So what can older adults safely take for allergy relief? Wozniak: Newer antihistamines such as Claritin® (loratadine) and Allegra® (fexofenadine) tend to be safer and better tolerated.
Avoid First-Generation Antihistamines
Certain antihistamines, the class of drug most commonly prescribed to treat allergies, can be dangerous for seniors. Two popular first-generation antihistamines include diphenhydramine (Benadryl) and chlorpheniramine (Chlor-Trimeton).
Some elderly people may have higher risk of side effects because of poor kidney function. The drowsiness and fatigue which may occur in a small percentage of patients may be more of a problem for the elderly because of the increased risk of bone fracture if they fall.
Since Zyrtec is now an over-the-counter antihistamine and can be taken without a doctor's knowledge, they're just advising caution in older folks. Based on the manufacturer's studies of Zyrtec metabolism in people over 65, they recommend that folks who are 77 years and older take only 5 mg per day (vs.
Claritin and Zyrtec are popular over-the-counter antihistamines. Doctors consider them safe and effective treatments for minor allergies. Both are second-generation antihistamines. These cause less drowsiness than first-generation antihistamines.
Claritin comes highly recommended by Dr. Fineman as an effective antihistamine. This medication comes in a wide variety of formats, including tablets, gel capsule pills, chewables and orally-disintegrating tablets (for those who have trouble swallowing pills).
Allergists recommend long-acting, non-sedating antihistamines — ones that won't make you sleepy — for everyday use. Though you may know them by their brand names, the generic versions tackle the same problems: Cetirizine (Zyrtec®, Aller-Tec®, Wall-Zyr®). Fexofenadine (Allegra®, Aller-ease®, Aller-Fex®, Wal-Fex®).
You should not use Zyrtec-D if you have narrow-angle glaucoma, severe high blood pressure (hypertension), severe coronary artery disease, if you are unable to urinate, or if you are allergic to hydroxyzine (Atarax, Vistaril). Do not use this medicine if you have taken an MAO inhibitor in the past 14 days.
Greg Panico, a spokesman for Janssen Pharmaceutica, which is owned by Johnson and Johnson, said that the withdrawal was a voluntary business decision. “The decision to voluntarily discontinue it recognises that the allergy marketplace is crowded with a number of other drugs,” Mr Panico said.
The older, so-called first generation H1-antihistamines, such as Chlorpheniramine, Diphenydramine, Doxepin, Hydroxyzine after oral or parenteral administration are metabolized in the liver and excreted in large part with the urines. Pharmacological action occurs after 30-60 minutes and persists for about 4-6 hours.
Age Limits.
For allergies, don't use under 2 years of age. Reason: not FDA approved. For age 2 - 6 years, talk with your child's doctor before using. For colds, not advised at any age.
Drowsiness, tiredness, and dry mouth may occur. Stomach pain may also occur, especially in children. If any of these effects last or get worse, tell your doctor or pharmacist promptly.
Is it safe to take Zyrtec every day? Yep. "When taken in the recommended doses, antihistamines can be taken daily. This is especially true with Zyrtec, since it doesn't show decreasing effectiveness if used daily," says Sima Patel, MD, an allergist at New York Allergy & Sinus Centers.
It's important to note that long-term use of first-generation antihistamines, like Benadryl, may increase the risk of dementia and cognitive decline, research suggests. And there's always a risk of taking too much of an antihistamine, especially with long-term use.
Depending on your symptoms, you can take antihistamines: Every day, to help keep daily symptoms under control. Only when you have symptoms. Before being exposed to things that often cause your allergy symptoms, such as a pet or certain plants.
Xyzal is one of the newer, third-generation antihistamines used to treat allergies. It is available OTC and by prescription.
However, medicines containing decongestants — including Allegra-D, Zyrtec-D and Claritin-D — could increase your blood pressure and heart rate or interfere with your heart medication.
Cetirizine can be taken at any time of the day. In most people it is non-sedating, so they take it in the morning. However, a percentage of people do find it to be sedating so if it does make you drowsy it is best to take it in the evening.
Histamine H1 receptor antagonist cetirizine impairs working memory processing speed, but not episodic memory.
First-generation (older) allergy medications may cause memory loss. However, newer antihistamines, cetirizine (Zyrtec) and loratadine (Claritin) are less likely to cause problems with memory and cognition.
Non-sedating antihistamines are used in the long-term control of allergy, as in hay fever, eczema, sinusitis, and chronic urticaria. No serious side effects have been reported.
Summary. Natural antihistamines may help you control your seasonal allergies. Common ones are stinging nettle, vitamin C, quercetin, butterbur, bromelain, and probiotics. Some alternative practices—such as acupuncture, nasal irrigation, and exercise—may also help you manage symptoms.
For many people with allergies, symptoms are the worst around 4 a.m. to 6 a.m. Taking an antihistamine at bedtime may help you or your child feel better in the morning during allergy season.
Cetirizine has the fastest onset of action among the newer antihistamines. Fexofenadine does not impair psychomotor or cognitive skills and shows no dose-related increase in sedation but has a slower onset of action than diphenhydramine and cetirizine.