tablets / SANOFI / [26]
Telfast 120mg film-coated tablets / SANOFI / [27]
Telfast 180mg film-coated tablets / SANOFI / [28]
Levocetirizine dihydrochloride / Xyzal 0.5mg/ml oral solution / UCB Pharma Ltd / [29]
Loratadine / Boots Hayfever Relief All Day 5mg/5ml Oral Solution / Pinewood Healthcare / [30]
Clarityn Allergy 1mg/ml Syrup / Bayer plc / [31]
Clarityn Rapide Allergy 10mg Tablets / Bayer plc / [32]
Loratadine 5mg/5ml Syrup / Pinewood Healthcare / [30]

Limitations

Information for this Q&A has been taken from the eMC. Generic products not listed in the eMC, ‘specials’ and lactose-free complementary medicines are not covered bythis Q&A.

The individual Summaries of Product Characteristics should be checked before prescribing as formulations may change.

It has been assumed that all information concerning lactose in manufacturers’ Summaries of Product Characteristics is complete and correct.

Although the ingredients of the products contain no obvious source of lactose, manufacturers often state that they cannot guarantee that the products have not been in contact with lactose during the manufacturing process.

References

  1. Pickett K. Q&A 131.6 – What factors need to be considered when prescribing for lactose intolerant adults? Wessex Drug and Medicines Information Centre. Date prepared: 15th August 2013 (partial revision 2nd October 2013 and 25th February 2014). Accessed via on11/7/2016.
  2. Zentiva. Summary of Product Characteristics for Alimemazine Tartrate 30mg/5ml Syrup. Date of revision of text: 23 April 2015.Accessed via:
  3. Zentiva. Summary of Product Characteristics for Alimemazine Tartrate 7.5mg/5ml Syrup. Date of revision of text: 23 April 2015. Accessed via:
  4. The Boots Company PLC. Summary of Product Characteristics for Boots Allergy Relief 1 Year Plus Antihistamine 2mg/5ml Syrup. Date of revision of text:11 March 2016. Accessed via: on12/7/2016.
  5. Sandoz Ltd. Summary of Product Characteristics for Chlorphenamine Elixir BP. Date of revision of text: 27/11/2014. Accessed via:
  6. GlaxoSmithKline Consumer Healthcare. Summary of Product Characteristics for Piriton Syrup. Date of revision of text: 31/12/2015. Accessed via:
  7. SANOFI. Summary of Product Characteristics for Phenergan Elixir. Date of revision of text: 12/10/2015.Accessed via:
  8. McNeil Products Ltd. Summary of Product Characteristics for Benadryl Allergy Liquid Release 10mg Capsules. Date of revision of text: 1/12/2014.Accessed via:
  9. McNeil Products Ltd. Summary of Product Characteristics for Benadryl Allergy Children’s 1mg/ml Oral Solution. Date of revision of text: 14/4/2016. Accessed via:
  10. McNeil Products Ltd. Summary of Product Characteristics for Benadryl Allergy Children’s 6+ 1mg/ml Oral Solution. Date of revision of text: 14/4/2016. Accessed via:
  11. UCB Pharma Ltd. Summary of Product Characteristics for Zirtek Allergy Solution 1mg/ml oral solution. Date of revision of text:05/2015. Accessed via: 12/7/2016.
  12. UCB Pharma Ltd. Summary of Product Characteristics for Zirtek allergy relief for children 1mg/ml oral solution. Date of revision of text: 06/2015.Accessed via:
  13. The Boots Company PLC. Summary of Product Characteristics for Boots Hayfever & Allergy Relief Syrup. Date of revision of text: 25/2/2011. Accessed via: on 12/7/2016.
  14. Thornton & Ross Ltd. Summary of Product Characteristics for Care Hayfever and Allergy 1mg/ml Solution. Date of revision of text: 5/3/2015.Accessed via:
  15. Pinewood Healthcare.Summary of Product Characteristics for Cetirizine Hydrochloride 5mg/5ml Oral Solution. Date of revision of text: 22/5/2015. Accessed via:
  16. Fannin (UK) Ltd. Summary of Product Characteristics for Cetirizine Hydrochloride 5mg/5ml Solution. Date of revision of text: 19/8/2015. Accessed via on 12/7/2016.
  17. GlaxoSmithKline Consumer Healthcare. Summary of Product Characteristics for Piriteze Allergy 1mg/ml Syrup. Date of revision of text:7/1/2016.Accessed via:
  18. Actavis UK Ltd. Summary of Product Characteristics for Desloratadine Actavis 5mg film-coated tablets. Date of revision of text:14/10/2015.Accessed via:
  19. Rosemont Pharmaceuticals Ltd. Summary of Product Characteristics for Desloratadine 0.5mg/ml Oral Solution. Date of revision of text: 8/2/2016. Accessed via on 12/7/2016.
  20. Actavis UK Ltd. Summary of Product Characteristics for Desloratadine 0.5mg/ml Oral Solution (Caduceus). Date of revision of text: 24/5/2016. Accessed via on 12/7/2016.
  21. Merck Sharp & Dohme Ltd. Summary of Product Characteristics for NeoClarityn Oral Solution. Date of revision of text: 26/3/2015.Accessed via:
  22. Dr. Reddy’s Laboratories (UK) Ltd. Summary of Product Characteristics for Fexofenadine hydrochloride 120mg film-coated Tablets. Date of revision of text: 31/3/2016. Accessed via on 12/7/2016.
  23. Fannin (UK) Ltd. Summary of Product Characteristics for Fexofenadine Hydrochloride 120mg Film-Coated Tablets. Date of revision of text: 7/10/2015. Accessed via on 12/7/2016.
  24. Dr. Reddy’s Laboratories (UK) Ltd. Summary of Product Characteristics for Fexofenadine hydrochloride 180mg film-coated Tablets. Date of revision of text: 18/9/2014. Accessed via on 12/7/2016.
  25. Fannin (UK) Ltd. Summary of Product Characteristics for Fexofenadine 180mg Film-coated Tablets. Date of revision of text: 1/8/2011. Accessed via on 12/7/2016.
  26. SANOFI. Summary of Product Characteristics for Telfast 30mg tablets. Date of revision of text: 18/5/2012. Accessed via:
  27. SANOFI. Summary of Product Characteristics for Telfast 120mg film-coated tablets. Date of revision of text: 7/1/2016.Accessed via:
  28. SANOFI. Summary of Product Characteristics for Telfast 180mg film-coated tablets. Date of revision of text: 12/9/2013.Accessed via: 12/7/2016.
  29. UCB Pharma Ltd. Summary of Product Characteristics for Xyzal 0.5mg/ml oral solution. Date of revision of text: 09/2015. Accessed via: on12/7/2016.
  30. Pinewood Healthcare. Summary of Product Characteristics for Loratadine 5mg/5ml Syrup. Date of revision of text: 01/2014. Accessed via: 12/7/2016.
  31. Bayer plc. Summary of Product Characteristics for Clarityn Allergy 1mg/ml Syrup. Date of revision of text:7/10/2015.Accessed via:
  32. Bayer plc. Summary of Product Characteristics for Clarityn Rapide Allergy 10mg Tablets.Date of revision of text:7/10/2015.Accessed via: 12/7/2016.

Quality Assurance

Prepared by

Gill Lewis. South West Medicines Information & Training

Date Prepared

14th July 2016

Checked by
Julia Kuczynska, South West Medicines Information & Training

Date of check

18th August 2016

Search strategy

  • In-house database/resources: British National Formulary Accessed via (all preparations listed in section 3.4.1 (Antihistamines). Accessed 12/7/2016
  • Electronic Medicines Compendium Accessed via: search terms used = alimemazine, chlorphenamine, clemastine, cyproheptadine, hydroxyzine, ketotifen, promethazine, acrivastine, cetirizine, desloratadine, fexofenadine, levocetirizine, loratadine,

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