Research suggests that fexofenadine is the least sedating of the newer antihistamines. According to drug safety monitoring reports, loratadine and fexofenadine are less likely to cause sedation than cetirizine.
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®).
Both medications are used to treat the same symptoms, including sneezing, runny nose, itchy eyes, itchy throat, and hives. In a clinical trial, both medications appeared to be equally effective in treating allergy symptoms.
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.
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)
Sandoz issued a voluntary recall of 1,023,430 units of Zyrtec (10 mg) capsules as a result of failed impurities and a specification being reported for impurity at the 21-month stability time point, according to an FDA Enforcement Report.
Side effects of antihistamines
sleepiness (drowsiness) and reduced co-ordination, reaction speed and judgement – do not drive or use machinery after taking these antihistamines. dry mouth. blurred vision. difficulty peeing.
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.
“Zyrtec is found to be more potent, or stronger, in laboratory studies, compared with Claritin,” says Dr. Kung. “It also reaches a higher concentration in the skin, which can be more helpful for skin-related allergies. However, Zyrtec has a greater chance of making you sleepy while taking it.”
Long term use of some antihistamines may increase your risk of dementia. Diphenhydramine (Benadryl®) blocks the effects of a neurotransmitter called acetylcholine. This neurotransmitter is vital for memory and learning.
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.
Cetirizine is unlikely to do you any harm if you take it for a long time. However it's best to take cetirizine only for as long as you need to. If you take it regularly over a long period there's a very small chance of severe itching if you stop treatment suddenly.
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.
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 .
Claritin is generally avoided during pregnancy and nursing. Pregnant women may take Claritin only if it is clearly needed. Nursing mothers should consult their doctor before breastfeeding. Claritin should not be used in children younger than 6 years of age unless directed by a doctor.
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.
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.