non sedating antihistamine

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Non sedating antihistamine

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Non sedating antihistamine About half the cards sent out are returned. ND undertook the final and independent statistical analysis. References Some of them also have antiserotonin or other actions that oppose allergic inflammation, and they are not entirely free from sedative effects either. Mild to even moderate sedation is not necessarily a major nuisance, particularly if stimulants need be added to the regimen e.
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During breastfeeding, loratadine and cetirizine are recommended. The lowest effective dose for the shortest period of time should be prescribed [ Powell, ]. Most manufacturers of antihistamines advise avoiding their use during breastfeeding as most antihistamines are present in breast milk in varying amounts [ Zuberbier, ; BNF 72, ].

However, LactMed a US drugs and lactation database states that: Loratadine would not be expected to cause any adverse effects in breastfed infants due to its lack of sedation and low milk levels, but it might have a negative effect on lactation [ LactMed, ].

Cetirizine is probably acceptable during breastfeeding if given in small, occasional doses. However, larger doses or more prolonged use may cause drowsiness and other effects in the infant, or decrease the milk supply particularly before lactation is well established [ LactMed, ].

Acute porphyria. Prescribe: Cetirizine with caution to people with renal impairment. Loratadine with caution to people with hepatic impairment. Reduce dose frequency to alternate days in severe impairment. The licensed oral doses of cetirizine are: Children aged 2 years to 5 years — 2. Children aged 6 years to 11 years — 5 mg twice daily. Adults and children aged 12 years and over — 10 mg once daily. The licensed oral doses of loratadine ar e: Children aged 2 years to 11 years and body weight up to 31 kg — 5 mg once a day.

Children age 2 years to 11 years and body weight 31 kg and over —10 mg once a day. Adults and children aged 12 years and over — 10 mg once a day. The licensed oral dose of fexofenadine is : Adults and children aged 12 years and over — mg once a day. Non-sedating antihistamines are associated with a lower incidence of drowsiness and sedation because they penetrate the blood—brain barrier to a lesser extent than sedating antihistamines [ Bernstein, ].

However, these adverse effects may still occur. Fexofenadine and loratadine may cause sedation at doses exceeding the recommended doses. Cetirizine may cause sedation at recommended doses. The sedative effects of antihistamines are enhanced when combined with alcohol. Rare adverse effects of antihistamines include hypotension, palpitation, arrhythmias, extrapyramidal effects, dizziness, confusion, depression, sleep disturbances, tremor, convulsions, hypersensitivity reactions including bronchospasm, angioedema, anaphylaxis, rashes, and photosensitivity reactions , blood disorders, liver dysfunction, nightmares, acute generalised exanthematous pustulosis, arthralgia and angle-closure glaucoma.

The manufacturer's SPC notes that desloratadine has been associated with an increased incidence of new-onset seizure in patients younger than 20 years of age. Drug interactions associated with non-sedating antihistamines include: Ritonavir — plasma concentration of non-sedating antihistamines possibly increased by ritonavir. In addition for fexofenadine: Antacids — absorption of fexofenadine reduced by antacids. Rifampicin — effects of fexofenadine possibly reduced by rifampicin. Ulipristal acetate — the manufacturer of ulipristal acetate advises that fexofenadine is taken at least 1.

Mild to even moderate sedation is not necessarily a major nuisance, particularly if stimulants need be added to the regimen e. Furthermore, patients can adjust doses themselves if needed. Sedating antihistamines are not needed for long-term itching, because glucocorticoids are indicated and more effective. It is wise to restrict or avoid using antihistamines astemizole, terfenadine that can cause cardiac dysrhythmias, because even severe cardiotoxicity can occur in certain pharmacokinetic drug-drug interactions.

Histamine H1 receptor antagonists antihistamines are used in the treatment of allergic disorders. The therapeutic effects of most of the older antihistamines were associated with sedating effects on the central nervous system CNS and antimuscarinic effects causing dry mouth and blurred vision. Non-specific "quinidine-like" or local anaesthetic actions often led to cardiotoxicity in animals and man.

Although such adverse effects varied from drug to drug, there was some degree of sedation with all old antihistamines. Non-sedating antihistamines have become available during the past 15 years. Some of them also have antiserotonin or other actions that oppose allergic inflammation, and they are not entirely free from sedative effects either.