Difference between revisions of "Know When to Take Antihistamines"

Antihistamines work by blocking histamine, a substance produced by your cells to prevent infection.<ref name="rf1">http://sepa.duq.edu/regmed/immune/histamine.html</ref> If your body detects a foreign substance, your cells will make histamine, which causes inflammation of blood vessels. Usually this is useful. But when your body mistakes a non-harmful substance, like pollen, for a harmful one, it can cause what we call seasonal allergies.<ref name="rf2">http://www.nhs.uk/Conditions/Antihistamines/Pages/How-does-it-work.aspx</ref>  Antihistamines are commonly known for treating seasonal allergies, but there are several other uses for both over-the-counter antihistamines and those prescribed by a doctor. Before taking antihistamines, understand how antihistamines work and what symptoms they treat.  

</ref><ref name="rf3">http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000549.htm</ref>

#* Second and third generation antihistamines generally have fewer side effects. Second generation antihistamines include cetirizine (Zyrtec) and loratadine (Claritin). Third generation antihistamines include desloratadine (Clarinex) and fexofenadine (Allegra). These medications cause less drowsiness than other antihistamines.<ref name="rf3" /><ref name="rf4">http://www.ncbi.nlm.nih.gov/books/NBK50554/</ref>

#Be aware of interactions. Antihistamines may cause reaction with other medications or substances. For example, you should avoid alcohol when taking antihistamines. Antihistamines can also interact with muscle relaxants (such as carisoprodol and cyclobenzaprine), sleeping pills (such as zolpidem), and sedatives (such as benzodiazepines) so avoid taking antihistamines with these medications.<ref name="rf5">http://familydoctor.org/familydoctor/en/drugs-procedures-devices/over-the-counter/antihistamines-understanding-your-otc-options.html</ref>

#* If you have glaucoma, overactive bladder or trouble urinating, respiratory issues such as asthma, heart issues or high blood pressure, kidney or liver issues, or thyroid disease, make sure to ask your doctor before taking antihistamines.<ref name="rf5" />

#Choose between over-the-counter (OTC) and prescription antihistamines. Try taking over the counter antihistamines if you have predictable, intermittent, short-term (few weeks) mild to moderate symptoms of an allergy such as sneezing, itchy, watery eyes or runny nose, or mild hives. If these don't work or you experience side effects, prescription medications may be a better option.<ref name="rf6">http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000547.htm</ref>

#Correctly take antihistamines. Follow the directions on the label for the particular medication you are taking. Most of the oral antihistamines should be taken everyday during the time you are experiencing allergy symptoms. If allergies are severe, uncontrolled by the medication, last longer than the common allergy season, or chronic contact your doctor.<ref name="rf7">http://emedicine.medscape.com/article/134825-medication</ref>

#Choose a child-strength antihistamine for children. Several antihistamines are available in child-strength formulations. Your pediatrician or pharmacist can advise you which is right for your child. Never give a young child adult-strength antihistamines.<ref name="rf8">https://www.healthychildren.org/English/health-issues/conditions/allergies-asthma/Pages/Allergy-Medicines.aspx</ref>

#* Follow the directions on the label. Generally, child-strength antihistamines are approved for use in children 2 and older. Some are approved for as young as 6 months. Consult your pediatrician if your child is younger than 2.<ref name="rf9">http://www.medscape.com/viewarticle/410914_3</ref><ref name="rf10">http://www.medscape.com/viewarticle/410914_4</ref>

#Know when to go to the doctor. Once you've started taking antihistamines, talk to your doctor if your symptoms are severe or get worse. You should also call your doctor if you develop a nosebleed or other nasal symptoms. Tell your doctor if the symptoms don't lessen or go away. Common symptoms include:<ref name="rf3" />

#Recognize emergency symptoms in children. Children are particularly prone to medication overdose. If you notice any of the following symptoms after giving your child antihistamines, call the Poison Help line at 1-800-222-1222<ref name="rf11">http://www.aapcc.org/</ref> and seek emergency medical attention for your child:<ref name="rf12">http://www.medscape.com/viewarticle/410914_6</ref><ref name="rf13">http://adc.bmj.com/content/87/5/400.full</ref><ref name="rf14">http://www.wfsb.com/story/25847521/preventing-overdosing-on-allergy-medications-for-children</ref>

#Use an antihistamine nasal spray for symptoms such as itchy or runny nose, sneezing, sinus congestion or postnasal drip. Antihistamine nasal sprays are used to directly treat cold and allergy-related nasal symptoms. These are available by prescription and include azelastine (Astelin, Astepro) and olopatadine (Patanase).<ref name="rf15">http://www.aaaai.org/conditions-and-treatments/treatments/drug-guide/nasal-medication.aspx</ref>

#* Side effect of these antihistamines slightly differ from the oral ones and include bitter taste, fatigue and weight gain, burning sensation in nostrils, and possible drowsiness.<ref name="rf16">http://www.nlm.nih.gov/medlineplus/druginfo/meds/a697014.html#side-effects </ref> Use as directed by your doctor.  

#Consider antihistamine eye drops to relieve itchy, watery red eyes. You can get them over the counter or as a prescription. For example, you could try azelastine (Optivar) or olopatadine (Pataday, Patanol) by prescription. Or, try ketotifen (Alaway, Zaditor) or pheniramine (Visine-A, Opcon-A) over the counter.<ref name="rf17">http://www.mayoclinic.org/diseases-conditions/allergies/in-depth/allergy-medications/art-20047403</ref> Side effects can include headache, burning sensation and dry eyes.

#Use a cold medication with an antihistamine for symptoms such as congestion, sneezing and runny nose associated with the cold.<ref name="rf18">http://www.entnet.org/content/antihistamines-decongestants-and-cold-remedies</ref> The antihistamine in cold medications may help symptoms associated with your cold and improve recovery,<ref name="rf19">http://www.aafp.org/afp/2004/0801/p486.html</ref> although they are more effective for older children and adults, and not all studies show a significant benefit.<ref name="rf20">http://www.ncbi.nlm.nih.gov/pubmed/12917904</ref> Many cold medications offer an antihistamine and decongestant combination.

#* Take the medication with a glass of water. Do not crush or chew the tablets.<ref name="rf21">http://reference.medscape.com/drug/allegra-d-pseudoephedrine-fexofenadine-343394</ref>

#Try an antihistamine for a dry cough. If you have a dry cough, an antihistamine can be a good first option to treat it.<ref name="rf22">http://www.health.harvard.edu/staying-healthy/that-nagging-cough</ref> Most antihistamines are effective to treat cough.<ref name="rf23">http://www.healthline.com/health/allergies/hay-fever-cough</ref>

#* Long-lasting, low drowsy options include: dimenhydrinate  (Dramamine, Gravol, Driminate), meclizine  (Bonine, Bonamine, Antivert, Postafen, and Sea Legs), and cyclizine (Marezine, Bonine For Kids, Cyclivert). Promethazine (Phenergan) is prescribed for treating nausea or vomiting, motion sickness, and allergic reactions, but can cause more drowsiness.<ref name="rf24">http://emedicine.medscape.com/article/2060606-medication</ref>

#Take an oral antihistamine for itchy rashes or hives. Rashes and hives may be caused by the production of too much histamine, and second or third generation antihistamines can help block your body’s release of histamine.<ref name="rf25">http://www.mayoclinic.org/diseases-conditions/chronic-hives/basics/treatment/con-20031634</ref> Talk with your doctor about taking one of the following daily:

#Apply a topical antihistamine if you have itching or a rash from bug bites or inflammation. Topical antihistamines come in lotion or cream form and can be applied directly to the affected area as needed, up to 4 times a day. They usually contain diphenhydramine, often in combination with a skin protectant like calamine.<ref name="rf26">http://www.medscape.com/viewarticle/554692_4</ref> If you develop pain, redness, swelling, hives, or difficulty breathing after an insect bite, contact emergency services right away. These are signs that you are having an allergic reaction to the bite.<ref name="rf27">http://acaai.org/allergies/types/insect-sting-allergies</ref>

#*Don't use topical antihistamines with oral antihistamines which can increase the concentration of antihistamine in your body. Make sure not to apply topical antihistamines to a very large area of your skin or skin that is broken or blistered.<ref name="rf28">http://www.pharmacytimes.com/publications/issue/2011/April2011/Combating-Contact-Dermatitis-</ref>

#Look for an antihistamine that can cause drowsiness if you have trouble sleeping. Some over the counter antihistamine products are marketed as sleeping aids because of the side effect of drowsiness. But, you can develop tolerance to the drowsiness caused by antihistamines. So the more or longer you use them, the less effective they will be. Be aware that they can also cause drowsiness and grogginess the next day.<ref name="rf28" />

#*This is usually given as 50-100 mg by mouth every 6 hours. Side effects include dry mouth, drowsiness and tremors.<ref name="rf29">http://reference.medscape.com/drug/atarax-vistaril-hydroxyzine-343395#4</ref>

#Ask your doctor about antihistamine use for Parkinson's. Antihistamines may help with abnormal movements in patients with Parkinson's. Diphenhydramine can sometimes be used since it blocks the neurotransmitters. This helps control abnormal movements associated with early stage Parkinson’s or as a side effect of medication.<ref name="rf30">http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682539.html#why</ref>  

#Avoid allergens. Avoid things that you have noticed trigger allergies. Common allergy triggers include certain foods, dust, insect bites, pet dander, drugs, latex, mold, and cockroaches.<ref name="rf31">http://acaai.org/allergies/types</ref>

#* Stay indoors between 5AM to 10AM if you have pollen allergies. Pollen counts are usually highest during these hours.<ref name="rf32">http://www.bidmc.org/Centers-and-Departments/Departments/Medicine/Divisions/Allergy-and-Inflammation/Allergies/Common-Allergens/Tips-on-How-to-Avoid-Common-Allergens.aspx</ref>

#Manage allergens in your home. It’s more difficult to avoid allergens out in public, but there are several things you can do to make your home more allergy-friendly.<ref name="rf33">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1112904/</ref><ref name="rf34">http://acaai.org/resources/tools/home-allergy-management</ref>

#* Wash bedding in hot water every week or two. This will help kill dust mites.<ref name="rf32" />

#See an allergist for an allergy test. If you have reduced allergens in your home and used antihistamines and you’re still not seeing relief, see an allergist and ask for an allergy test. These tests allow your allergist and physician to determine your precise allergies and come up with a treatment plan for you.<ref name="rf35">http://acaai.org/allergies/treatment/allergy-testing</ref>

#* You may experience an allergic reaction to some tests. It’s important to have an allergy specialist perform any allergy test. The American College of Allergy, Asthma & Immunology has a “Find an Allergist” feature on their website.<ref name="rf36">http://acaai.org/locate-an-allergist</ref>

#* Allergy tests can be done as either skin tests or blood tests. Skin tests are fast and allow many allergens to be tested at the same time. Blood tests are often used if you have a severe skin condition or are likely to have a severe allergic reaction to a skin test.<ref name="rf35" />

#Try natural remedies. Certain natural treatments ''may'' help reduce allergy symptoms. You should always consult your doctor before trying any treatment, including ones that are natural or herbal. Even natural treatments can interfere with medical conditions and prescription medications.<ref name="rf37">http://umm.edu/health/medical/altmed/condition/allergic-rhinitis</ref>

#* Vitamin C supplements (2,000 mg daily) may help improve allergy symptoms.<ref name="rf38">http://umm.edu/health/medical/altmed/supplement/vitamin-c-ascorbic-acid</ref><ref name="rf39">http://www.ncbi.nlm.nih.gov/pubmed/7919130</ref>

#* Spirulina, a type of blue-green algae, may help reduce symptoms such as nasal discharge, sneezing, and congestion. It may also improve immune response, although more study is needed. take 4-6 500mg tablets a day.<ref name="rf40">http://www.ncbi.nlm.nih.gov/pubmed/18343939</ref><ref name="rf41">http://umm.edu/health/medical/altmed/supplement/spirulina</ref>

#* Butterbur (''Petasites hybridus'') has been shown to be effective at reducing allergy symptoms such as itchy eyes. It may also relieve nasal allergies.<ref name="rf42">https://nccih.nih.gov/health/butterbur</ref><ref name="rf43">http://www.ncbi.nlm.nih.gov/pubmed/23711828</ref> Pregnant and breastfeeding women and young children should not use butterbur. Take 500mg a day or as directed by your doctor.<ref name="rf37" />

#* Biminne is an herbal formulation in traditional Chinese medicine. It has been shown to be effective at improving allergy symptoms.<ref name="rf44">http://www.ncbi.nlm.nih.gov/pubmed/12027069</ref> Speak with your doctor before taking biminne.<ref name="rf37" />

#Consider acupuncture. Some studies suggest that acupuncture can help relieve allergy symptoms, although more study is needed.<ref name="rf45">http://www.healthline.com/health/allergies/acupuncture</ref><ref name="rf37" /> Talk with your doctor to see whether acupuncture is a good option for you.

#* The regulatory body for acupuncturists in the US is the National Certification Commission for Acupuncture and Oriental Medicine. Always make sure that you get treated by a licensed acupuncturist.<ref name="rf46">http://www.nccaom.org/</ref>

*Some antihistamines can also work in a part of the brain that controls nausea and vomiting.<ref name="rf5" />

*As with any eye drop, avoid touching the container to your eye since this can cause contamination.<ref name="rf47">http://reference.medscape.com/drug/pataday-patanol-olopatadine-ophthalmic-343635#91</ref>

*Good sleep hygiene includes:<ref name="rf48">http://sleepfoundation.org/ask-the-expert/sleep-hygiene</ref> going to bed and getting up the same time each day, avoiding stimulation before sleeping, avoiding activities like exercise, watching TV, computer work, avoiding alcohol and caffeine before bed. You should associate your bed with sleep. Don’t read or do other work in bed.