Food Allergy (Pediatric) Drug Summary

Last updated: 20 November 2025
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Antiasthmatic & COPD Preparations

Content on this page:

Antiasthmatic & COPD Preparations

Antiasthmatic & COPD Preparations


Drug Dosage Remarks
Monoclonal Antibody
Omalizumab ≥1 year old: 75-600 mg SC injection every 2 or 4 weeks
Dose depends on pretreatment IgE level and body weight		 Adverse Reactions
  • CNS effect (headache); Respiratory effects (respiratory infections, sinusitis, pharyngitis); Other effects (local site reaction, viral infection, anaphylaxis, malignancies)
Special Instructions
  • Contraindicated in patients with severe hypersensitivity to the drug
  • Should not be used for emergency treatment of allergic reactions, including anaphylaxis
  • Corticosteroids should be tapered gradually upon initiation of Omalizumab
  • Use with caution in patients at risk of parasitic infections
  • Monitor for the development of eosinophilia, vasculitic rash, worsening pulmonary symptoms, cardiac complications, and/or neuropathy, especially upon reduction of oral corticosteroids
  • Discontinue therapy if patients develop signs and symptoms similar to serum sickness (eg fever, arthralgia, rash)
Selective Beta2-Adrenoreceptor Agonist  
Salbutamol (Albuterol) Outpatient/hospital Setting:
Infants and children ≤5 years old:
MDI (90 mcg/actuation): 2-6 puffs every 20 minutes for the first hour then 2-3 puffs hourly as needed 
Nebulized solution: 1.25-2.5 mg every 20 minutes for up to 3 doses or continuously as needed 
Childn ≥6 years old:
MDI (90 mcg/actuation): 4-10 puffs every 20 minutes for the first hour for mild to moderate exacerbations 
Nebulized solution: 2.5-5 mg every 20 minutes for up to 3 doses or continuously as needed 		 Adverse Reactions
  • Dependent on patient’s age, dose and route of administration
  • CV effects (tachycardia, chest pain, chest discomfort, palpitation, flushing, arrhythmias); CNS effects (headache, insomnia, dizziness, drowsiness, irritability); GI effects (nausea/vomiting, mouth dryness, diarrhea, unusual taste); Endocrine effects (hyperglycemia, hypokalemia, lactic acidosis); Other effects (muscle tremor, cramping, cough, epistaxis, hypersensitivity reactions)
Special Instructions
  • Use with caution in patients with cardiovascular disease (ie hypertension, arrhythmia), DM, glaucoma, hyperthyroidism, hypokalemia, seizure disorders
  • Use of face mask is advised in children <4 years old

Antihistamines & Antiallergics


Drug Dosage Remarks
First Generation Adverse Reactions
  • Most common: CNS effects (drowsiness, lassitude, dizziness, incoordination, paradoxical stimulation)
  • Other common: CNS effects (headache, psychomotor impairment); Antimuscarinic effects (dry mouth, viscous secretions, urinary retention, blurred vision)
  • Occasionally can cause GI effects (nausea/vomiting, diarrhea, epigastric pain, anorexia or increased appetite); CV effects (palpitations, arrhythmias, rarely hazardous ventricular arrhythmias); Hypersensitivity reactions (rashes, angioedema, anaphylaxis); Other effects (convulsion, sweating, myalgia, tremor, hypotension)
Special Instructions
  • Should be used with caution in patients with history of asthma, cardiovascular disease (ie hypertension, ischemic heart disease), angle-closure glaucoma, urinary retention, epilepsy, renal or hepatic impairment
    • Reduction of dosage may be needed
Azatadine 6-12 years old: 0.5-1 mg PO 12 hourly
Brompheniramine 6-12 years old: 2-4 mg PO 6-8 hourly
Buclizine 5-10 years old: 12.5-25 mg PO 6-8 hourly
Chlorpheniramine 1-5 years old: 1-2 mg PO 4-8 hourly
Max dose: 6 mg/day
6-12 years old: 2-4 mg PO 4-8 hourly
Max dose: 12 mg/day
or
87.5 mcg/kg SC 6 hourly
Max dose: 40 mg/day
Clemastine ≤1 year old: 0.1-0.25 mg PO 12 hourly 
1-3 years old: 0.25-0.5 mg PO 12 hourly 
3-6 years old: 0.5 mg PO 12 hourly
6-12 years old: 0.5-1 mg PO 12 hourly 
>12 years old: 1 mg PO 12 hourly, may increase to 6 mg/day in refractory cases 
Cyproheptadine
 2-6 years old: 2 mg PO 6-8 hourly 
Max dose: 12 mg/day 
7-14 years old: 4 mg PO 6-8 hourly 
Max dose: 16 mg/day
Dexchlorpheniramine  2-6 years old: 0.5 mg PO 4-8 hourly 
Max dose: 3 mg/day
6-12 years old: 1 mg PO 4-8 hourly 
Max dose: 6 mg/day
Dimethindene 10-20 drops of 0.1% solution PO 8 hourly
Diphenhydramine 6.25-25 mg PO 6-8 hourly or
5 mg/kg/day IM/IV divided 6 hourly 
Max dose: 300 mg/day
Homochlorcyclizine
 5-10 mg PO 6-12 hourly
Hydroxyzine 6 months-6 years old: 5-15 mg/day PO in divided doses
Max dose: 2 mg/kg/day
>6 years old, ≤40 kg: 15-25 mg/day PO in divided doses
Dose may be increased to 2 mg/kg/day to 50-100 mg/day
>40 kg: Same as adult dose
or
30 months-15 years old: 1 mg/kg/day PO
Ketotifen  6 months-3 years old: 0.5 mg PO 12 hourly 
>3 years old: 1 mg PO 12 hourly
Mebhydrolin
 2-5 years old: 50-150 mg/day PO in divided doses
6-12 years old: 100-200 mg/day PO in divided doses
Oxatomide
 Initial dose: 0.5 mg/kg PO 12 hourly
Optimal dose: 0.5-1 mg/kg PO 12 hourly
Promethazine  2-5 years old: 5-15 mg/day PO divided 12-24 hourly
Max dose: 15 mg/day 
5-10 years old: 10-25 mg/day PO divided 12-24 hourly or 6.25-12.5 mg IM
Max dose: 60 mg/day
>10 years old: 25 mg PO 24 hourly at night or
10-20 mg PO 8-12 hourly
May increase to 25 mg PO 12 hourly 
Triprolidine 
(Triprolidine hydrochloride) 		 4 months-<2 years old: 0.313 mg PO 4-6 hourly
Max dose: 1.252 mg/day 
2-<4 years old: 0.625 mg PO 4-6 hourly
Max dose: 2.5 mg/day 
4-<6 years old: 0.938 mg PO 4-6 hourly
Max dose: 3.744 mg/day 
6-<12 years old: 1.25 mg PO 4-6 hourly
Max dose: 5 mg/day 
>12 years old: 2.5 mg PO 4-6 hourly 
Max dose: 10 mg/day 
Second Generation
Cetirizine
 2-6 years old: 2.5 mg PO 12 hourly or 
5 mg PO 24 hourly
>6 years old: 5-10 mg PO 24 hourly 
Max dose: 10 mg/day 		 Adverse Reactions
  • CNS effects (drowsiness, lassitude, dizziness, headache, incoordination; paradoxical stimulation at high doses); Antimuscarinic effects (dry mouth, viscous secretions, urinary retention, blurred vision); GI effects (nausea/vomiting, diarrhea, epigastric pain)
    • Cause little or no sedation and antimuscarinic effect than first generation antihistamines
    • Cetirizine may cause higher incidence of drowsiness as compared with other second generation antihistamines
  • Occasionally has CV effects (palpitations, arrhythmias); Dermatologic effect (rashes); Hypersensitivity reactions (bronchospasm, angioedema, anaphylaxis); Other rare effects (hair loss, blood disorders, myalgia, tinnitus, convulsion)

Special Instructions

  • Should be used with caution in patients with renal or hepatic impairment
Desloratadine  6-11 months old: 1 mg PO 24 hourly 
1-5 years old: 1.25 mg PO 24 hourly
6-11 years old: 2.5 mg PO 24 hourly 
>12 years old: 5 mg PO 24 hourly 
Ebastine  6-12 years old: 5 mg PO 24 hourly, may increase to 10 mg PO 24 hourly, if needed  
Fexofenadine
 6-12 years old: 30 mg PO 12 hourly
>12 years old: 60 mg PO 12 hourly or
120-180 mg PO 24 hourly
Levocetirizine   2-6 years old: 1.25 mg PO 12 hourly
>6 years old: 5 mg PO 24 hourly
Loratadine1
 2-12 years old, ≤30 kg: 5 mg PO 24 hourly 
2-12 years old, >30 kg: 10 mg PO 24 hourly
>12 years old: 10 mg PO 24 hourly
Mequitazine
 0.25 mg/10 kg body wt/day PO
Mizolastine  >12 years old: 10 mg PO 24 hourly 
1Combination with Betamethasone is available. Please see the latest MIMS for specific formulations and prescribing information.

Antihistamines & Antiallergics (Allergen Extract)


Drug Dosage Remarks
Peanut (Arachis hypogaea)
allergen powder		 Initial dose escalation dose:
Dose 1: 0.5 mg PO
Dose 2: 1 mg PO
Dose 3: 1.5 mg PO
Dose 4: 3 mg PO
Dose 5: 6 mg PO
Doses to be given at 20-30 minutes intervals
Up-dosing dose: 
Dose of 3 mg, 6 mg, 12 mg, 20 mg, 40 mg, 80 mg, 120 mg, 160 mg, 200 mg, 240 mg, 300 mg given at 2-week intervals
Maintenance dose: 300 mg/day
 Adverse Reactions
  • GI effects (abdominal pain, nausea/vomiting, oral pruritus, oral paresthesia); Respiratory effects (throat irritation, cough, rhinorrhea, sneezing, throat tightness, wheezing, dyspnea); Dermatologic effects (pruritus, urticaria, anaphylactic reaction, ear pruritus)
Special Instructions
  • To be used in conjunction with a peanut-avoidant diet
  • Patients must be observed after the last dose for at least 60 minutes until suitable for discharge
  • Patients who tolerate at least the 3 mg single dose during initial dose escalation must return to the healthcare setting for initiation of up-dosing
  • If possible, up-dosing should begin the day after initial dose escalation. If the patient is unable to begin up-dosing within 4 days, initial dose escalation should be repeated in a healthcare setting
  • Initial dose escalation must be completed before starting up-dosing
  • Contraindicated in patients with uncontrolled asthma, history of eosinophilic esophagitis, or other eosinophilic gastrointestinal disease
  • Use with caution in patients with asthma, high risk for eosinophilic esophagitis, chronic or recurrent local gastrointestinal allergic symptoms

Cardiac Drug


Drug Dosage Remarks
Epinephrine 
(Adrenaline)		 Outpatient Setting:
15-<30 kg:
0.15 mg IM/SC (anterolateral thigh), may administer a second dose 5-15 min after the first injection if needed
≥30 kg: 0.3 mg IM/SC (anterolateral thigh), may administer a second dose 5-15 minutes after the first injection if needed
or
0.01 mg/kg/dose of 1:1,000 solutionn IM/SC (anterolateral thigh), may be repeated every 5-15 minutes as needed for up to 3 injections
Max dose:
15-<30 kg: 0.3 mg/dose
≥30 kg: 0.5 mg/dose
Hospital Setting:
0.01 mg/kg/dose IV every 3-5 minutes as needed
Max dose: 1 mg/dose
May consider continuous infusion if with inadequate response to IM Epinephrine and IV saline
 Adverse Reactions
  • CV effects (palpitation, tachycardia, cardiac arrhythmia, hypertension, pallor); CNS effects (transient anxiety, apprehension, nervousness, dizziness, headache); GI effects (nausea/vomiting, dry throat); Other effects (diaphoresis, dyspnea, pulmonary edema, weakness, tremor, ocular irritation) 
Special Instructions
  • Contraindicated in patients with narrow-angle glaucoma, shock, organic brain damage, heart failure, coronary insufficiency
  • Use with caution in patients with cardiovascular disease (eg coronary artery disease, hypertension), cerebrovascular disease, diabetes mellitus (DM), thyroid disease, urinary retention, in patients taking tricyclic antidepressants 
  • Central line administration is preferred when administering as a continuous infusion
  • IV infusions require an infusion pump
  • Cardiac and BP monitoring are required during continuous or IV infusion

Corticosteroid Hormones


Drug Dosage Remarks
Methylprednisolone  Hospital Setting:
1-2 mg/kg IV
Max dose: 60-80 mg IV		 Adverse Reactions
  • CV effects (cardiomyopathy, hypertension, edema); CNS effects (headache, insomnia, psychiatric disturbances); GI effects (increased appetite, peptic ulcer, nausea, indigestion); Dermatologic effects (bruising, urticaria, skin test reaction suppression, impaired wound healing); Other effects (DM, hypokalemia, pituitary adrenal axis suppression, growth suppression, weakness, osteoporosis)
Special Instructions
  • Contraindicated in patients with systemic fungal infections, varicella, and concomitant administration of live or attenuated vaccines
  • Use with caution in patients with tuberculosis, heart failure, recent myocardial infarction, DM, GI disease (eg diverticulitis, peptic ulcer, ulcerative colitis), hepatic/renal impairment, myasthenia gravis, osteoporosis, history of seizure disorder, thyroid dysfunction 
Prednisone Hospital Setting:
Initial dose: 0.5 mg/kg/day PO in 3-4 divided doses
May increase 2-3x as necessary
Maintenance dose: 0.125-0.25 mg/kg/day PO
Max dose: 40 mg PO 24 hourly or in 2-4 divided doses

Disclaimer

All dosage recommendations are for children with normal renal and hepatic function unless otherwise stated. 
Not all products are available or approved for above use in all countries. 
Products listed in the Drug Summary are based on indications stated in the locally approved product monographs. 
Please refer to local product monographs in Related MIMS Drugs for country-specific prescribing information. 

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