Which medications in the drug class First-generation antihistamines are used in the treatment of Allergic Rhinitis?

Updated: Dec 26, 2018
  • Author: Javed Sheikh, MD; Chief Editor: Michael A Kaliner, MD  more...
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Answer

First-generation antihistamines

The older, first-generation H1 antagonists (eg, diphenhydramine, hydroxyzine) are effective in reducing most symptoms of allergic rhinitis, but they produce a number of adverse effects (eg, drowsiness, anticholinergic effects). They can be used prn, but adverse effects may limit their usefulness when taken on a daily basis. Some patients tolerate the adverse effects with prolonged use, but they may experience cognitive impairment, and driving skills may be affected. [92, 93, 94, 95, 96] Administration at bedtime may help with drowsiness, but sedation and impairment of cognition may continue until the next day.

The second-generation antihistamines are nonsedating in most patients and are preferred as first-line therapy. Few adverse effects are reported (cetirizine may cause drowsiness in as many as 10% of patients); therefore, many specialists prefer the use of second-generation agents for allergic rhinitis. Caution patients taking medications with sedative effects about driving and operating heavy machinery. [95, 96]

Chlorpheniramine (Chlor-Trimeton, Aller-Chlor, Allergy Relief, Allergy-Time, Ed-ChlorPed, Pharbechlor)

First-generation agent, available OTC in the United States. Competes with histamine on H1-receptor sites on effector cells in blood vessels and respiratory tract.

Diphenhydramine (Benadryl, Aler-Dryl, Allergy Relief, Banophen, Diphen, Genahist, Ormir)

Common first-generation agent available OTC in the United States. Competes with histamine on H1-receptor sites on effector cells in blood vessels and respiratory tract. For symptomatic relief of symptoms caused by release of histamine in allergic reactions.

Hydroxyzine (Vistaril)

Effective first-generation agent but frequently produces sedation. Considerable sedation may occur with higher doses. Antagonizes H1 receptors in periphery. May suppress histamine activity in subcortical region of CNS.


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