There is now little role for sedating antihistamines in allergic conditions.
Less sedating antihistamines are equally efficacious. The less sedating antihistamines can be taken long term with no loss of efficacy, and an ongoing good safety profile.
Cetirizine is eliminated in the urine, while fexofenadine is excreted in the faeces.
The newer antihistamines are likely to be as safe in pregnancy but have not been used by as many women, so they do not have the same evidence of safety.
They are useful for treating the itching that results from the release of histamine.
The early so-called ‘first generation’ antihistamines, such as promethazine, caused sedation.
These sprays should be considered first-line treatment in moderate to severe allergic rhinitis.
Combination treatments containing both corticosteroids and antihistamines are also available.
The sedating, first generation antihistamines now have little role in therapeutics.