When you have runny itchy, itchy eyes and nose, sneezing, stuffy nose, post-nasal drip (mucus running down the back of your throat) and coughing, what do you take?
All of those symptoms are caused by histamines. Histamines are released when we have a cold or allergies. Histamine can also cause hives (itchy, red, raised bumpy rash).
So, we treat them by taking an ANTIhistamine. The antihistamine neutralizes some or all of the histamines so that our symptoms are lessened.
Antihistamines come in many forms –oral, topical, nasal spray and eye drops.
These oral antihistamines can help with cold/allergy symptoms and hives…
The following are available OTC:
1. Benadryl (diphenhydramine) –I recommend for rashes and to take at bedtime if the patient can’t sleep due to cold/allergy symptoms (it will help symptoms and cause drowsiness).
2. Dimetapp allergy (brompheniramine)
3. Chlor-Trimeton (chlorpheniramine)
4. Tavist (clemastine)
The above antihistamines work well but can cause a lot of sedation for most people (although some young kids may become hyperactive). It has been estimated that up to 80% of the Benadryl sold is used as a sleeping aid.
Helpful hint: Diphenhydramine (the active ingredient in Benadryl) is used in most OTC sleeping pills and can be used to treat motion sickness.
5. Allegra (fexofenadine) –I recommend to treat symptoms of both allergies and colds. It is the least likely to cause drowsiness and is taken only once a day.
6. Claritin and Alavert (loratadine) – This works well for most people as well -and may be less expensive then Allegra.
7. Zyrtec (cetirizine) –I suggest this if loratadine doesn’t help or causes drowsiness.
8. Xyzal (levocetirizine) –I recommend to treat patients that have rashes and itchy skin due to allergies. It often causes drowsiness. –NEW OTC 2017!
The three above do not usually cause drowsiness. They are available in generics, combo products with pseudophedrine (decongestants) and come in formulations for kids 2 years old to adult.
The following antihistamine is available with a prescription…
9. Clarinex (desloratadine) –I do not recommend. It does not come in a generic and in my experience, it has not worked any better than the OTC Claritin generic.
Helpful Hint: If a person has an allergic rash, using Benadryl (diphenhydramine) and Zantac (ranitidine) together can help!
Oral antihistamines are also used to treat acid reflux, motion sickness and dizziness…but that is a story for a different time.
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