Old versus new antihistamines. The old ones make you sleepy
and probably cause deaths on the road.
Antihistamine tablets, capsules, or liquid
medicines
You have seen that there are two main kinds of antihistamines to take by mouth:
- Older antihistamines, which cause sleepiness
- Newer antihistamines, which cause little or no
sleepiness
Our advice is that you should not take the older
antihistamines which cause sleepiness, unless your doctor prescribes them
because you need a tablet to help you sleep. They may be cheap, but there is
clear evidence that they may cause road accidents and hinder learning by
children in school. The newer antihistamines work just as well and, at least at
normal doses, have no measurable harmful effect on driving or learning. The
older antihistamines have these harmful effects even in people who do not notice
sleepiness from the tablets.Even preschool children
should not have the older antihistamines in our opinion, again unless there is a
specific reason why a doctor prescribes them in order to cause sedation or
sleepiness. One reason for doing so is to reduce scratching in children with
eczema.
The newer low-sedating antihistamines are at least as
effective for hayfever and other conditions. They cost more, but are still on
the whole reasonably priced.
Examples of the newer and safer antihistamines
Manufacturers can and do change the ingredients of
non-prescription medicines without changing the brand name or informing the
medical profession. No doubt they do so because they think you are more likely
to part with your money on the basis of a known brand name than because you
understand what is in the medication. Because of this, information on these
drugs is especially likely to become inaccurate. Please let us know if you find
errors.
| Official name |
Trade names |
OTC?* |
| acrivastine |
Semprex, Benadryl Allergy Relief capsules |
No |
| cetirizine |
Zirtec, Zyrtec |
Yes |
| desloratadine (NEW 2001) |
Neoclarityn |
No |
| fexofenadine |
Telfast 120, Telfast 180, Allegra |
No |
| loratadine |
Clarityn, Clarityne, Boots Antihistamine Tablets, Claritin |
Yes |
| mizolastine |
Mizollen, Mistamine |
No |
|
terfenadine (superseded by fexofenadine) |
Triludan, Seldane, Aller-eze, Histafen |
Yes |
*OTC means some or all
medicines in this row can be purchased 'over the counter' in the UK, without a
doctor's prescription.
All these are good. They differ in a number of ways, such as
the size of the tablets, the length of time for which they act, how effective
they are, the extent to which they may still have a slight tendency to cause
sleepiness (though all are superior to old antihistamines for this) and in side
effects and drug interactions as well as price. Your doctor should be able to
recommend one. Fexofenadine (Telfast) is a development from terfenadine, its
main advantage being an improvement in safety. In fact terfenadine is turned
into fexofenadine in the body, so people have been exposed to fexofenadine since
terfenadine was introduced about 15 years ago. However, fexofenadine, unlike
terfenadine and some of the others, is not yet available without a prescription
in the UK.
With so many antihistamines which mostly don't cause
significant sleepiness, there is no good reason to take one which makes you
sleepy unless you particularly want to be made sleepy. True, the older
antihistamines are cheaper. But for most of the day it is important that you
should have normal alertness. Drowsiness is a cause of accidents and impaired
performance in work and study.
Antihistamine sprays or drops for your nose or eyes
Help in the nose or eyes, where they are applied,
and only there. If you have symptoms elsewhere, you will need another treatment
for those..As sprays for the nose they are not
as effective as steroid sprays , but some people prefer not to use a steroid,
and your doctor may prefer to prescribe a drug which is not a steroid. If you
think they may suit you, you could try them.
The newer antihistamine eye drops are more
important because steroid drops do cause serious side effects sometimes and
doctors rightly do not like to use the admittedly effective steroid eye drops.
The antihistamine eye drops are similar to the so-called 'antiallergic' eye
drops in effectiveness.
Examples of antihistamine nose sprays and eye drops
| Official name |
Trade names |
OTC?* |
| azelastine nasal spray |
Rhinolast |
No |
| levocabastine nasal spray |
Livostin |
No |
| levocabastine eye drops |
Livostin |
No |
|
