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.
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.
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.
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).
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.
The well-known side effects of the first-generation antihistamines, sedation and decreased reaction time, are more pronounced in the elderly. The anticholinergic effects are drying of the mouth and eyes, blurred vision, urinary retention, and constipation.
What they actually recommend is that if you're over 65, or if you have liver or kidney problems, you should ask your doctor if it's OK to use it. 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.
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.
Allergy Medications
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.
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.
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.
Histamine H1 receptor antagonist cetirizine impairs working memory processing speed, but not episodic memory.
Second-generation antihistamines are effective in elderly patients with allergic rhinitis in drops and oral forms. Their safety is based on a relatively low rate of passage across the blood–brain barrier.
Avoid the use of alcohol, sedatives, and tranquilizers as cetirizine can increase the risk of drowsiness. Cetirizine may cause central nervous system depression; avoid activities requiring mental alertness until accustomed to the medication.
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.
“The most common side effects you tend to see are fatigue, headaches, and dry mouth,” says Shih. If you're someone for whom the benefits of regular antihistamine use far outweighs the occasional minor side effect, longterm use is safe for most adults and children, he adds.
Over-the-counter medications such as Benadryl and other antihistamine allergy medications also can lead to temporary brain fog and forgetfulness.
Known central nervous system (CNS) adverse effects of cetirizine include anxiety, depression, insomnia, and paranoia.
Which allergy medications are best for people with high blood pressure? Second-generation antihistamines that are not combined with decongestants are the best choice for people with hypertension. These include oral medications like: Cetirizine (Zyrtec)
One study also suggests cetirizine and hydroxyzine have a greater chance of causing anxiety and mood changes than other antihistamines. Hydroxyzine can also be used to treat anxiety conditions. So if you notice your symptoms worsen after starting this medication, contact your provider to discuss it further.
In 95% of patients after oral administration of 10 mg cetirizine, it has been showed that the highest blood levels achieved 60 min later. Our patient was admitted to the emergency department with complaints of palpitations exactly 1 h after taking the drug, and AF was documented on emergency ECG.
The second-generation nonsedating antihistamines generally are considered as safer alternatives for use in older adults who require treatment for allergic rhinitis and other allergy symptoms.
Claritin and Zyrtec are effective and safe for most people with minor allergies. However, as with all medications, there may be some side effects. Loratadine—present in Claritin—may not be safe for people with severe liver conditions.