The Side Effects of Antihistamine drugs
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Antihistamines are type of medications used for allergic reactions, rhinitis, and common cold. Most common feature of all antihistamines is blockade of histamine type 1 receptors. They are an ingredient in most over the counter cough syrups. However, they can cause some side effects.
Antihistamines can be divided into first generation and second generation. First generation anti histamines crosses the blood brain barrier and they can cause more side effects. Second generation or newer antihistamines does not crosses the blood brain barrier and they cause less side effects.
Commonly available first generation antihistamines are Chlorpheniramine (Piriton, Histop), Promethazine (Phenergan), and Dephenhydramine (Benadryl). Most of the old antihistamines are available in over the counter medications.
Common second generation antihistamines are Cetirizine, Loratidine, Fexofenadine (Telfast) and Levocetirizine.
Antihistamines are available as wide tablets, injections, skin creams, eye drops and nasal drops.
What are the side effects of antihistamines?
Most common side effect is drowsiness and sedation. They are much more common in older first generation anti histamines. However, cetirizine (second generation) is more sedating than other newer antihistamines. Other second generation antihistamines are less sedating than cetirizine and older antihistamines. Due to this side effect, it is not prudent to drive motor vehicles or operate machinery with these drugs until the patient knows how it affects him.
Older antihistamines can cause headache, psychological impairment, urinary retention, blurred vision and dry mouth. In addition they can cause constipation.
Other rare side effects of antihistamines are hypotension, palpitation, cardiac rhythm problems, dizziness, confusion, depression, sleep problems, tremors, fits, allergic reactions (difficulty in breathing, edema of mouth and tongue, and anaphylaxis, rashes, and photosensitive rashes), liver problems, and glaucoma.
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Use of antihistamines is pregnancy and breast feeding
Most of the antihistamine manufactures advice not to use these drugs in pregnancy and breast feeding. However, except Loratidine there is no documented evidence of fetal harm. In addition, most of the antihistamines are secreted in breast milk.
Liver disease
Antihistamines, especially older ones should not be used in severe liver failure. It is because they tend to cause drowsiness.
If you have following conditions then do not use older antihistamines, even though they are freely available.
1. prostatic hypertrophy
2. urinary retention
3. glaucoma
4. intestinal obstruction
5. epilepsy
6. porphyria
Conclusion
Antihistamines are common medications used for allergies, common cold and cough. Older antihistamines cause more side effects. However, ironically most of the older antihistamines are available over the counter. Therefore you need some knowledge before taking a cough syrup.
Sources
British National Formulary
Warning and disclaimer
This article is for the general information only. You should consult your doctor if you are to take prescription drugs.
Useful links
- Best non-drowsy allergy medications that work - by Dr. Manura Nanayakkara
Some drugs used in allergies cause drowsiness, especially older drugs. This is especially problematic in driving, studying and operating machinery - Side effects of Promethazine (Phenergan)
This is a common over the counter medication used for vomiting, allergic reactions, motion sickness and to induce sleep. It is a first generation antihistamine with some unpleasant side effects. However, side... - Side effects of Histop (Chlorpheniramine)
This is the popular name for an over the counter generic drug Chlorpheniramine. This medicine is a first generation antihistamine. It is used for symptomatic relief of allergies such as colds, cough, allergy,...







always exploring Level 8 Commenter 11 months ago
Very helpful. Thank you.