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.
Second-generation antihistamines are effective in elderly patients with allergic rhinitis in drops and oral forms.
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®).
Second-generation antihistamines were first developed in the 1980s. They cause less sleepiness than first-generation antihistamines and also interact with fewer medications. Some examples of second-generation antihistamines include: Cetirizine (Zyrtec)
ZYRTEC-D® Allergy Relief Tablets with Decongestant and Cetirizine HCl. Adults under 65 and children 12 years and older One 10 mg capsule once daily; do not take more than one 10 mg capsule in 24 hours. Adults 65 years and over Ask a doctor. Adults with liver or kidney disease Ask a doctor.
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. Other medical problems common in elderly patients may contribute to sedation.
If you take an antihistamine frequently or daily, your health care provider may recommend a second-generation antihistamine as they are less likely to cause side effects like sleepiness and fatigue. Example of second-generation antihistamine are: Zyrtec (cetirizine) Xyzal (levocetirizine)
First generation antihistamines, while very effective at controlling symptoms, are often associated with symptoms in older adults such as anxiety, confusion, sedation, blurred vision, reduced mental alertness, urinary retention and constipation.
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.
You can also experience side effects from taking a regular antihistamine—like Zyrtec, Claritin, or Benadryl—including dry mouth, confusion, flushing, visual impairment, and fever. What's more—getting off antihistamines can cause allergic reactions as well.
Do not use with any other antihistamines applied to the skin (such as diphenhydramine cream, ointment, spray) because increased side effects may occur. Cetirizine is very similar to hydroxyzine and levocetirizine. Do not use these medications while using cetirizine.
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.
Appropriate studies performed to date have not demonstrated geriatrics-specific problems that would limit the usefulness of fexofenadine in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require an adjustment in the dose for patients receiving fexofenadine .
Avoid first-generation antihistamines.
The side effects—possible anxiety, confusion, drowsiness, urine retention, dry mouth and eyes, and dizziness—make these drugs inappropriate for seniors.
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.
To sum it up, all first-generation H1 antihistamines should be taken close to bedtime or when you're able to sleep. Second-generation H1 antihistamines and H2 blockers can typically be taken at any time of the day. One exception to this is cetirizine, which can cause drowsiness for up to 14% of those who take it.
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.
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.
Antihistamines like diphenhydramine (Benadryl) and cetirizine (Zyrtec) aren't known to raise blood pressure when used alone. Antihistamines are part of many combination over-the-counter (OTC) cough and cold products. They may be combined with a medication that can raise your blood pressure.