New generation histamine drugs. Which skin allergy pills help best?
Due to the expansion of the lumen small vessels the blood flow through them is facilitated, which, in turn, leads to a significant improvement in microcirculation and blood supply to peripheral tissues with oxygen and nutrients. It is by expanding the lumen of small vessels that Cinnarizine improves blood supply to the brain, kidneys and limbs. The drug also reduces blood viscosity and increases the elasticity of red blood cell membranes, which also helps to improve blood supply to peripheral tissues through which numerous small vessels pass.
Relaxation effect blood vessels, which arose under the influence of Cinnarizine, is not eliminated by biologically active substances that usually have a pronounced vasoconstrictor effect, such as adrenaline, norepinephrine, dopamine, angiotensin and vasopressin.
In addition, Cinnarizine has moderate antihistamine activity, due to which it reduces excitability vestibular apparatus and tone of the sympathetic nervous system. The drug also increases tissue resistance to oxygen starvation(hypoxia).
Summarizing the above, we can conclude that Cinnarizine improves cerebral and peripheral blood circulation, reduces the excitability of the vestibular apparatus and increases tissue resistance to oxygen starvation. That is why Cinnarizine is effective in treating deficiency cerebral circulation, cerebral atherosclerosis, focal post-stroke changes, as well as to improve peripheral circulation during various diseases, including endarteritis, Raynaud's syndrome, diabetic angiopathy, IHD, etc.
Cinnarizine - indications for use
Cinnarizine is indicated for use in the following conditions and diseases:1. Chronic cerebrovascular insufficiency (dizziness, tinnitus, headache, memory impairment and poor concentration).
2. Cerebrovascular disorders:
- Post-stroke focal disorders;
- Atherosclerosis of cerebral vessels;
- The rehabilitation period after a traumatic brain injury;
- Encephalopathy;
- Senile vascular dementia(dementia).
4. Prevention of kinetosis (sea and air sickness).
5. Prevention of migraine attacks.
6. Peripheral circulatory disorders (prevention and treatment):
- "Intermittent" claudication;
- Raynaud's disease;
- Diabetic angiopathy;
- Trophic or varicose ulcers;
- Obliterating endarteritis;
- Thromboangiitis obliterans;
- Nonspecific aortoarteritis;
- Leriche syndrome;
- Paresthesia (pins and needles sensation, tingling, numbness, etc.);
- Night cramps in arms and legs;
- Coldness of the extremities;
- Acrocyanosis.
Therapeutic effect, indications for use - video
Cinnarizine - instructions for use
How to use?
Contraindications
Hypersensitivity, pregnancy, lactation period, age up to two years.
Overdose
Symptoms: headache, hypersomnia, cardiopalmus. With a body weight of less than 30 kg, when consumed in an amount of more than 0.01 g, disturbances in the functioning of the extrapyramidal system and tachycardia are possible.
Treatment: Antidotes are unknown. Provocation of vomiting with emetic root syrup (the use of emetic root preparations is necessary even in case of spontaneous vomiting); gastric lavage, consumption of activated carbon and large volumes of water; symptomatic and restorative treatment. Dialysis is ineffective.
Special instructions and precautions
The use of the drug must be discontinued at least 8 days before the skin allergy test. Use of loratadine in pregnant women and during pregnancy breastfeeding permissible only if the intended positive effect for mother exceeds possible risk for a child. You should be careful about the concomitant use of liver enzyme inhibitors (guanidine, Prozac), because missing necessary clinical trials, confirming the admissibility of such combinations.
Caution must be exercised when driving or when performing work that requires high concentration.
Drug interactions
Inhibitors of the cytochrome P450-dependent monooxygenase system increase plasma levels of loratadine and descarboethoxyloratadine. Loratadine reduces the concentration of erythromycin in the blood (by 14-16%). Given the likelihood of developing a dose-dependent sedative effect, caution must be exercised when using the drug concomitantly with other antiallergens, barbiturates, benzodiazepines, opiate receptor agonists, antipsychotic drugs, antidepressants, tranquilizers, sedatives and hypnotics, as well as when drinking alcohol.
Storage conditions
Store in a dry place, protected from direct sun rays place, at a temperature of 15-25 degrees. The expiration date is indicated on the packaging. The drug is sold without a prescription.
When choosing from all the medications intended to combat allergies, it is best to opt for single-component medications, which include one single antihistamine. Antihistamines are truly effective in combating allergic reactions of any origin.
Why are single-component products in this category used by specialists most often?
This fact is very easy to explain: the fact is that these medications are much easier for patients to tolerate, since they cause certain side effects only in very rare cases.
The most common side effect that can occur with the use of these pharmaceuticals is considered to be drowsiness. If this effect has developed, then the patient should temporarily refrain from working with dangerous mechanisms, as well as from driving a car. Even if the patient does not experience drowsiness of this kind medications in any case, they slow down his reaction. Plus, we should not forget that the use of this type of medication along with sedatives or alcoholic beverages will only enhance the effect of the former.
The strength of drowsiness during a course of therapy with one or another antihistamine is determined both by the medication used and by the individual characteristics of the patient’s body. Among this type of medicines, which are less likely than others to cause this side effect and can be purchased at a pharmacy without a prescription, can be considered: clemastine, so chlorpheniramine maleate, pheniramine maleate, and brompheniramine maleate. But such medications as doxylamine succinate And diphenhydramine hydrochloride on the contrary, they very often cause the development of this side effect.
Against the background of the use of certain antihistamines, some other side effects may become noticeable, namely dry throat, nose and oral cavity. There are also cases where people develop dizziness, migraines and nausea. Others experience blurred vision, loss of coordination, low blood pressure, decreased appetite, and upset stomach. When using these medications by older people suffering from a hypertrophied prostate gland, it is quite possible to develop difficulty urinating. Sometimes these medications also cause anxiety, nervousness and insomnia. By the way, insomnia very often develops in children.
When choosing one or another antihistamine in the fight against allergic pathologies, first use its minimum dose and make sure that it is normally tolerated by your body. Reliable information regarding contraindications, as well as special instructions to the use of a specific antihistamine. It is important in this case not to deviate from the prescribed dosages, since certain adverse reactions against the background of the use of this type of medication, they can also develop as a result of an overdose.
Allergic conjunctivitis especially often makes itself felt in the spring. The person seems to be completely healthy, yet his eyes are constantly watering, swollen and itchy.
What's the matter?
Most likely, allergic conjunctivitis on the face. Having heard such a diagnosis, the first thing that comes to mind is antihistamines. Indeed, it is these pharmaceuticals that are used in the fight against this disease.
What happens to the eyes with allergic conjunctivitis?
Around the end of spring, people can watch the leaves begin to bloom on the trees, fluff flies around all the time, and flowers bloom. As a result, people prone to allergic reactions begin to have red and swollen eyes. In addition, these symptoms are also accompanied by burning and itching. Sometimes people begin to be afraid of daylight. In general, allergic conjunctivitis manifests itself differently in all people. It should also be noted that this pathology can be caused by a reaction not only to fluff or pollen, but also for animal hair, dust, perfumes, household chemicals, and so on.
Is it possible to get rid of this disease without the help of medications?
In fact, it is impossible to ignore this pathology, since it is characterized by symptoms that significantly worsen not only the mood, but also the appearance of the patient, while significantly changing usual image life. It should also be noted that this pathology “takes hold” of both eyes at once.
In what cases is it impossible to do without the help of antihistamines?
First of all, it is worth noting that in the fight against this disease, antihistamines are used in the form eye drops. Their use is extremely necessary in cases where the development allergic conjunctivitis has already begun. Antihistamine eye drops help prevent the release of histamine in the first place. As a result, histamine is unable to penetrate the space between cells and, therefore, begin its destructive effects.
In principle, this type of medicine is recommended to be used not so much for treatment as for the prevention of allergic conjunctivitis. This is explained by the fact that their use for preventive purposes gives a stronger therapeutic effect. We draw the attention of readers to the fact that antihistamines in the form of eye drops in the fight against allergic conjunctivitis should in no case be used by patients who wear lenses. If their use in such cases is really necessary, then it is recommended to put on the lenses approximately fifteen minutes after instillation.
How is allergic conjunctivitis prevented?
In order to prevent the development of this allergic pathology, it is recommended to use special antiallergic agents in the form of eye drops. Agree, it is better to use these medications and not feel the symptoms of this disease than to experience all the signs of allergic conjunctivitis and fight them with other more serious pharmaceuticals.
Antihistamines are considered to be medications used to treat certain allergic pathologies or reactions. These pharmaceuticals belong to the category of the most commonly used drugs among all histaminergic medications. If we talk about their use during pregnancy, then in this case it is immediately worth drawing the attention of all expectant mothers to the fact that their use is possible only after consulting an allergist, and also under his strict supervision. Unfortunately, all medications in this group are strictly prohibited for use in the first trimester of pregnancy. Starting from the second trimester, they can be used only if you really cannot do without their help. We note right away that there is not a single medication on the list of antihistamines that can be confidently called completely safe.
Right now, pregnant women will be given information regarding certain antihistamines and their effects on pregnancy. Let's start with diphenhydramine. This medication is strictly contraindicated for use throughout pregnancy, as it tends to cause premature birth. The same goes for betadrine. If we talk about diprazine, then it can be prescribed during pregnancy only in in case of emergency. Nothing is yet known about exactly how this antihistamine affects the course of pregnancy. Suprastin is allowed to be used only in the second trimester of pregnancy and then only as prescribed by a doctor.
As for tavegil, it is strictly forbidden to use it only in the first trimester of pregnancy. During clinical studies on animals, scientists were able to establish that the use of this medication in the second and third trimester can cause the development of certain birth defects. Cyproheptadine And bicarfen Under no circumstances should it be used during pregnancy. Flonidan can be prescribed to the expectant mother only in extreme cases severe cases. But as for Zyrtec, this medication is allowed to be used during pregnancy, but only in strictly specified dosages, since only in this case it does not tend to have a teratogenic effect. Pheniramine can only be prescribed to a pregnant woman from the second trimester of pregnancy.
Ditek is produced in aerosol form, despite this, this medication is unsafe for all pregnant women, despite the fact that numerous clinical studies have failed to establish its direct effect on the growth and development of the fetus. It is highly undesirable to use this period and antihistamines such as ketotifen, histaglobulin, zafirlukast, cromolyn sodium and some others.
Based on the foregoing, we can conclude that almost all antihistamines are dangerous not only for a pregnant woman, but also for the fetus. That’s why it’s not worth taking unnecessary risks. Use any pharmaceutical product must necessarily be agreed with a specialist.
There are several groups of medications used for allergic diseases. This:
- antihistamines;
- membrane-stabilizing drugs - cromoglycic acid preparations () and ketotifen;
- topical and systemic glucocorticosteroids;
- intranasal decongestants.
In this article we will talk only about the first group - antihistamines. These are drugs that block H1-histamine receptors and, as a result, reduce the severity of allergic reactions. Today there are more than 60 antihistamines for systemic use. Depending on the chemical structure and the effects they have on the human body, these drugs are combined into groups, which we will talk about below.
What are histamine and histamine receptors, the principle of action of antihistamines
There are several types of histamine receptors in the human body.Histamine is a biogenic compound formed as a result of a number of biochemical processes, and is one of the mediators involved in the regulation of vital functions. important functions organism and play a leading role in the development of many diseases.
IN normal conditions this substance is inactive in the body, bound state, however, at different pathological processes(, hay fever, and so on), the amount of free histamine increases many times, which is manifested by a number of specific and nonspecific symptoms.
Free histamine has the following effects on the human body:
- causes spasm of smooth muscles (including bronchial muscles);
- dilates capillaries and reduces blood pressure;
- causes stagnation of blood in the capillaries and increased permeability of their walls, which entails thickening of the blood and swelling of the tissues surrounding the affected vessel;
- reflexively excites the cells of the adrenal medulla - as a result, adrenaline is released, which contributes to the narrowing of arterioles and an increase in heart rate;
- increases the secretion of gastric juice;
- plays the role of a neurotransmitter in the central nervous system.
Externally, these effects manifest themselves as follows:
- bronchospasm occurs;
- the nasal mucosa swells - nasal congestion and mucus discharge appear;
- itching, redness of the skin appears, all kinds of rash elements form on it - from spots to blisters;
- digestive tract an increase in the level of histamine in the blood is responded to by a spasm of the smooth muscles of the organs - severe cramping pain is noted throughout the abdomen, as well as an increase in the secretion of digestive enzymes;
- on the part of the cardiovascular system, and may be observed.
There are special receptors in the body for which histamine has an affinity - H1, H2 and H3 histamine receptors. H1-histamine receptors located in smooth muscles play a role in the development of allergic reactions. internal organs, in particular, the bronchi, in inner shell– endothelium – blood vessels, in the skin, as well as in the central nervous system.
Antihistamines act specifically on this group of receptors, blocking the action of histamine through competitive inhibition. That is, the drug does not displace histamine already bound to the receptor, but occupies a free receptor, preventing histamine from attaching to it.
If all receptors are occupied, the body recognizes this and gives a signal to reduce histamine production. Thus, antihistamines prevent the release of new portions of histamine, and are also a means of preventing the occurrence of allergic reactions.
Classification of antihistamines
Several classifications of drugs in this group have been developed, but none of them is generally accepted.
Depending on the characteristics of the chemical structure, antihistamines are divided into the following groups:
- ethylenediamines;
- ethanolamines;
- alkylamines;
- quinuclidine derivatives;
- alphacarboline derivatives;
- phenothiazine derivatives;
- piperidine derivatives;
- piperazine derivatives.
IN clinical practice more wide application received classification antihistamines by generation, of which there are currently 3:
- 1st generation antihistamines:
- diphenhydramine (diphenhydramine);
- doxylamine (donormil);
- clemastine (tavegil);
- chloropyramine (suprastin);
- mebhydrolin (diazolin);
- promethazine (pipolfen);
- quifenadine (fencarol);
- cyproheptadine (peritol) and others.
- 2nd generation antihistamines:
- acrivastine (Semprex);
- dimethindene (fenistil);
- terfenadine (histadine);
- azelastine (allergodil);
- loratadine (lorano);
- cetirizine (cetrin);
- bamipin (Soventol).
- 3rd generation antihistamines:
- fexofenadine (Telfast);
- desloratodine (erius);
- Levocetirizine.
1st generation antihistamines
First generation antihistamines have a pronounced sedative effect. Based on the predominant side effect, drugs in this group are also called sedatives. They interact not only with histamine receptors, but also with a number of other receptors, which determines their individual effects. They act for a short time, which is why they require multiple doses throughout the day. The effect comes quickly. Available in different dosage forms- For oral administration(in the form of tablets, drops) and parenteral administration (in the form of an injection solution). Affordable.
With prolonged use of these drugs, their antihistamine effectiveness is significantly reduced, which necessitates the need for periodic - once every 2-3 weeks - drug changes.
Some 1st generation antihistamines are included in combination medications for the treatment of colds, as well as sleeping pills and sedatives.
The main effects of 1st generation antihistamines are:
- local anesthetic – associated with a decrease in membrane permeability to sodium; the most powerful local anesthetics from this group of drugs are promethazine and diphenhydramine;
- sedative – caused high degree penetration of drugs of this group through the blood-brain barrier (that is, into the brain); the severity of this effect in different drugs is different, it is most pronounced in doxylamine (it is often used as a hypnotic); the sedative effect increases with simultaneous use alcoholic drinks or taking psychotropic drugs; when taking extremely high doses of the drug, instead of the effect of sedation, pronounced agitation is observed;
- anti-anxiety, calming effect is also associated with the penetration of the active substance into the central nervous system; most expressed in hydroxyzine;
- anti-sickness and anti-emetic - some representatives of the drugs in this group inhibit the function of the labyrinth of the inner ear and reduce the stimulation of receptors of the vestibular apparatus - they are sometimes used for Meniere's disease and motion sickness in transport; This effect is most pronounced in drugs such as diphenhydramine and promethazine;
- atropine-like effect - causes dryness of the mucous membranes of the oral and nasal cavities, increased heart rate, visual impairment, urinary retention, constipation; may enhance bronchial obstruction, lead to exacerbation of glaucoma and obstruction when - when specified diseases not applicable; These effects are most pronounced in ethylenediamines and ethanolamines;
- antitussive - drugs of this group, in particular diphenhydramine, act directly on the cough center located in the medulla oblongata;
- the antiparkinsonian effect occurs by inhibiting the effects of acetylcholine by the antihistamine;
- antiserotonin effect - the drug binds to serotonin receptors, alleviating the condition of patients suffering from migraine; especially pronounced in cyproheptadine;
- dilatation of peripheral vessels - leads to a decrease in blood pressure; is maximally expressed in phenothiazine preparations.
Since drugs in this group have a number of unwanted effects, they are not the drugs of choice for the treatment of allergies, but are still often used for it.
Below are some of the most commonly used representatives of the drugs in this group.
Diphenhydramine (diphenhydramine)
One of the first antihistamines. It has pronounced antihistamine activity, in addition, it has a local anesthetic effect, and also relaxes the smooth muscles of internal organs and is a weak antiemetic. Its sedative effect is similar in strength to the effects of neuroleptics. IN high doses It also has a hypnotic effect.
It is quickly absorbed when taken orally and penetrates the blood-brain barrier. Its half-life is about 7 hours. It undergoes biotransformation in the liver and is excreted by the kidneys.
It is used for all kinds of allergic diseases, as a sedative and sleeping pills, as well as in complex therapy radiation sickness. Less commonly used for pregnancy vomiting and seasickness.
Orally prescribed in the form of tablets of 0.03-0.05 g 1-3 times a day for 10-14 days, or one tablet before bed (as a sleeping pill).
1-5 ml of 1% solution are administered intramuscularly, 0.02-0.05 g of the drug in 100 ml of 0.9% sodium chloride solution is administered intravenously.
Can be used as eye drops, rectal suppositories or creams and ointments.
Side effects this drug are: short-term numbness of the mucous membranes, headache, dizziness, nausea, dry mouth, weakness, drowsiness. Side effects go away on their own, after reducing the dose or completely stopping the drug.
Contraindications are pregnancy, lactation, prostate hypertrophy, and angle-closure glaucoma.
Chloropyramine (suprastin)
It has antihistamine, anticholinergic, myotropic antispasmodic activity. It also has antipruritic and sedative effects.
It is quickly and completely absorbed when taken orally, the maximum concentration in the blood is observed 2 hours after administration. Penetrates the blood-brain barrier. Biotransformed in the liver, excreted by the kidneys and feces.
Prescribed for all kinds of allergic reactions.
It is used orally, intravenously and intramuscularly.
Orally, take 1 tablet (0.025 g) 2-3 times a day, with meals. The daily dose can be increased to a maximum of 6 tablets.
In severe cases, the drug is administered parenterally - intramuscularly or intravenously, 1-2 ml of a 2% solution.
When taking the drug, there may be side effects such as general weakness, drowsiness, decreased reaction speed, poor coordination of movements, nausea, dry mouth.
Enhances the effect of sleeping pills and sedatives, as well as narcotic analgesics and alcohol.
Contraindications are similar to those of diphenhydramine.
Clemastine (tavegil)
By structure and pharmacological properties very close to diphenhydramine, but it lasts longer (within 8-12 hours after administration) and is more active.
The sedative effect is moderate.
Take 1 tablet (0.001 g) orally before meals with a drink. big amount water, 2 times a day. In severe cases, the daily dose can be increased by 2, maximum 3 times. The course of treatment is 10-14 days.
Can be used intramuscularly or intravenously (within 2-3 minutes) - 2 ml of 0.1% solution per dose, 2 times a day.
Side effects are rare when taking this drug. Possible headache, drowsiness, nausea and vomiting, constipation.
Prescribed with caution to persons whose profession requires intense mental and physical activity.
Contraindications are standard.
Mebhydrolin (diazolin)
In addition to the antihistamine, it has anticholinergic and. Sedative and hypnotic effects extremely weakly expressed.
When taken orally, it is slowly absorbed. The half-life is only 4 hours. Biotransformed in the liver and excreted in the urine.
Used orally, after meals, in a single dose of 0.05-0.2 g, 1-2 times a day for 10-14 days. The maximum single dose for an adult is 0.3 g, the daily dose is 0.6 g.
Generally well tolerated. Sometimes it can cause dizziness, irritation of the gastric mucosa, blurred vision, and urinary retention. In especially rare cases - when taking a large dose of the drug - a slowdown in the reaction rate and drowsiness.
Contraindications are inflammatory diseases gastrointestinal tract, angle-closure glaucoma and prostatic hypertrophy.
2nd generation antihistamines
Second generation antihistamines are characterized by high efficiency, rapid onset of action and a minimum of side effects, however, some of their representatives can cause life-threatening arrhythmias. The goal of developing drugs in this group was to minimize sedation and other side effects while maintaining or even stronger antiallergic activity. And it was a success! Antihistamines of the 2nd generation have a high affinity specifically for H1-histamine receptors, with virtually no effect on choline and serotonin receptors. The advantages of these drugs are:
- rapid onset of action;
- long duration of action ( active substance binds to protein, which ensures longer circulation in the body; in addition, it accumulates in organs and tissues, and is also slowly excreted);
- additional mechanisms of antiallergic effects (suppress the accumulation in respiratory tract eosinophils, and also stabilize mast cell membranes), providing a wider range of indications for their use (,);
- at long-term use the effectiveness of these drugs does not decrease, that is, there is no effect of tachyphylaxis - there is no need to periodically change the drug;
- since these drugs do not penetrate or penetrate in extremely small quantities through the blood-brain barrier, their sedative effect is minimal and is observed only in patients who are particularly sensitive in this regard;
- do not interact with psychotropic drugs and ethyl alcohol.
One of the most adverse effects of 2nd generation antihistamines is their ability to cause fatal arrhythmias. The mechanism of their occurrence is associated with blocking by an antiallergic drug potassium channels heart muscle, which leads to prolongation of the QT interval and the occurrence of arrhythmia (usually ventricular fibrillation or flutter). Most pronounced this effect in drugs such as terfenadine, astemizole and ebastine. The risk of its development increases significantly with an overdose of these drugs, as well as in the case of combining their use with antidepressants (paroxetine, fluoxetine), antifungals (intraconazole and ketoconazole) and some antibacterial agents(antibiotics from the macrolide group - clarithromycin, oleandomycin, erythromycin), some antiarrhythmics (disopyramide, quinidine), when the patient consumes grapefruit juice and severe.
The main form of release of 2nd generation antihistamines is tablets, but parenteral ones are not available. Some drugs (such as levocabastine, azelastine) are available in the form of creams and ointments and are intended for topical administration.
Let's take a closer look at the main drugs in this group.
Acrivastine (Semprex)
It is well absorbed when taken orally and begins to act within 20-30 minutes after administration. The half-life is 2-5.5 hours, it penetrates the blood-brain barrier in small quantities and is excreted unchanged in the urine.
Blocks H1-histamine receptors, in small degree has a sedative and anticholinergic effect.
It is used for all kinds of allergic diseases.
In some cases, while taking it, drowsiness and a decrease in reaction speed are possible.
The drug is contraindicated during pregnancy, lactation, severe, severe coronary heart disease, and children under 12 years of age.
Dimetindene (fenistil)
In addition to antihistamine, it has weak anticholinergic, antibradykinin and sedative effects.
It is quickly and completely absorbed when taken orally, the bioavailability (degree of digestibility) is about 70% (in comparison, when using cutaneous forms of the drug this figure is much lower - 10%). The maximum concentration of the substance in the blood is observed 2 hours after administration, the half-life is 6 hours for the regular form and 11 hours for the retard form. It penetrates the blood-brain barrier and is excreted in bile and urine in the form of metabolic products.
The drug is used orally and topically.
Adults take 1 capsule of retard orally at night or 20-40 drops 3 times a day. The course of treatment is 10-15 days.
The gel is applied to the affected areas of the skin 3-4 times a day.
Side effects are rare.
Contraindication is only the 1st trimester of pregnancy.
Increases the effects of alcohol on the central nervous system, sleeping pills and tranquilizers.
Terfenadine (histadine)
In addition to antiallergic, it has a weak anticholinergic effect. It does not have a pronounced sedative effect.
Well absorbed when taken orally (bioavailability is 70%). The maximum concentration of the active substance in the blood is observed after 60 minutes. Does not penetrate the blood-brain barrier. Biotransformed in the liver to form fexofenadine, excreted in feces and urine.
The antihistamine effect develops after 1-2 hours, reaches its maximum after 4-5 hours, and lasts for 12 hours.
The indications are the same as for other drugs in this group.
Prescribe 60 mg 2 times a day or 120 mg 1 time a day in the morning. The maximum daily dose is 480 mg.
In some cases, when taking this drug, the patient develops side effects such as erythema, fatigue, headache, drowsiness, dizziness, dry mucous membranes, galactorrhea (leakage of milk from the mammary glands), increased appetite, nausea, vomiting, in case of overdose - ventricular arrhythmias.
Contraindications include pregnancy and breastfeeding.
Azelastine (allergodil)
Blocks H1-histamine receptors and also prevents the release of histamine and other allergy mediators from mast cells.
It is quickly absorbed in the digestive tract and from the mucous membranes, the half-life is as much as 20 hours. Excreted in the form of metabolites in the urine.
Typically used when allergic rhinitis And .
When taking the drug, side effects are possible such as dryness and irritation of the nasal mucosa, bleeding from it and taste disorders when administered intranasally; irritation of the conjunctiva and a feeling of bitterness in the mouth - when using eye drops.
Contraindications: pregnancy, lactation, children under 6 years of age.
Loratadine (lorano, claritin, lorizal)
H1-histamine receptor blocker long acting. The effect after a single dose of the drug continues throughout the day.
There is no pronounced sedative effect.
When taken orally, it is absorbed quickly and completely, reaches maximum concentration in the blood after 1.3-2.5 hours, and is half eliminated from the body after 8 hours. Biotransformed in the liver.
Indications include any allergic diseases.
It is generally well tolerated. In some cases, dry mouth may occur, increased appetite, nausea, vomiting, sweating, pain in joints and muscles, hyperkinesis.
Contraindications include hypersensitivity to loratadine and lactation.
Prescribed with caution to pregnant women.
Bamipin (Soventol)
H1-histamine receptor blocker for topical use. Prescribed for allergic skin lesions (urticaria), contact allergy, as well as for frostbite and burns.
The gel is applied in a thin layer to the affected areas of the skin. After half an hour, the drug can be reapplied.
Cetirizine (Cetrin)
Metabolite of hydroxyzine.
It has the ability to easily penetrate the skin and quickly accumulate in it - this determines the rapid onset of action and high antihistamine activity of this drug. There is no arrhythmogenic effect.
It is rapidly absorbed when taken orally, its maximum concentration in the blood is observed 1 hour after administration. The half-life is 7-10 hours, but if renal function is impaired, it extends to 20 hours.
The range of indications for use is the same as for other antihistamines. However, due to the characteristics of cetirizine, it is the drug of choice in the treatment of diseases manifested by skin rash– urticaria and allergic dermatitis.
Take 0.01 g in the evening or 0.005 g twice a day.
Side effects are rare. These are drowsiness, dizziness and headache, dry mouth, nausea.
3rd generation antihistamines
Third generation antihistamines have high antiallergic activity and are devoid of arrhythmogenic effect. These drugs are active metabolites (metabolic products) of previous generation drugs. They are devoid of cardiotoxic (arrhythmogenic) effect, but retain the advantages of their predecessors. In addition, 3rd generation antihistamines have a number of effects that enhance their antiallergic activity, which is why their effectiveness in treating allergies is often higher than that of the substances from which they are produced.
Fexofenadine (Telfast, Allegra)
It is a metabolite of terfenadine.
Blocks H1-histamine receptors, prevents the release of allergy mediators from mast cells, does not interact with cholinergic receptors, and does not depress the central nervous system. It is excreted unchanged in feces.
The antihistamine effect develops within 60 minutes after a single dose of the drug, reaches its maximum after 2-3 hours, and lasts for 12 hours.
Side effects such as dizziness, headache, weakness are rare.
Desloratadine (erius, eden)
It is an active metabolite of loratadine.
Has anti-allergic, anti-edematous and antipruritic effects. Upon admission to therapeutic doses has virtually no sedative effect.
The maximum concentration of the drug in the blood is achieved 2-6 hours after oral administration. The half-life is 20-30 hours. Does not penetrate the blood-brain barrier. Metabolized in the liver, excreted in urine and feces.
In 2% of cases, headaches may occur while taking the drug, increased fatigue and dry mouth.
In case of renal failure, prescribe with caution.
Contraindications include hypersensitivity to desloratadine. As well as periods of pregnancy and lactation.
Levocetirizine (aleron, L-cet)
Cetirizine derivative.
The affinity for H1-histamine receptors of this drug is 2 times higher than that of its predecessor.
Facilitates the course of allergic reactions, has a decongestant, anti-inflammatory, antipruritic effect. Practically does not interact with serotonin and cholinergic receptors, does not have a sedative effect.
When taken orally, it is quickly absorbed, its bioavailability tends to 100%. The effect of the drug develops 12 minutes after a single dose. The maximum concentration in blood plasma is observed after 50 minutes. It is excreted primarily by the kidneys. Excreted in breast milk.
Contraindicated in cases of hypersensitivity to levocetirizine, severe renal failure, severe galactose intolerance, deficiency of the lactase enzyme or impaired absorption of glucose and galactose, as well as during pregnancy and lactation.
Side effects are rare: headache, drowsiness, weakness, fatigue, nausea, dry mouth, muscle pain, palpitations.
Antihistamines and pregnancy, lactation
Therapy allergic diseases in pregnant women is limited, since many drugs are dangerous to the fetus, especially in the first 12-16 weeks of pregnancy.
When prescribing antihistamines to pregnant women, the degree of their teratogenicity should be taken into account. All medicinal substances, in particular antiallergic ones, are divided into 5 groups depending on how dangerous they are to the fetus:
A – special studies have shown that harmful effects there is no drug for the fetus;
B – not found during experiments on animals negative impact on the fetus, no special studies have been conducted on humans;
C – experiments on animals have revealed a negative effect of the drug on the fetus, but this has not been proven in humans; drugs of this group are prescribed to a pregnant woman only when the expected effect outweighs the risk of its harmful effects;
D – the negative impact of this has been proven medicine on the human fetus, however, its purpose is justified in individual, life-threatening mothers, situations where safer drugs were ineffective;
X – the drug is certainly dangerous for the fetus, and its harm exceeds any theoretical one possible benefit for the mother's body. These drugs are absolutely contraindicated in pregnant women.
Systemic antihistamines during pregnancy are used only when the expected benefit outweighs the possible risk to the fetus.
None of the drugs in this group are included in category A. Category B includes 1st generation drugs - tavegil, diphenhydramine, peritol; 2nd generation – loratadine, cetirizine. Category C includes Allergodil, Pipolfen.
The drug of choice for the treatment of allergic diseases during pregnancy is cetirizine. Loratadine and fexofenadine are also recommended.
The use of astemizole and terfenadine is unacceptable due to their pronounced arrhythmogenic and embryotoxic effects.
Desloratadine, suprastin, levocetirizine cross the placenta and are therefore strictly contraindicated for use by pregnant women.
Regarding the lactation period, we can say the following... Again, uncontrolled use of these drugs by a nursing mother is unacceptable, since no human studies have been conducted on the extent of their penetration into breast milk. If these medications are needed, the young mother is allowed to take the one that is approved for her child to take (depending on age).
In conclusion, I would like to note that even though this article describes in detail the drugs most commonly used in therapeutic practice and their dosages are indicated, the patient should start taking them only after consulting a doctor!
Which doctor should I contact?
When acute symptoms If you have allergies, you can contact your general practitioner or pediatrician, and then an allergist. If necessary, a consultation with an ophthalmologist, dermatologist, ENT doctor, or pulmonologist is scheduled.
It’s not for nothing that allergies are called a disease of the 21st century - today people of all ages have to deal with it, and not only in the spring and summer, when plants bloom, but often all year round. Allergic reactions are provoked by anything: food, medicines and household chemicals, pet hair, pollen, ordinary dust, sun and even cold. Therefore, the question of which allergy medicine to choose from all those offered in pharmacies is very relevant.
Manifestations of allergies are not painful, but very unpleasant: watery eyes, sneezing, nasal discharge, rashes on the face and body that itch and become inflamed. This condition is especially difficult for young children. IN difficult cases Quincke's edema occurs and anaphylactic shock develops. That’s why it’s so important to know which anti-allergy medications, in which cases it’s best to use them, what their differences and features are. After all, each allergy remedy has its own composition and mechanism of action, dosages and contraindications are also different. In order not to harm yourself and restore normal well-being as quickly as possible, you should study the rating in detail and choose the best remedy from allergies.
What are allergy remedies?
IN modern therapy Three generations of anti-allergy tablets are used. Representatives of the latest generation have incomparably less side effects and contraindications, they have a quick and longer-lasting effect even at small dosages. But along with them they are also used traditional means against allergies for children and adults of the first generation - sometimes only they can improve the patient’s condition.
In addition to antihistamines, the following can also be prescribed against allergies for children and older patients:
- corticosteroids – hormonal injections or tablets;
- mast cell membrane stabilizers.
Below we will discuss in more detail the most popular anti-allergy drugs from the listed categories. The rating is based on the effectiveness of the drug, the amount side effects and cost.
Antihistamines of different generations
To relieve allergy symptoms, you need to act in two directions: eliminate the source of the allergy, and suppress the release of histamine, a substance that the body begins to actively produce in response to an irritant. The latter is achieved with the help of drugs from this group, they at different speeds and effectively relieve irritation and inflammation of the mucous membranes of the eyes and nasopharynx, treat rashes and swelling, and other symptoms. Today, four generations of anti-allergy drugs are used.
In modern practical medicine, and even more so in pediatrics, these anti-allergenic drugs are used in rare cases. But sometimes they become the only possible salvation, so it’s worth learning more about them too. There are many more disadvantages to such medications than advantages, the main one being long list contraindications and side effects.
- Negative effects on the central nervous system - almost all tablets from this class have a pronounced hypnotic and sedative effect.
- With rare exceptions, the therapeutic effect does not last long.
- Such medications can reduce muscle tone.
- Psychomotor agitation may occur with prolonged use of these drugs or accidental overdose.
- During therapy with these medications, you should not perform tasks that require increased concentration.
- Anti-allergy medications of this generation enhance the effect of alcohol, analgesic medications and some other drugs.
- With a course of treatment of more than three weeks, tachyphylaxis develops - addiction to the active component of the drug, as a result of which its effectiveness decreases. For this reason, if allergy symptoms have not disappeared after three weeks of therapy, the product used requires replacement.
In the USA and Europe, many of the medications in this category were banned and are no longer used. This is due to too frequent negative actions, among which are tachycardia, dryness of the oral mucosa, urinary retention, constipation, decreased clarity of vision.
Advantages
Almost the only advantage that these antihistamines have in skin allergies- availability. Compared to new medications of the latest generations, these are several times cheaper. The effect appears quickly, but does not last long. Some of the tablets are used as antiemetic or as an alternative when the effect of the main drug decreases.
Rating of the best first generation antihistamines for allergies
| Rating | #1 | #2 | #3 |
| Name |  |  |
|
| Price | 3 RUR | 157 RUR | 55 RUR |
| Points | |||
| Gentle effect on the body | Ease of use | Availability in the pharmacy network | Quick results |
Suprastin
Still quite commonly prescribed to treat allergies, especially in emergency situations– in this case it is administered as a solution intramuscularly or intravenously. In comparison with analogues from this class, it has few side effects and contraindications. The active component is chloropyramine, it does not stay in the blood for long, is not deposited in cells and is almost completely excreted through the kidneys along with urine. For this reason, Suprastin should not be taken by those patients who, in addition to allergies, also have renal failure of any form. Renders sedative effect, provokes drowsiness, but is quite effective for urticaria, conjunctivitis of an allergic nature, atopic dermatitis, Quincke's edema.
- Low cost.
- Proven effectiveness.
- Causes drowsiness and inhibits reflex reactions.
- Not prescribed for small children and pregnant women, drivers, doctors.
This is a drug proven by many years of experience, today it is used as aid in the treatment of pseudoallergic reactions and anaphylactic shock. Available in tablet or liquid injection form. Despite the fact that Tavegil belongs to the first generation, it is still popular today, along with more gentle analogues.
- Low price - from 100 rubles per package.
- High efficiency– Tavegil really helps to quickly cope with itching, swelling, sneezing and runny nose, and lacrimation.
- The effect can last up to eight hours - of all the tablets in this category, only these have such a long-lasting effect.
- Sometimes Tavegil itself causes allergies.
- It should not be used to eliminate allergies in pregnant women and small children under one year of age.
- After taking the pills, it is forbidden to drive or perform other important tasks that require increased attention and precision of movements.
The active component of this drug is the substance diphenhydramine. Diphenhydramine, without exaggeration, is called the progenitor of all antihistamines. In addition to antiallergic, it also has an anti-inflammatory effect and is included in the triad - a combination of drugs used by ambulance teams during emergency treatment.
- Low cost.
- Fast action.
- Combines well with other medications.
- Drowsiness, lethargy, inhibition of reactions or vice versa, excessive excitement, insomnia.
- The active substance affects heart contractions and causes anemia.
- It is better not to use Diphenhydramine for systemic treatment children and pregnant or lactating women.
The active component of this drug is mebhydrolin.
- Suitable for all age categories.
- It's inexpensive.
- It acts quickly and retains its effect for a long time.
- Can be used for prevention purposes.
- Ineffective for severe forms of allergies as the main drug.
- Has contraindications and side effects.
- Contraindicated in pregnancy and breastfeeding, heart failure, epilepsy, glaucoma, prostatitis adenoma.
Peritol
This remedy is effective for almost all types of allergies, quickly eliminates symptoms hay fever, urticaria, neurodermatitis, dermatitis due to suppression of histamine release. Also used to treat migraines, anorexia, cachexia. The active substance is cyproheptadine salts.
- Available in tablets for adults and in syrup for children over two years old.
- Has a wide spectrum of action.
- Stimulates the absorption of nutrients, which is important for patients suffering from anorexia, having problems with eating and weight gain.
- Leads to disturbances in the outflow of urine and swelling.
- Not for pregnant and lactating women.
- Causes weight gain, which is not suitable for everyone.
- Has a sedative effect and causes drowsiness.
Second generation antihistamines for allergies
The main difference and advantage of these medications is their insignificant effect on the central nervous system. Drowsiness or slow reactions occur much less frequently, only if the dosage is violated or the patient’s individual hypersensitivity to the active components. They also have less impact on the heart tissue and digestive tract. If you need to choose a good one, inexpensive remedy against allergies for children, doctors often turn to drugs in this particular category.
Flaws
- Not all remedies are suitable for women during the period of bearing and feeding a child or infants.
- Should not be taken if you have kidney disease.
- High price.
Advantages
- Fast action, lasting for 8–12 hours;
- Significantly fewer side effects.
- Possibility of use in pediatrics.
Below is an overview of the most commonly purchased medications from this group.
Rating of the best second-generation antihistamines for allergies
| Rating | #1 | #2 | #3 |
| Name |  |  |
|
| Price | 366 RUR | 792 RUR | 550 RUR. |
| Points | |||
| Gentle effect on the body | Ease of use | Effectively eliminating the body's allergic reaction | Availability in the pharmacy network | Quick results |
Claritin
Leader in its class. It is prescribed to eliminate manifestations of allergies in patients of all ages, including the elderly and infants over one year old.
- Does not depress the nervous system, does not reduce concentration.
- It acts within 20–30 minutes after administration and remains effective for up to 8 hours.
- The tablets quickly help reduce annoying itching, swelling and redness of the skin, and are no less effective for laryngospasms and bronchospasms.
- Effects on the kidneys.
- Quite a high cost - for the same amount you can buy a safer product of the latest generation.
Another popular second-generation remedy, despite the abundance of modern improved medications. According to reviews, Fenistil is inferior in effectiveness to Claritin. But, nevertheless, it is very popular among young mothers, as it is available in various pharmaceutical forms. It is convenient to use for the treatment of allergies in infants: drops are taken orally, and the ointment is used externally against itching and redness.
- Quickly stops an allergy attack and blocks further production of histamines.
- Effective for all types of allergies - food, sun, cold, chemical substances, plants and animal hair.
- Weak sedative effect.
- Incompatibility with alcohol and certain medications.
- Prescribed with caution to pregnant, lactating and young children.
A potent, but not the most harmless remedy against severe and persistent allergies. It has a prolonged effect - in some patients it lasts up to ten days or more. Therefore, Gistalong is the drug of choice in the treatment of chronic allergies in patients of different ages.
- A serious side effect is the effect on the heart muscle and the frequency of its contractions.
- The drug should not be prescribed to persons with heart defects and other pathologies of the cardiovascular system.
- Contraindicated in pregnant women, lactating women, and small children; not used to suppress acute allergies.
- High cost, up to 460 rubles per package. But, given that most patients only need to take one or two dosages per month, it is quite affordable.
- While taking Gistalong, you can stop taking other antihistamines.
- One dose is enough to forget about allergies for several weeks.
- Suitable for treating allergies chronic in a neglected form.
Semprex
This is another histamine H1 receptor antagonist. Used to treat all types of allergies, including cold allergies, and is effective for atopic eczema. The active substance of the drug is acrivastine.
- Does not affect psychomotor activity and emotional condition patient.
- Does not cause drowsiness.
- Can be used for diagnoses such as glaucoma and prostate adenoma.
- If the dosage is exceeded, the drug itself can cause allergies - skin rashes, itching, swelling, etc.
Third generation antihistamines
They are metabolites of previous generation drugs. Not affected by exposure nervous system and heart, has almost no effect on kidney function. Accordingly, their prices are higher.
Flaws
- Due to their high cost, they cannot be used to treat children under the age of 2–6 years (with rare exceptions).
- Not everyone can afford such expensive products.
Advantages
- Minimum side effects.
- Excellent efficiency.
- Duration of action.
- For children they are made in the form of syrups and suspensions with pleasant tastes.
Tsetrin
This is a recognized leader among medications produced today. It does not cause drowsiness, does not inhibit reactions and reflexes, does not impair attention and vision, liver, kidney and heart functions. Moreover, the cost of one package is no more than 200 rubles. Suitable for eliminating manifestations of allergies of any kind, it begins to act within a quarter of an hour after administration. To maintain a stable condition of the patient, one dose per day is enough. And most importantly, it has virtually no contraindications and is prescribed at any age.
Cetrin analogues from this category: Cetirizine, Zirtec, Zodak, Telfast, Fexofenadine, Erius.
Glucocorticoids for allergies
As a rule, they are used for serious forms of pathology and are prescribed both locally and systemically, in the form of tablets and injections. These products contain the same hormones that are produced by the adrenal cortex. Therefore, corticosteroids help relieve inflammation and allergies where classical remedies are powerless. The most common medications from this class are:
- Prednisolone;
- Dexamethasone;
- Beclamethasone.
Corticosteroids are prescribed to treat bronchial asthma, side effects are less pronounced if they are used for inhalation. The main drawback is the unpredictability of possible side effects. Because hormonal pills and the solutions should absolutely not be used independently.
Mast cell membrane blocking agents
These are Ketotifen, Cromoglin, Cromohexal, Intal. Available in the form of tablets, inhalations, syrups, sprays. Rarely prescribed to children under two years of age. The active components stabilize the membranes of mast cells and thereby stop the production of histamine, a substance that triggers an allergic reaction. They are also used exclusively on the recommendation of a doctor, especially in pediatrics.
conclusions
There is no universal remedy for allergies. Each patient has his own physiological characteristics, because for everyone there are their own best allergy pills, which are ideal for him, but another patient may not be satisfied for one reason or another. Sometimes it takes months and years to find the optimal remedy. But the range of modern anti-allergy medications allows you to ultimately find exactly what you need - the question, as a rule, is the price and availability of a well-stocked pharmacy.
Spring. Nature awakens... Primroses bloom... Birch, alder, poplar, hazel release flirty earrings; bees and bumblebees are buzzing, collecting pollen... The season begins (from the Latin pollinis pollen) or hay fever - allergic reactions to plant pollen. Summer is coming. Cereals, tart wormwood, fragrant lavender bloom... Then autumn comes and ragweed, the pollen of which is the most dangerous allergen, becomes the “hostess”. During the flowering of the weed, up to 20% of the population suffers from lacrimation, cough, and allergies. And here comes the long-awaited winter for allergy sufferers. But here awaits many cold allergy. Spring again... And so all year round.
And also an out-of-season allergy to animal fur, cosmetical tools, house dust, etc. Plus drug allergy, food. In addition, in recent years, the diagnosis of “allergy” has been made more often, and the manifestations of the disease are more pronounced.
The condition of patients is alleviated by medications that relieve the symptoms of allergic reactions, and above all, antihistamines (AHPs). Histamine, which stimulates H1 receptors, can be called the main culprit of the disease. It is involved in the mechanism of occurrence of the main manifestations of allergies. Therefore, antihistamines are always prescribed as antiallergic drugs.
Antihistamines - blockers of H1 histamine receptors: properties, mechanism of action
The mediator (biologically active intermediary) histamine affects:
- Skin, causing itching and hyperemia.
- Airways, causing swelling, bronchospasm.
- Cardiovascular system, causing increased vascular permeability, heart rhythm disturbances, and hypotension.
- Gastrointestinal tract, stimulating gastric secretion.
Antihistamines relieve symptoms caused by the endogenous release of histamine. They prevent the development of hyperreactivity, but do not affect the sensitizing effect ( increased sensitivity) allergens, nor on the infiltration of the mucous membrane by eosinophils (a type of leukocytes: their content in the blood increases with allergies).
Antihistamines:
It should be taken into account that the mediators involved in the pathogenesis (mechanism of occurrence) of allergic reactions include not only histamine. In addition to it, acetylcholine, serotonin and other substances are “guilty” of inflammatory and allergic processes. Therefore, drugs that have only antihistamine activity only relieve acute manifestations of allergies. Systematic treatment requires complex desensitizing therapy.
Generations of antihistamines
We recommend reading:
According to the modern classification, there are three groups (generations) of antihistamines:
H1 histamine blockers of the first generation (tavegil, diphenhydramine, suprastin) - penetrate through a special filter - the blood-brain barrier (BBB), act on the central nervous system, providing a sedative effect;
H1 histamine blockers of the second generation (fenkarol, loratadine, ebastine) - do not cause sedation (in therapeutic doses);
H1 histamine blockers of the third generation (Telfast, Erius, Zyrtec) are pharmacologically active metabolites. They do not pass through the BBB, have a minimal effect on the central nervous system, and therefore do not cause sedation.
The characteristics of the most popular antihistamines are shown in the Table:
|
loratadine CLARITINE |
cetirizine |
|||||
|
comparative |
||||||
|
Efficiency |
||||||
|
Duration |
||||||
|
Time |
||||||
|
Frequency |
||||||
|
unwanted |
||||||
|
Elongation |
||||||
|
Sedative |
||||||
|
Gain |
||||||
| Side effects erythromycin |
||||||
|
Increase |
||||||
|
application |
||||||
|
Opportunity |
||||||
|
Application |
Maybe |
contraindicated |
||||
|
Application |
contraindicated |
contraindicated |
contraindicated |
|||
|
Necessity |
||||||
|
Necessity |
||||||
|
Necessity |
contraindicated |
|||||
|
price |
||||||
|
Price |
||||||
|
Price |
||||||
|
astemizole HISMANAL |
terfenadine |
fexofenadine |
|
|
comparative |
|||
|
Efficiency |
|||
|
Duration |
18 - 24 |
||
|
Time |
|||
|
Frequency |
|||
|
comparative |
|||
|
Elongation |
|||
|
Sedative |
|||
|
Gain |
|||
| Side effects at joint use with ketoconazole and erythromycin |
|||
|
Increase |
|||
|
application |
|||
|
Opportunity |
> 1 |
||
|
Application |
Maybe |
contraindicated |
Maybe |
|
Application |
contraindicated |
contraindicated |
contraindicated |
|
Necessity |
|||
|
Necessity |
|||
|
Necessity |
contraindicated |
contraindicated |
|
|
price |
|||
|
Price |
|||
|
Price |
|||
Benefits of 3rd generation antihistamines
This group combines pharmacologically active metabolites of some drugs of previous generations:
- fexofenadine (telfast, fexofast) is an active metabolite of terfenadine;
- Levocetirizine (xyzal) is a derivative of cetirizine;
- Desloratadine (Erius, Desal) is an active metabolite of loratadine.
The latest generation of drugs are characterized by significant selectivity; they act exclusively on peripheral H1 receptors. Hence the benefits:
- Efficacy: rapid absorption plus high bioavailability determine the speed of relief of allergic reactions.
- Practicality: do not affect performance; the lack of sedation plus cardiotoxicity eliminates the need for dose adjustment in elderly patients.
- Safety: non-addictive - this allows you to prescribe long courses of therapy. There is virtually no interaction between them and concomitantly taken medications; absorption does not depend on food intake; the active substance is excreted “as is” (unchanged), i.e. the target organs (kidneys, liver) are not affected.
Medicines are prescribed for seasonal and chronic rhinitis, dermatitis, and bronchospasm of an allergic nature.
3rd generation antihistamines: names and dosages
note: Dosages are for adults.
Fexadin, Telfast, Fexofast take 120-180 mg x 1 time per day. Indications: symptoms of hay fever (sneezing, itching, rhinitis), idiopathic (redness, itchy skin).
Levocetirizine-teva, xysal take 5 mg x 1 time per day. Indications: chronic allergic rhinitis, idiopathic urticaria.
Desloratadine-teva, Erius, Desal are taken 5 mg x 1 time per day. Indications: seasonal hay fever, chronic idiopathic urticaria.
Third generation antihistamines: side effects
Despite their relative safety, third-generation H1 histamine receptor blockers can cause: agitation, convulsions, dyspepsia, abdominal pain, myalgia, dry mouth, insomnia, headache, asthenic syndrome, nausea, drowsiness, dyspnea, tachycardia, blurred vision, weight gain, paronyria (unusual dreams).
Antihistamines for children
Xyzal drops are prescribed to children: over 6 years of age daily dose 5 mg (= 20 drops); from 2 to 6 years in a daily dose of 2.5 mg (= 10 drops), more often 1.25 mg (= 5 drops) x 2 times a day.
Levocetirizine-teva – dose for children over 6 years of age: 5 mg x 1 time per day.
Erius syrup is approved for children aged 1 to 6 years: 1.25 mg (= 2.5 ml of syrup) x 1 time per day; from 6 to 11 years: 2.5 mg (= 5 ml syrup) x 1 time per day;
adolescents over 12 years old: 5 mg (= 10 ml syrup) x 1 time per day.
Erius is able to inhibit the development of the first phase of the allergic reaction and inflammation. When chronic course urticaria, the disease reverses. Therapeutic effectiveness of erius in treatment chronic urticaria confirmed in a placebo-controlled (blind) multicenter study. Therefore, Erius is recommended for use in children over one year of age.
Important: A study of the effectiveness of Erius in the form of lozenges in a pediatric group has not been conducted. But pharmacokinetic data identified in a drug dose determination study involving pediatric patients indicate the possibility of using 2.5 mg lozenges in the age group of 6–11 years.
Fexofenadine 10 mg is prescribed to adolescents over 12 years of age.
The doctor talks about allergy medications and their use in pediatrics:
Prescribing antihistamines during pregnancy
During pregnancy, third-generation antihistamines are not prescribed. In exceptional cases, the use of Telfast or Fexofast is allowed.
Important: There is insufficient information on the use of fexofenadine (Telfast) drugs by pregnant women. Since studies conducted on experimental animals did not reveal signs of an adverse effect of Telfast on the general course of pregnancy and intrauterine development, the medicine is considered conditionally safe for pregnant women.
Antihistamines: from diphenhydramine to erius
Many allergy sufferers owe their improved well-being to the first generation of antihistamines. “Side” drowsiness was taken for granted: but my nose didn’t run and my eyes didn’t itch. Yes, the quality of life suffered, but what can you do – the disease. The latest generation of antihistamines has made it possible for a large cohort of allergy sufferers not only to get rid of allergy symptoms, but also to live a normal life: drive a car, play sports, without the risk of “falling asleep on the go.”
4th generation antihistamines: myths and reality
Often, in advertisements for allergy treatments, the term “new generation antihistamine” or “fourth generation antihistamine” appears. Moreover, this non-existent group often includes not only the latest generation of antiallergic drugs, but also drugs under new trademarks belonging to the second generation. This is nothing more than a marketing gimmick. The official classification lists only two groups of antihistamines: first generation and second. The third group is pharmacologically active metabolites, to which the term “III generation H1 histamine blockers” is assigned.
Any person who has experienced allergies at least once knows the basic principles of combating this disease.
And the main one is use of antihistamines: drugs that inhibit the action of histamine, which provokes allergic reactions.
Today the list of these means (and not only medications) is quite extensive. And it is even divided into several generations.
What does generation mean?
Preparations of this type began to be used in the 30s of the last century. Since then, medicine in this direction has begun to rapidly develop and evolve. Already classified 4 generations antiallergic drugs, which differ in terms of action, time of activation and, alas, the presence of side effects:
Release form
They can be different:
- tablets and capsules: the most common and easy-to-use form. The only drawback is that for rapid absorption into the body they need to be washed down or chewed with something;
- syrups. They are used in the treatment of children. They have a pleasant taste of some berry or fruit, which does not cause prejudice in the child towards the medicine;
- ampoules for injections. They are used for potent drugs and during the acute course of the disease;
- ointments and gels. Used for itching and skin rashes, concomitant dermatological diseases;
- toothpastes. Used for allergic stomatitis, a classic example is LACALUT paste;
- sprays. Used for inflammation of the nasal mucosa and swelling. In these cases, they are very effective when tablets are not effective due to a wide range of effects on the body.
Rating of the best antihistamines by generation
Let’s make a reservation right away – antihistamines of any generation contraindicated during pregnancy, newborns and children, usually under 2 years of age. Patients who are lactose intolerant should also consult a doctor first.
In other cases, medical recommendations should be strictly followed.
First
Diphenhydramine
It already seems that these tablets have always existed - they have been used for so long and effectively. It is most often produced in tablets, so it is convenient to use. The active ingredient of Diphenhydramine is diphenhydramine. It blocks h1 receptors, which are responsible for the production of histamine, and has a calming effect. Can be used as an analgesic and sleeping pill.
The undoubted advantages of diphenhydramine include its availability and relative speed of action - the drug begins to act actively after 20-30 minutes after administration. Valid for up to 4 hours.
Side effects include drowsiness and slow reaction.
An overdose of the drug can lead to hallucinations.
Suprastin
The active ingredient of this drug is chloropyramine.
It has an effect similar to Diphenhydramine, blocking the body's receptors. Begins its impact in 15-20 minutes and reaches maximum activity within an hour.
Renders medicinal effect from 3 to 6 hours. TO side effects negative character include drowsiness, lethargy, short-term changes in blood structure are possible.
Contraindicated in acute attacks bronchial asthma.
Diazolin
The active ingredient is mebhydrolin.
In addition to the anti-allergic effect, it eliminates itching well and quickly. Among the pronounced side effects is a negative effect on the gastric mucosa.
It begins to act 15 minutes after administration and actively affects processes in the body for up to 5 hours. Incompatible with alcohol.
Tavegil
The active substance is clemastine. Most often it is available in the form of a solution in ampoules for administration, so it begins to act within a few minutes. The duration of action for this group is almost a record – 12 hours.
Indicated when anaphylactic shock. Causes dry mouth and fatigue. Contraindicated in case of fructose intolerance.
Pipolfen
The active ingredient is promethazine. Available in the form of a solution for injection.
Activation of this drug occurs within 4-6 hours.
Side effects, in addition to sedatives, may include nightmares during sleep. It is often used as a sedative before and after surgery.
Second
Zodak
The active ingredient of this Czech drug is cetirizine.
Available in the form of drops. It is used for allergic rhinitis and conjunctivitis, and can relieve Quincke's edema.
The pharmacological effect is especially noticeable in the first 1.5 hours. Sometimes it causes drowsiness and dry mouth (but not to the same extent as 1st generation products), and quickly passes into breast milk.
Claritin
Active ingredient: loratadine. It is produced in the form of tablets or syrup, which is especially suitable for use in children.
It begins to act 30 minutes after administration and has a medicinal effect on the body for 24 hours, so Claritin is taken once a day.
Its side effects include occasional headaches and an unexpected increase in appetite in adult patients.
Trexil
The main component is terfenadine. Pharmacological effect is achieved in 1-2 hours and lasts up to 4 hours. Available in the form of tablets and suspension.
Unlike many antihistamines, it is not contraindicated for glaucoma.
There is almost no negative effect on the central nervous system. Gastrointestinal upset and even vomiting are possible, but in rare cases. Rarely, nosebleeds may also occur.
Fenistil
The leader in the composition of this medicine is dimethindene. Manufacturers present it in the form of drops and gel; now it is often used in capsules.
In the form of a gel, the drug is especially effective for skin allergic reactions, in the form of capsules - for food and medicinal types allergies.
Infrequent negative reactions of the body to this drug include rash and difficulty breathing.
Gistalong
The active ingredient is astemizole, available in tablets.
The drug has a long, even delayed effect - it begins to activate within 1 to 3 days and continues to participate in metabolism for 9-12 hours.
It can cause convulsions, and in case of overdose, even cardiac arrest, so the medicine must be used under the supervision of a doctor.
Third
Zyrtec
The main component is cetirizine. Produced in the form of drops and tablets.
Has no negative impact on cardiovascular system. It is especially indicated for dermatoses; it also quickly relieves Quincke's edema.
Begins to participate in metabolism within 30 minutes.
Contraindicated in patients with renal failure, pregnant and lactating women.
Tsetrin
The manufacturer from India also lists cetirizine as the main component. Release form: film-coated tablets.
Particularly effective on early stages allergic reactions,
develops in the body within 20 minutes after ingestion.
Distinctive quality - the medicine retains its effect for 3 days after stopping use. May be accompanied by diarrhea and abdominal pain if the components are poorly tolerated.
Telfast
The main component is fenoxofinadine. It comes in tablet form.
Relieves swelling, indicated for urticaria, mainly in acute form.
The maximum concentration in the body reaches in 1-3 hours, and is removed with cessation of action after 11 hours.
Possible dizziness, disruption of the gastrointestinal tract, increased heart rate. Elderly people should use with caution, but without adjusting the usual dosage.
Fenkarol
The active ingredient in this drug is quifenadine, there is also a medicine with the same name. The drug is taken orally in the form of tablets or injected intramuscularly.
Fenkarol is indicated for all types of allergic reactions. Its effect begins in 1 hour and can last up to a day.
The drug can cause a negative reaction from the gastrointestinal tract, so it is prescribed to patients with peptic ulcers with caution.
Levocetrizine
The main component has the same name. Most often it is taken in tablets.
Preferable for hay fever.
It reaches its maximum spectrum of action within an hour. Often used in children over 2 years of age to treat hay fever.
May cause itchy skin and even hives, you should strictly monitor the dosage.
Fourth
Some pharmacists and doctors consider this group non-existent, explaining this by the fact that the group of drugs latest action Only new names are introduced. In fact, let's say, Levocetrizine in various collections and works different authors found in groups 3 and 4, the same applies to Citirizine.
Without delving into scientific disputes, we admit that there is some truth in this. But there is also modern drugs, which can really be attributed to the newest antihistamines. Among them, Erius undoubtedly takes precedence:
List of budget drugs
Here is a list of inexpensive, but effective drugs in increasing order, judging by generations of drugs:
- Diphenhydramine (price from 65 rubles);
- Dibazol (from 75 rubles);
- Suprastin (120 rubles);
- Trexyl (from 97 rubles);
- Claritin (175 rubles);
- Cetirizine (105 rubles);
- Zyrtec (RUB 199).
Erius syrup costs around 500 rubles in various pharmacies.
Traditional antihistamines
There are and are not medications for the treatment of allergies, but usually for external use. Traditionally these include:
- baths using herbs - calendula, yarrow, sage and chamomile;
- lotions and compresses with the same composition;
- decoctions with chamomile, viburnum and its upper branches;
- eggshell powder with the juice of several lemons;
- celery root infusion. With this type of treatment, it must be taken into account that an excess of root in such a drug can cause sudden jump allergic reaction. Only a knowledgeable person should prepare the product;
- mumiyo.
At the same time, you need to remember that a clear natural remedy or herb, like natural medicine, allergies do not happen, since this disease is diverse. It is better to consult a doctor in time for effective and timely treatment to stop an allergic reaction at the initial stage.
Video on the topic
The doctor will tell you what medications we use to treat allergies in a video clip:
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