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Antihistamine Drugs

Dr Roger Henderson
Reviewed by Roger HendersonReviewed on 29.04.2024 | 5 minutes read
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Antihistamine drugs are a group of medications that prevent the level of histamine from rising in our body and reduce the symptoms this can cause. Antihistamines can be used to treat a range of conditions from allergic reactions, motion sickness and insomnia to insect bites, allergic conjunctivitis and nausea. However, the term "antihistamines" most commonly refers to medication used to treat hay fever.

Antihistamines that are available to buy over-the-counter in the UK include: Piriton® (the active drug is chlorphenamine, Clarityn (the active drug is loratadine, Piriteze (where the active drug is cetirizine and Benadryl® allergy relief (the active drug is acrivastine. These are generally licensed for the treatment of hay fever, allergic reactions to pets, dust mites and food, insect bites, chickenpox rash and prickly heat rash. They’re available as creams, tablets and oral liquid.

Doctor’s advice

Who should take antihistamines?

If you’re suffering from hay fever or allergic-type symptoms such as an itchy nose, itchy rash or bite on the skin or redness and minor swelling of the skin, then an antihistamine may help relieve these symptoms for you.

Minor allergic reactions to products (washing detergent, creams, perfume), food or plant reactions (stinging nettles) can be safely treated with over-the-counter antihistamines and should get better in hours to days but make sure to avoid whatever caused the reaction in future.

If you find that you’re getting regular allergic reactions and don’t know the reason why, you should discuss with your doctor, and you may benefit from allergy testing.

How do antihistamines work?

Histamine is a naturally occurring chemical in your body that is activated and released from your cells when your immune system is triggered by a foreign substance (such as pollen). Histamine sets off a chain reaction, allowing your immune system to detect and remove the thing that caused it.

Whilst this is a useful and important response, the release of histamine can also cause redness, swelling and itchiness that can be bothersome. People that suffer from hay fever or other allergies release a higher than normal amount of histamine from their immune system.

Antihistamines help to prevent and reduce the effect of histamine in the body, and therefore are effective at relieving allergic symptoms.

Antihistamines can be classified as drowsy or non-drowsy. Chlorphenamine (Piriton) can make you drowsy so care should be exercised when driving or operating heavy machinery, and alcohol should be avoided. Some antihistamines that cause drowsiness are also found in over-the-counter sleeping tablets such as diphenhydramine.

All other over-the-counter antihistamines are classed as non-drowsy: cetirizine, loratadine and acrivastine. These are less likely to cause drowsiness, but it is still a possible side effect.

How do I take antihistamines? Should anyone avoid them?

Different medications have different doses and schedules for how often you can take them. Check with your pharmacist or read the box carefully if you are not sure.

Most antihistamines are safe to take for long periods of time - for example throughout the hay fever season - but chlorphenamine should not be used for longer than two weeks at a time without consulting a doctor. Antihistamine creams are also available to buy and may be more suitable for treating localised reactions such as insect bites or stings.

Talk to your doctor if you are pregnant or breastfeeding before taking antihistamines. Do not take any antihistamines three days before taking an allergy skin test as this can affect your results.

Like all medications, don’t take them if you have previously had an allergic reaction to the medication, if you have severe kidney or liver problems, or if you have other medications or medical conditions where you would normally discuss with your doctor or pharmacist before starting something new.

Are there any side effects?

Yes, antihistamines can cause side effects, and these depend on the specific type and how your body reacts to them. Some side effects are mild, while others may need closer attention.

First-Generation Antihistamines

Older drugs like diphenhydramine and chlorphenamine are effective but often come with noticeable side effects. They can cross into the brain, which is why they cause drowsiness.

Common issues

The most well-known side effect is feeling sleepy. You might also notice a dry mouth, dizziness, or blurred vision. These drugs can also slow down your gut, leading to constipation or making it harder to pass urine.

Uncommon problems

Some people feel jittery or restless instead of sleepy, especially children. Older adults may experience confusion or even memory trouble, so these medications are often avoided in this group.


Second-Generation Antihistamines

These include loratadine and cetirizine. They’re designed to work outside the brain, so they rarely make you drowsy.

Mild side effects

You might feel slightly sleepy with some (like cetirizine), but most people don’t. Headaches and dry mouth occasionally happen, but they’re less common than with the older drugs.

Rare reactions

Stomach upset or a racing heartbeat could occur, but these are unusual.


When Should You Be Careful?

  • If you’re pregnant, some antihistamines are safer than others, but always check first.
  • If you’re breastfeeding, some types can pass into breast milk and cause drowsiness in the baby.
  • If you’re on other medications, interactions are possible. This is especially true for first-generation antihistamines when combined with alcohol or sedatives, which can make you even sleepier.
  • If you have health conditions, conditions like glaucoma, prostate problems, or irregular heart rhythms might worsen with antihistamines.

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Dr Roger Henderson
Reviewed by Roger Henderson
Reviewed on 29.04.2024
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