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AllergyAwareUK

Drug Allergy Guidance: Why Clear Recording and Allergen-Aware Prescribing Matter

  • Allergy Aware UK
  • Aug 2, 2024
  • 3 min read
Prescribing blindfolded
Prescribing blindfolded

NICE guidance (CG183) sets out the standard for managing drug allergies in the UK: take a structured history, record it clearly, communicate it across care, and provide patients with written advice. But this process can break down if prescribers rely on unlicensed products — because allergen profiles may not be available in standard resources like the EMC, leaving professionals unable to make fully informed decisions.

Who this helps: Healthcare professionals, patients with known drug allergies, and families seeking reassurance that safe prescribing practices are being followed.


Key takeaways

  • NICE CG183 is the baseline UK guidance for drug allergy diagnosis and management.

  • Drug allergy records should be structured, separate from side effects, and shared across care settings.

  • Patients should receive clear written advice on what to avoid and what to do if exposed.

  • Prescribers must be cautious when using unlicensed products, where allergen data may not be available through standard resources like the EMC.


What NICE CG183 requires

NICE’s Drug Allergy: Diagnosis and Management guideline (CG183) outlines best practice for identifying and documenting drug allergies:

  • Take a structured allergy history at first presentation or when reactions are suspected.

  • Record clearly whether a reaction is a true allergy or a non-allergic adverse drug reaction (ADR).

  • Communicate allergy status across care — in GP records, hospital notes, discharge summaries, and pharmacy systems.

  • Provide written information to patients, listing the drugs or drug classes to avoid and outlining what to do if accidental exposure occurs.

This structured approach helps prevent dangerous prescribing errors, improves patient confidence, and supports safe switching between brands or medicines.


The risk of unlicensed products

While licensed medicines must provide excipient and allergen information in their Summary of Product Characteristics (SmPC) and on the Electronic Medicines Compendium (EMC), unlicensed products are different.

  • They do not have an approved SmPC.

  • They are not listed on the EMC.

  • Allergen and excipient information may be unclear or unavailable.

This creates a gap in prescriber knowledge. If allergen profiles cannot be accessed, clinicians risk making decisions without full awareness of potential triggers — exposing patients with allergies to avoidable harm.


Why this matters in practice

  • A patient labelled “penicillin allergic” may miss out on first-line antibiotics — unless their record is clear, structured, and verified.

  • A patient with lactose, soya, or peanut allergies may unknowingly receive an unlicensed medicine containing traces of these excipients — because their prescriber could not check the allergen profile on standard systems.

  • Prescribers who use unlicensed medicines carry greater personal responsibility, since they must make informed choices in the absence of centralised allergen data.


Patient empowerment

Patients should feel confident asking:

  • “Is this medicine licensed?”

  • “Has the allergen profile been checked?”

  • “If unlicensed, has the manufacturer confirmed excipient safety?”

Carrying written documentation of confirmed allergies — and ensuring GP and hospital records are consistent — makes it easier for healthcare professionals to act safely.


When to seek help

If you think you’ve been given a medicine containing an allergen, or if you develop symptoms such as rash, swelling, wheeze, or difficulty breathing after taking a medicine:

  • Use your adrenaline auto-injector immediately (if prescribed).

  • Call 999 without delay.

  • Ask your GP or pharmacist to report the incident via the MHRA Yellow Card scheme.


References

 
 
 

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