Table 5

Second line treatment of anaphylaxis12 13 51 52 56 60

DrugIV/IM doseAction
H1-antagonistsChlorphenamine 10 mg (child: 2.5–5 mg)Control pruritus, urticaria, angioedema, nasal/ocular symptoms
H2-antagonists

  • Ranitidine 50 mg (child: 1 mg/kg)

  • Injected slowly due to potential hypotensive effect

  • Small synergistic effect with

  • H1-antagonist in limiting above symptoms

SteroidsHydrocortisone 200 mg (child: 25–100 mg)Prevent biphasic anaphylaxis (delayed onset of action)
β-agonistsSalbutamol (albuterol) 5 mg (child: 2.5 mg) nebulisedRelieve wheeze, cough, dyspnoea