Prather Pediatric and Allergy Center - Ask Doctor Brent

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Title: Antihistamines - Old and New

Category: Asthma and Allergy


We have used antihistamines for years to treat allergies from hives to hay fever. Many such as Benadryl and Chlortrimeton, which can be bought over the counter, did a fair job. The main problem with antihistamines is that they all made you sleepy and had other undesirable side affects particularly when used over a long period of time. Now we have a new generation of antihistamines called the second generation h-1 receptor antagonists. Two which are now on the American market are Hismanal and Seldane. Both of these are very good antihistamines to treat hay fever. Hismanal is also very good to control itching from hives or eczema. Both antihistamines are very expensive and are probably over priced for a mild weekend of hay fever. They are ideally used for severe hay fever sufferers or someone with chronic hives that really needs a potent medicine that will not make them sleepy.

Besides Hismanal and Seldane, which are well tolerated, well studied and have been heavily used in the United States for the past several years, there are three new second generation h-1 antagonists which will probably hit our market soon. These include Cetirizine, Loratadine, and Azelastine. These are already being used world wide with great results and hopefully will soon enter the American market. If they do, there is a good chance that the cost of Seldane and Hismanal will come down. Also they may be just as good or maybe even better and their cost may be lower. With five effective, potent, non-sedating antihistamines to choose from it will be rare that a patient will have to use the old fashioned first generation antihistamines any more. By the year 2000, I predict that it will be actually hard to find the old fashioned antihistamines in drug stores.

One good thing which occurs with high technology, research and continuing improvements in new medicines is that we can control old diseases easier with much less side affects. One major misconception about antihistamines is that they should never be used by a patient who is having asthma. This is an old concept that went out about ten years ago. With the new antihistamines, which do not have drying effects like the first generation did, this is absolutely not a problem. In fact studies show that good control of a runny nose will make it easier to control a patient's asthma. For the specific best use of any of these non-sedating antihistamines, check with your physician. The chances are good that once you find the right medicine for your particular case, you will not have to see the doctor as often or not have to take as many other medicines. A couple of good national reference centers for any specific questions you may have on any of these antihistamines include the:

* American College of Allergy and Immunology; 800 E. North- west Highway, Suite 1080;

Palatine, IL 60067,

Phone number is:

(800) 842-7777;


* The Asthma and Allergy Foundation (800) 7-ASTHMA; Phone number is:



* The National Allergy and Asthma Network

Phone number is:

(800) 878-4403


In July much negative publicity was given to Seldane. It is still a good and safe drug when used properly. The danger arises when it is overdosed or used with Nizoral or Erythromycin. Ask your physician about this if you are taking Seldane. Likewise, Hismanal should never be overdosed.