First, let's find out what contributes to the development of an allergic reaction. What can cause us to experience sudden itching of the skin, swelling of the mucous membrane of the respiratory tract, abdominal pain and other manifestations of acute allergies? The reason for this is the release of histamine, a mediator that is released in response to an allergen.
Therefore, in the fight against allergy symptoms, taking drugs that block histamine receptors, reducing its effect on the body, plays an important role. They are called antihistamines. There are two generations of antihistamine drugs. 1, 2 Let's look at them in more detail.
1st generation antihistamines
Each generation is a kind of evolutionary round in the development of medicines. The newer they are, the more favorable their safety profile, the lower the risk of developing drug resistance, and the longer the duration of action. 2
The first generation appeared in the early 20th century, and their effects are associated with a blocking effect on histamine receptors. However, unfortunately for allergy sufferers, the connection with these receptors is very fragile and easily reversible, and it is for this reason that the clinical effect of these drugs quickly decreases, and frequent use of these drugs is required. On average, it appears 30 minutes after administration, and its duration of action is limited to 4-12 hours. This is due to the fact that these drugs are quickly metabolized and excreted in the urine. 1
Unfortunately, 1st generation antihistamines have a number of serious side effects that significantly limit their use. The fact is that the active substances penetrate the blood-brain barrier (a kind of physiological filter between the circulatory system and the central nervous system, through which nutrients, bioactive substances and some medications enter the brain), where they bind to brain receptors, and a blockade develops central serotonin and m-cholinergic receptors. This can cause the development of a sedative effect of varying severity, from minor to strong.
There are other side effects - dry mouth, increased obstruction (obstruction) of the respiratory tract, increased viscosity of sputum, tachycardia, blurred vision. Among the negative properties, it is worth noting the development of tachyphylaxis, that is, a decrease in the effect after a certain period of use, usually after 15-20 days. 12
The most well-known 1st generation antihistamines:
Antihistamines 2nd generation
2nd generation drugs are distinguished by their minimal effect on serotonin and so-called m-cholinergic receptors, and also by the fact that histamine receptors are very sensitive to them. These drugs last longer - up to 48 hours - so they can be taken less frequently, which may reduce the risk of side effects. 1
They practically do not cause sedation, they do not have the effect of tachyphylaxis, so they can be prescribed for a long time (on the recommendation of a doctor). However, it is worth remembering that 2nd generation drugs can have undesirable effects on the heart, so when taking them for a long time, it is necessary to monitor the functioning of the heart muscle. 1
Second generation antihistamines:
Active metabolites of 2nd generation drugs
There are absolutely modern developments that are practically devoid of the disadvantages of allergy medications of previous generations. They do not affect the heart and central nervous system, do not suppress mental reactions, and are not addictive.
These drugs include fexofenadine and desloratadine. The first is indicated for seasonal allergic rhinitis and chronic urticaria, it prevents the release of histamine and the development of reactions to the allergen. In this case, the effect begins approximately 1 hour after taking the dose and lasts up to a day. The second drug is prescribed for allergic rhinitis and urticaria. It blocks the release of biologically active allergy factors and prevents symptoms of the disease. Relieves spasm, reduces swelling and itching, normalizes capillary permeability. The effect appears relatively quickly, within about 30 minutes after dosing, and lasts up to 24 hours.
Allergy is a companion of progress. The higher the level of hygiene, the more cases of allergies. The more pollution in the air, water and land, the more people suffer from this disease. Fortunately, science does not stand still, and pharmaceutical scientists are creating new and new remedies for allergies. The most effective of which are listed in this top 10.
Antihistamines are of I, II and III generations:
- I – effective tablets, powders, ointments, but with a large number of side effects. They quickly relieve symptoms, but are not intended for systemic treatment of allergies.
- II – remedies for allergies of a wider spectrum. They act more gently, but also have a number of side effects.
- III – latest generation allergy medications. They act specifically at the cellular level without affecting the central nervous system. Suitable for long-term treatment. Virtually no side effects.
10. Donormil
Cost: 330 rubles.
Generation: I
Donormil is mainly used as a sleeping pill, but sometimes it is prescribed to allergy sufferers as part of complex therapy. After all, with an exacerbation of allergies, especially accompanied by severe skin itching, it is difficult to get a good night's sleep.
9. Suprastin
150 rub.
Generation: I
One of the oldest allergy remedies on the post-Soviet market. Even with long-term use, it does not cause an overdose and does not accumulate in the blood serum. Bonus: antiemetic and anti-sickness effect.
Cons: short-term therapeutic effect. Like other antiallergic drugs of the first group of effectiveness, it has a sedative effect. It also causes side effects such as tachycardia, as well as dryness of the nasopharynx and oral cavity, which is unlikely to please those suffering from bronchial asthma.
8. Fenistil
370 rub.
Generation: II
Unlike previous medications, Fenistil comes in the form of an emulsion or gel and is applied to the skin. It is not intended to eliminate the causes of allergies, but relieves symptoms - it cools, softens, moisturizes and has a weak local anesthetic effect.
7. Loratadine
80 rub.
Generation: II
A domestic and, as a result, inexpensive drug (those who wish can buy it produced in Hungary, a little more expensive). Unlike other drugs of the second group of effectiveness, it is practically devoid of cardiotoxic effects.
Second-generation drugs have a number of advantages compared to previous ones - for example, there is no sedative effect, mental activity remains at the same level. And, most importantly, the prolonged effect of the drug. One tablet a day is enough for people with pollen allergies to feel quite tolerable even during times of wild flowering.
6. Claritin
200 rub.
Generation: II
The active ingredient in Claritin is loratadine. It acts quickly, within half an hour after administration, and lasts a day, which made Claritin one of the most popular and effective remedies for allergies. For children, the drug is available in the form of syrup. And adult allergy sufferers will appreciate that Claritin does not enhance the effects of alcohol on the nervous system.
5. Cetrin
240 rub.
Generation: III
Cetrin is in fifth place in the ranking of the best allergy remedies. It helps to cope with various symptoms with virtually no side effects, and in mild bronchial asthma it relieves spasms. The active substance is cetirizine, which has a high ability to penetrate the skin. This makes it especially effective for skin allergies. In addition, cetirizine is an effective third-generation drug, which means it has neither cardiotoxic nor sedative effects.
4. Zodak
200 rub.
Generation: III
Zodak is also made on the basis of cetirizine (like Cetrin), but is produced in the Czech Republic.
3. Zyrtec
320 rub.
Generation: III
A product based on cetirizine produced in Belgium. One of the best allergy pills, a highly effective drug, acts quickly, eases the course and prevents the development of an allergic attack.
2. Eden
120 rub.
Generation: III
The active substance of Eden is desloratadine, a third group antihistamine, a descendant of loratadine. Like all substances in this group, it practically does not cause drowsiness and does not affect the reaction rate. Excellent for tissue swelling, lacrimation, and skin itching. An effective product made in Ukraine.
1. Erius
Average cost of Erius: 500 rubles.
Generation: III
Erius is the most effective third-generation antihistamine. The active substance in Erius is also desloratadine. The drug itself is produced by Bayer, USA, which is easy to guess by looking at the price. It acts quickly and almost immediately, effectively eliminates itching, rashes, runny nose and redness on the skin - one of the most effective allergy pills at the moment.
1. Dexamethasone
Dexamethasone price: from 50 rubles per drops to 150 per set of ampoules.
Dexamethasone can be compared to the heavy artillery among the most effective allergy medications. It is used in emergency cases when it is necessary to stop a very severe allergic attack or severe inflammation. Along with antiallergic properties, it has anti-inflammatory, immunosuppressive and anti-shock effects.
Remember that self-medication for allergies can lead to a deterioration in your health. There are contraindications. Only an allergist can prescribe medicine for allergies.
The article provides a list of the best 1st, 2nd and 3rd generation drugs that can make life easier for people prone to allergies. After reading the entire article, you will be able to understand why some antihistamines are better than others. Find out which of them and why pregnant and lactating women should not take them. You can watch an interesting video on the topic of what antiallergic medications you should take with you when going on vacation.
Antihistamines - which ones are better?
Drugs that suppress histamine (the hormone that triggers allergic reactions in the body) come in different forms. They can be purchased at the pharmacy in the form of capsules, tablets, nasal spray and even eye drops. Antihistamines can cause serious side effects in the body, so some are sold only with a doctor's prescription.
Note! Only a doctor can answer the question of which antihistamines are best, and then on an individual basis, having familiarized himself with the characteristics of your body and identifying the allergen that worries you.
Currently, there are three generations of drugs that suppress histamine. They differ in their constituent components, effect and duration of impact on the body:
- First generation: endowed with sedative properties (suppresses consciousness, calms, relieves irritability) and acts as a sleeping pill.
- Second generation: has a powerful anti-allergic effect. Such drugs do not suppress consciousness, but can seriously disrupt the normal rhythm of the heart, which, if a person is inattentive to his health and drug inactivity, leads to death.
- Third generation: active metabolites (product of bio-physical-chemical processing of 2nd generation drugs). The effectiveness of these drugs is more than 3 times higher than the effectiveness of 1st and 2nd generation antihistamines.
To choose the best medicine that can block the activity of histamine without disrupting the functioning of the main body systems, you must have an understanding of the main components of such drugs and the effectiveness of their effects. It is this topic that is addressed in the following sections of the article.
To treat allergies, you can use not only tablets, but also.
First generation drugs
The duration of exposure to antihistamines of this group is 4 - 6 hours, after which the patient must take a new dose of the drug. The list of main side effects includes dry mouth and temporary loss of blurred vision. Let's consider popular types of drugs, different forms of release.
The drug contains the active component chloropyramine. The product is effective for common types of allergies, including seasonal and those caused by insect bites. "Suprastin" is prescribed from 1 month of life. After administration, the medicine begins to act after 15 - 25 minutes. The maximum effect is achieved within an hour and lasts up to 6 hours. The product helps stop gagging, is a moderate antispasmodic and has the ability to relieve inflammation.
"Suprastin" is sold in tablet form and as a solution in ampoules. It is recommended to take the tablets only with meals, which avoids irritation of the gastric mucosa. Injections are prescribed for prolonged allergies that cannot be cured with pills.
The approximate cost of the drug is 120 - 145 rubles. (available for free sale).
Another name for the soothing antihistamine is “Clemastine” (the active substance is clemastine hydrofumarate). The medicine is intended to alleviate allergies that may occur in response to pollen, pet dander, mosquito bites, or skin contact with a chemical. All these factors cause allergic symptoms (skin rash, sneezing, red eyes, nasal congestion). After taking Tavegil, the actions of histamine are blocked, as a result the mentioned symptoms disappear.
This type of antihistamine is a long-acting (long-acting) medicine. From the gastrointestinal tract the drug penetrates into the blood. After 2 hours, its maximum concentration in plasma is observed. After 5-6 hours, its antihistamine activity develops intensively, which can last 12-24 hours.
"Tavegil" can be purchased in the form of tablets, syrup and solution for injection. The price of the medicine starts from 120 rubles and depends on the form of release, as well as on the number of tablets or ampoules in the package. The product is dispensed without a doctor's prescription.
Typically, this drug is prescribed to children and adult patients whose bodies do not accept other antihistamines due to addiction. Compared to them, Fenkarol has a less pronounced sedative effect (does not suppress consciousness), which allows it to be taken during working hours. The antiallergic drug proves its effectiveness in the treatment of allergies to pollen, drugs and food.
45% of the active component of the drug (hifenadine) penetrates into the blood 30 minutes after administration. After 1 hour, the maximum content of the active substance in the blood plasma is reached. The duration of its effect lasts no more than 6 hours.
In pharmacies, the medicine is sold in tablet and powder form, as well as in the form of an injection solution. You can buy Fenkarol for 260 - 400 rubles (the cost depends on the form of release and the quantity in the package). The drug is sold without a prescription.
Second generation drugs
Compared to the drugs described above, this group of histamine-suppressing drugs is much more effective, which is reflected in the following factors:
- Firstly, they do not cause drowsiness, do not cause stool problems, dry mucous membranes and difficulty urinating.
- Secondly, they do not affect mental and physical activity.
- Thirdly, they are not addictive, which allows them to be used for long-term treatment (over a year).
- Fourth, the duration of the corrective effect of the dose taken is 24 hours, which allows you to take the drug once a day.
Important! Taking 2nd generation antiallergic drugs should be accompanied by medical supervision, because This group of drugs acts as blockers of potassium channels of the heart (responsible for the excitability and rest of the heart muscle). For this reason, self-medication is dangerous.
The product contains the active ingredient loratadine, which can cope with seasonal (caused by pollen, dampness) and year-round (caused by dust, animal dander, detergents) allergies. The drug is effective for allergies to mosquito bites and copes with the manifestations of pseudoallergic syndrome (the pathology is similar to allergies, but has other causes). It is also prescribed for the treatment of itchy dermatoses.
The medicine can be purchased in the form of syrup and tablets. The average cost in the pharmacy chain for Claridol is 90 rubles. (over the counter).
The active component of the drug is loratadine. This antiallergic drug is prescribed to patients to get rid of skin rashes, false allergies, inflammation of the mucous membranes of the nose and eyes. After 8 - 12 hours, after taking the tablets or syrup, the active substance enters the phase of maximum activity. The duration of its corrective effect in the body lasts 24 hours.
"Lomilan" is produced in tablets and in the form of a homogeneous (homogeneous) suspension. The average cost of Lomilan tablets is 120 rubles, the suspension is 95 rubles. Over-the-counter release.
The drug is made on the basis of the substance - rupatadine. The drug is prescribed for the treatment of runny nose and urticaria caused by allergies. Its active component quickly cleanses the skin of rashes, relieves itching, and makes breathing free. Rupatadine does not depress the central nervous system.
Peculiarity!“Rupafin” should not be taken with grapefruit juice, because the product increases the activity of rupatadine by 3.5 times. The human body will not be able to correctly perceive this factor, and this can result in serious consequences for it (the appearance of swelling, nausea and vomiting, disruption of the heart).
"Rupafine" is produced only in tablets (there are no other dosage forms), they are taken regardless of food intake (1 tablet, 1 time per day). The average cost of tablets in a pharmacy chain is 587 rubles. (available without a doctor's prescription).
III generation drugs
This group of antihistamines does not have a cardiotoxic (blocking potassium channels of the heart) or sedative (calming) effect, so the drugs can be prescribed to drivers, as well as people whose work requires increased concentration. The third generation of drugs is not addictive, which makes it possible to effectively treat both seasonal and year-round allergies.
The drug is prescribed to get rid of seasonal allergies and chronic urticaria. The active component of this antihistamine is fexofenadine hydrochloride, which, in turn, belongs to the active metabolites (bio-physical-chemical processing products) of terfenadine (2nd generation antihistamine).
The drug shows its effectiveness within 1 hour after administration. The maximum concentration of the drug in the blood plasma is observed after 6 hours. The duration of exposure to fexofenadine is 24 hours.
The active component of this antiallergic drug is desloratadine. The substance blocks histamine receptors for 27 hours, so the medicine needs to be taken only once a day (5 - 20 mg). Trexil does not have a negative effect on the human central nervous system. Does not suppress consciousness or induce sleep.
An antihistamine can be purchased at a pharmacy without a prescription for about 89 rubles.
The active ingredient of the drug is fexofenadine (the active metabolite of terfenadine - a 2nd generation histamine blocker). The medicine is available in tablet form, 30, 120 and 180 mg. The tablets are taken 1-2 times a day at the dose prescribed by the doctor. Fexofenadine quickly penetrates the blood plasma and blocks the production of histamine for 24 hours.
The cost of the antihistamine "Telfast" depends on the amount of active ingredient in one tablet and can range from 128 to 835 rubles.
If you are going on vacation, then watch this video material. In it, the allergist names the medications that you should put in your suitcase. You should not take the recommendations of a specialist lightly, especially if you are going to an exotic country where there are many new plants and delicious fruits that you have never tried.
Question answer
What antiallergic drugs can pregnant women take?
Usually these are Levocetirizine and Fexofenadine. During pregnancy and breastfeeding, you should only take medications prescribed by your doctor.
What harm can antihistamines cause to a pregnant woman and her fetus?
Particularly dangerous for women carrying a child are 1st generation antiallergic drugs, in particular Diphenhydramine and Diazolin, which can complicate the course of pregnancy (dizziness, increased fatigue, dry mucous membranes) and cause heart disease in the fetus.
What antiallergic drugs are prescribed to infants?
A child can be prescribed Zyrtec from birth (consultation with an allergist and pediatrician is required). The medicine is released in drops. The drug is contraindicated for premature babies and those whose mothers smoked during pregnancy.
Are antihistamines prescribed for chickenpox to relieve itching?
In this case, the most common drugs are Suprastin, Diphenhydramine and Tavegil. Please note that they do not use lotions and creams that contain these components, but medications in the form of tablets.
What tablets can be given to children with allergies for mosquito bites?
Be sure to consult a pediatrician and allergist about this. Zirtec and Suprastin are usually prescribed. If allergies are hereditary, doctors do not recommend that parents give their children the same antiallergic drugs that they themselves take.
What to remember:
- There are 3 generations of histamine-suppressing medications.
- The best anti-allergy drugs are 3rd generation drugs; when used correctly, they do not have serious side effects.
- Antihistamines are available in the form of tablets, syrup, injections and eye drops.
- During pregnancy and breastfeeding, women should not take 1st and 2nd generation medications; their active ingredients pose a danger to the baby.
- It is better to give anti-allergy medications to children as recommended by a doctor.
There are three (according to some authors - four) generations of antihistamines. The first includes drugs that, in addition to antiallergic, also have a sedative/hypnotic effect. The second includes drugs with a minimally pronounced sedation effect and a powerful antiallergic effect, but in some cases causing serious, life-threatening arrhythmias. Antihistamine drugs of the new - third - generation are metabolic products (metabolites) of second-generation drugs, and their effectiveness is 2-4 times higher than that of their predecessors. They have a number of unique positive properties and do not cause side effects such as drowsiness and negative effects on the heart. It is the third generation drugs that will be discussed in this article.
New (third) generation antihistamines: mechanism of action and effects
Medicines in this group act exclusively on H1-histamine receptors, that is, they have selectivity of action. Their antiallergic effect is also ensured due to the following mechanisms of action. So, these drugs:
- inhibit the synthesis of mediators of systemic allergic inflammation, including chemokines and cytokines;
- reduce the number and disrupt the functions of adhesion molecules;
- inhibit chemotaxis (the process of release of leukocytes from the vascular bed into damaged tissue);
- inhibit the activation of allergy cells and eosinophils;
- inhibit the formation of superoxide radical;
- reduce increased reactivity (hyperreactivity) of the bronchi.
All of the above mechanisms of action provide powerful antiallergic and, to a certain extent, anti-inflammatory effects: eliminate itching, reduce the permeability of the capillary wall, swelling and hyperemia of tissues. Do not cause drowsiness, do not have a toxic effect on the heart. They do not bind to cholinergic receptors, therefore, do not cause side effects such as blurred vision and. They have a high safety profile. It is thanks to these properties that new generation antihistamines can be recommended for long-term treatment of a number of.
Side effects
As a rule, these drugs are well tolerated by patients. However, occasionally, while taking them, the following undesirable effects may develop:
- fatigue;
- dry mouth (extremely rare);
- hallucinations;
- drowsiness, insomnia, agitation;
- , heartbeat;
- nausea, vomiting, epigastric discomfort, in isolated cases -;
- muscle pain;
- allergic reactions: skin rashes, accompanied or not, shortness of breath, Quincke's edema, anaphylactic reactions.
Indications and contraindications for the use of third generation antihistamines
Food can cause food allergies and cause illness. Indications for the use of drugs in this group are:
- allergic rhinitis (both year-round and seasonal);
- (also seasonal and year-round);
- chronic;
- allergic;
New generation antihistamines are contraindicated only in cases of individual hypersensitivity of the patient's body to them.
Representatives of new generation antihistamines
This group of medicines includes:
- Fexofenadine;
- Cetirizine;
- Levocetirizine;
- Desloratadine.
Let's look at each of them in more detail.
Fexofenadine (Altiva, Telfast, Tigofast, Fexofast, Fexofen-Sanovel)
Release form: film-coated tablets of 120 and 180 mg.
Pharmacologically active metabolite of the second generation drug, terfenadine.
After oral administration, it is quickly absorbed in the digestive tract, reaching a maximum concentration in the blood after 1-3 hours. It almost does not bind to blood proteins and does not penetrate the blood-brain barrier. The half-life is 11-15 hours. It is excreted mainly in bile.
The antiallergic effect of the drug develops within 60 minutes after a single dose; within 6 hours the effect increases and persists throughout the day.
Adults and children over 12 years of age are recommended to take 120-180 mg (1 tablet) once a day, before meals. The tablet should be swallowed without chewing with 200 ml of water. The course of treatment is determined individually depending on the characteristics of the disease. Even after regular use of fexofenadine for 28 days, there were no signs of intolerance.
For patients suffering from severe or severe symptoms, the drug should be used with caution.
It should not be used during pregnancy, since clinical studies have not been conducted on this category of patients.
The drug passes into breast milk, so nursing mothers should not take it either.
Cetirizine (Allertek, Rolinoz, Cetrin, Amertil, Zodak, Cetrinal)
While taking antihistamines, you should avoid alcohol. Release form: film-coated tablets, solution and drops for oral use, syrup.
Metabolite of hydroxyzine. The strongest antagonist of H1-histamine receptors.
The use of this drug in average therapeutic doses significantly improves the quality of life of patients suffering from seasonal and chronic allergic rhinitis.
After oral administration, the effect appears after 2 hours and lasts for a day or more.
In patients with impaired renal function, the dose of cetirizine should be adjusted depending on the value of creatinine clearance: for mild renal failure, 10 mg of an antihistamine is prescribed 1 time per day, which is the full dose; moderate degree – 5 mg 1 time per day (half dose); if the creatinine clearance rate corresponds to a severe degree of renal failure, it is recommended to take 5 mg of cetirizine every other day, and for patients on hemodialysis with end-stage renal failure, taking the drug is completely contraindicated.
Contraindications to the use of cetirizine are also individual hypersensitivity to it and congenital pathology of carbohydrate metabolism (glucose-galactose malabsorption syndrome and others).
Cetirizine, taken in normal doses, may cause temporary adverse reactions such as fatigue, drowsiness, central nervous system stimulation, dizziness and headache. In some cases, while taking it, dry mouth, impaired accommodation of the eye, difficulty urinating and increased activity of liver enzymes are noted. As a rule, after discontinuation of the drug, these symptoms disappear on their own.
During the treatment period, you should stop taking it.
Persons suffering from convulsive syndrome and epilepsy should take the drug with extreme caution due to the increased risk of occurrence.
During pregnancy, use if absolutely necessary. Do not take during lactation, as it is excreted in breast milk.
Levocetirizine (L-cet, Alerzin, Aleron, Zilola, Cetrilev, Aleron neo, Glencet, Xyzal)
Release form: film-coated tablets, drops for oral administration, syrup (dosage form for children).
Cetirizine derivative. The affinity for H1-histamine receptors of this drug is several times higher than that of its predecessor.
When taken orally, it is quickly and completely absorbed, and the degree of absorption does not depend on food intake, but its speed decreases in the presence of food in the stomach. In some patients, the effect of the drug begins within 12-15 minutes after administration, but in the majority it develops later, after 30-60 minutes. The maximum concentration in the blood is determined after 50 minutes and persists for 48 hours. The half-life is from 6 to 10 hours. Excreted by the kidneys.
In persons suffering from severe renal failure, the half-life of the drug is prolonged.
Excreted in breast milk.
Adults and children over 6 years of age are recommended to use the tablet form of the drug. 1 tablet (5 mg) is taken orally, without chewing, with a sufficient amount of water. Frequency of administration – 1 time per day. If levocetirizine is prescribed in the form of drops, the dose for adult patients and children 6 years of age and older is 20 drops once a day. Children under 6 years of age are prescribed in the form of syrup or drops, the dose of which depends on the age of the child.
Persons with severe renal impairment should have their creatinine clearance calculated before prescribing the drug. If this value indicates first-degree renal dysfunction, then the recommended dose of an antihistamine is 5 mg per day, that is, the full dose. In case of moderate renal dysfunction, it is 5 mg once every 48 hours, that is, every other day. In case of severe renal impairment, the drug should be taken 5 mg 1 time every 3 days.
The duration of treatment varies widely and is selected individually depending on the disease and the severity of its course. Thus, for hay fever, the course of treatment, as a rule, is 3-6 months, for chronic allergic diseases - up to 1 year, in case of potential contact with an allergen - 1 week.
Contraindications to the use of levocetirizine, in addition to individual intolerance and severe chronic renal failure, are congenital (galactose intolerance, lactase deficiency and others), as well as pregnancy and lactation.
Side effects are similar to those of other drugs in this group.
While taking levocetirizine, drinking alcoholic beverages is strictly contraindicated.
Desloratadine (Alersis, Lordes, Trexil neo, Erius, Eden, Alergomax, Allergostop, DS-Lor, Fribris, Eridez)
Release form: film-coated tablets, 5 mg each and an oral solution containing 0.5 mg of active substance per ml (dosage form for children). Some drugs, in particular Allergomax, are also available in the form of a nasal spray.
Everyone has an allergic reaction from time to time, and some people suffer from allergies almost all the time, so new generation antihistamines are relevant for most people. Statistics show that the number of allergy sufferers is steadily increasing every year. This is due to the environmental situation and weakened immunity.
Antihistamines - what are they in simple words?
Antihistamines help fight allergies. They are medications that weaken the effects of histamine in the human body. Histamine is a special substance produced by the cells of the body’s immune system and designed to fight bacteria and viruses. But since an allergy is a “mistake” of the immune system, histamine does not bring any benefit, but acts on the receptors, causing swelling of the mucous membranes, redness and itching of the skin, etc. Antihistamines act on H1-histamine receptors and block them. Thus, histamine cannot influence the receptors, as a result of which the manifestations of allergies are reduced: itching, tearing, swelling of the mucous membranes, etc. are reduced.
There are several generations of antihistamines, each of which has its own differences. The first generation was created in the 30s of the last century and became a real breakthrough in the fight against allergies. After some time, second and third generation drugs were created.
Generations of antihistamines differ significantly from each other: they have different properties and side effects. This applies to drugs of three generations. 4th generation antihistamines are very conventional; most often this is an advertising ploy by manufacturers who want to emphasize the innovativeness of their products. Which ones are better? Let's take a look at the features of each category to choose the best antihistamines.
1st generation antihistamines
This is the most common group of anti-allergy drugs that have a pronounced sedative effect: they cause drowsiness and calm. They are quite powerful and do not last long, usually 4-5 hours, can be found in any pharmacy, their price is quite low, and their quality and effectiveness are time-tested. The use of first-generation antihistamines lasts no more than 7-10 days, after this period addiction begins and the effectiveness of the drugs noticeably decreases. These drugs are prescribed after certain vaccines, in the treatment of skin diseases, as well as in case of an acute allergic reaction to a temporary external irritant.
Side effects of this group include:
- decreased blood pressure;
- increased appetite;
- cardiopalmus;
- discomfort in the stomach, vomiting and nausea;
- thirst, drying of mucous membranes;
- weakening of attention and muscle tone.
- Suprastin. Available in ampoules and tablets, the active substance is chloropyramine. Used to treat angioedema, eczema, urticaria, allergic rhinitis, swelling of the mucous membranes. Also used to eliminate skin itching, incl. after an insect bite. Suprastin can be given to children starting from one month, but it is important to calculate the dosage. This remedy can be used at high temperatures, which are difficult to bring down, and also as a sedative for colds and viral diseases.
Suprastin should not be used during pregnancy and lactation.
- Diazolin. This is a fairly mild product that does not cause drowsiness and is suitable for long-term use. Diazolin can be used during pregnancy, with the exception of the first trimester, and is also suitable for children from two years of age. This product is available in the form of tablets, ampoules, and suspensions with various dosages.
- Fenistil. A very effective universal remedy that is used for all types of allergies. Causes drowsiness only in the first few days of treatment, then the sedative effect disappears. Can be used externally (gel) for insect bites. Suitable for children from 1 month (externally), it can be taken by pregnant women from the second trimester if their condition due to allergies causes serious concern. Available in the form of capsules, suspensions, tablets, gel.
- Fenkarol. An effective remedy, often used in the fight against seasonal allergies, as well as in blood transfusions. Prescribed to children from 1 year and pregnant women from the 2nd trimester (under medical supervision).
- Tavegil. One of the most powerful drugs with a long period of action (12 hours). Causes drowsiness. Available in tablets and syrup form, it is approved for children from 1 year of age. Pregnant women should not take this medicine.
Antihistamines 2nd generation
These are improved antihistamines that do not have a sedative effect and have a prolonged effect. You need to take them once a day, the use can be long-term, since these medications are not addictive. Their price is usually low. They are quite effective in treating skin diseases, eliminating Quincke's edema, and are used to alleviate chickenpox. These medications are not recommended for older people and those with heart disease. Below is a list of the most effective second generation products.
- Loratadine. An effective product available in the form of syrup and tablets. Helps fight allergies and their consequences - anxiety, sleep disturbances, weight gain. The medicine can be given to children from three years of age; pregnant women can take the drug in the second and third trimesters. In critical situations, the doctor may prescribe Loratadine up to 12 weeks of pregnancy.
- Rupafin. A fairly strong drug that is used in the treatment of skin allergic reactions. The product is safe, acts quickly, and the effect lasts throughout the day. It cannot be used during pregnancy; use by children under 12 years of age is also prohibited. During lactation, Rupafin can be taken only as prescribed by a doctor.
- Kestin. The most powerful drug in this group, the effect of which lasts for two days. Used in the most difficult cases, it quickly removes angioedema, relieves suffocation, and reduces skin rashes. At the same time, Kestin is toxic to the liver, so it cannot be taken systematically. It is contraindicated for pregnant women and children under 1 year of age.
Also effective second generation drugs include Claritin, Zodak, Cetrin, Parlazin, Lomiran, Cetrisin, Terfanadine, Semprex.
Important! Long-term use (more than a month) of these drugs is dangerous without a doctor’s permission, especially for powerful drugs. Therefore, do not forget to consult a specialist.
Antihistamines 3rd generation
Third-generation antihistamines are considered the newest, but, in fact, they are an improved version of the second generation. They have the same long-lasting effect, do not have a sedative effect, but are completely harmless to the heart and non-toxic to the liver. Thanks to these properties, they can be taken for a long time (for example, for seasonal allergies, psoriasis, bronchial asthma). These are the safest antihistamines for pregnant women, but you should still consult your doctor before taking them.
Important: Antihistamines during pregnancy can be dangerous in the first trimester, so you should consult your gynecologist. If there is a threat of miscarriage, then you should abstain from such drugs if possible. Antihistamines during breastfeeding also need to be discussed with your pediatrician. If powerful drugs are prescribed, it makes sense to stop breastfeeding for a while.
3rd generation antihistamines are considered the most powerful and fastest-acting. A list of the names of the best of them is given below.
- Telfast (Allegra). A new drug that not only reduces the response of receptors to histamine, but also suppresses the production of this substance. As a result, allergy symptoms disappear very quickly. It works throughout the day and is not addictive when taken for a long time. Children under 12 years of age and expectant mothers cannot use Telfast; it is also contraindicated during lactation.
- Cetrizine. This remedy is often classified as the fourth generation; in this case, the division into categories is very arbitrary. This is a drug of the latest generation, which begins to act almost instantly (20 minutes after administration), and you can take tablets once every three days. In the form of syrup, Cetrizine can be given to children from six months of age, but it is contraindicated for pregnant women. If the medicine was prescribed by a doctor during lactation, then feeding should be stopped for the period of treatment for allergies. This drug can be taken for a long time.
- Desloratadine. A strong antihistamine and anti-inflammatory agent. In therapeutic doses it is well tolerated, but if the dosage is exceeded, it can lead to headaches, dry mouth, rapid heart rate, and insomnia. It cannot be taken during pregnancy, but in critical cases (suffocation from bronchospasm, Quincke's edema) it can be treated under the supervision of a doctor.
- Xizal. Xyzal and its analogues are effective antihistamines for skin allergies and itching, seasonal allergic manifestations, urticaria and chronic year-round allergies. They have a prolonged effect and relieve allergy symptoms 40 minutes after administration. Xyzal is available in the form of drops and tablets and is safe for children over 2 years of age.
Also good third generation products include Desal, Lordestin, Erius, Suprastinex.
Antihistamines 4th generation
Such drugs are a new word in the fight against allergies, since they are practically free of side effects, despite their high efficiency. They are not harmful to the heart, like most earlier antihistamines, do not cause drowsiness or addiction, and are easy to use (taken every 1-3 days). The only contraindication is pregnancy and early age of the child. As for the disadvantages of fourth generation antihistamines, this is the high price of the medicine.
The most popular and effective remedies of this generation:
- Fexofenadine. An effective remedy in the fight against all types of allergies, it is as safe as possible and has virtually no side effects. Available in tablets and syrup form, it can be given to children over 6 years old.
- Levocetrizine. A powerful remedy that is used to treat year-round and seasonal allergies, reduces the manifestations of conjunctivitis. It is non-toxic to the liver and heart, so it can be taken for months.
How to choose the best allergy remedy
The best antihistamines are not always the most expensive and modern; it is important to understand how relevant a particular drug is in a certain situation. For example, during an illness accompanied by insomnia or restless sleep, first-generation drugs will be preferable. They will eliminate allergy symptoms, and their sedative effect will be very useful. If an allergy has overtaken a person who does not want to get out of the usual rhythm of life, then he should pay attention to the newest metabolite drugs. In any case, before long-term use of the drug, you should consult your doctor, especially if you need to treat a child or a pregnant woman.
symptom-treatment.ru
Rating of the best allergy remedies
Exclusive of its kind - Cetrin
the best allergy drug at the moment
In first place in terms of effectiveness is the third generation antihistamine, Cetrin.
The average estimated cost of the drug is from 160 to 200 rubles.
The main advantages of Cetrin are its high degree of effectiveness, as well as its rapid action after taking the drug. It is also preferable because it does not cause drowsiness and “abstains” from negative effects on the liver.
Cetrin should be taken to eliminate symptoms of seasonal allergies, hay fever or atopic dermatitis.
This drug is the best choice for both adults and children. It has a pleasant taste and has virtually no contraindications or restrictions on use. Unlike other drugs, it is enough to use it once a day, which greatly simplifies the application process.
In the ranking of the most effective antiallergic drugs, Cetrin takes first place. On a ten-point scale, he can safely be given 9.5 points. 0.5 points are deducted for the only drawback - the price. Allergy medications can be purchased at a more reasonable price, but this is precisely the case when it is appropriate to remember the words of the wise Jew: “I am not rich enough to buy cheap things.”
Claritin is a true, reliable, safe medicine for allergies
Next on the list of the most effective drugs for treating allergies is Claritin (Loratadine).
The average cost of this drug is from 160 to 220 rubles.
Before the advent of third generation antihistamines, Claritin was the most common. It is one of the first antiallergic drugs that did not affect the patient's state of attention, which made it possible for use by doctors and drivers.
It is used for various manifestations of the allergic process, ranging from skin forms (itching and redness) to laryngospasm (suffocation).
Claritin is good for its speed of action, the possibility of use in children after one year, as well as in people who need concentrated attention while working.
The rating of this drug is 9.2 out of 10, since the drug has some disadvantages, such as restriction of use in persons with impaired renal function, in women who are breastfeeding, and in children under one year of age. To some extent, the price also stops it - for the same money you can buy the safest and most effective Cetrin.
Fenistil - old, but still effective...
The average price for it currently ranges from 220 to 280 rubles.
Fenistil is a second generation antiallergic drug. It has less effect compared to Claritin, however, it is much more effective than first-generation drugs.
The drug is used for the development of an allergic reaction from foods, medications, skin rashes and nasal discharge during the flowering period.
Fenistil has a good, pronounced anti-allergic effect, preventing the development of an allergic reaction even with a high concentration of allergen and histamine.
In terms of frequency of use, it is in third place among all drugs in the rating. Its rating is 8.2 out of 10. The drug has such disadvantages as a sedative, calming effect, increased effect of alcohol when used together, distortion of the effect of some other drugs. Contraindicated in breastfeeding, pregnancy, and in children under 2 years of age.
Dangerous, but extremely effective - Gistalong
Gistalong (Astemizole) is an antihistamine drug with the longest clinical effect.
The price of this drug ranges from 300 to 460 rubles, which makes it one of the most expensive drugs.
Gistalong belongs to the second generation drugs. Has the longest therapeutic effect (in some people it can reach up to 20 days)
This drug is used in the treatment of chronic allergic processes.
The duration of action of Gistalong allows it to be used with a frequency of about once a month. Its use allows you to avoid taking other antiallergic drugs.
Despite its duration of action and antiallergic activity, the drug ranks only fourth in the ranking. Its rating on a ten-point scale is 8 out of 10. This result is due to the side effects of this drug - when taken, it may disrupt the normal heart rhythm, which can lead to death in people with heart disease. Contraindicated for use in the acute phase of allergy development, as well as in pregnant women and children.
Time-tested drug - Tavegil
good reliable first generation allergy remedy
Tavegil (Clemastine) is one of the most common and used first-generation drugs.
You can buy Tavegil for, on average, 100 rubles.
The drug is used in both tablet and injection forms. It has a fairly strong antiallergic effect. It is often used as an additional drug for anaphylactic shock and pseudoallergic reactions.
The low incidence of side effects and high efficiency allowed Tavegil to be included in the ranking of the most used drugs. In addition, the drug begins to act quite quickly, and the effect of its use lasts quite a long time, which makes it the drug of choice in the treatment of allergic processes.
The average rating of this drug on a ten-point scale is 8. 3 out of 10. Tavegil receives a similar rating for such shortcomings as the possible development of an allergic reaction to tavegil itself, a slight sedative effect, which makes it impossible for drivers and doctors to use it. Also, the drug is contraindicated for use in pregnant women, nursing mothers and children under 1 year of age.
Will help quickly and in any situation - Suprastin
Suprastin (Chloropyramine) is a drug often used in most branches of medicine. You can buy it for 120-140 rubles.
One of the most effective first generation histamine blocking drugs
It is used for almost all types and manifestations of allergic reactions; used to provide emergency care for allergies (one of the mandatory medications).
Suprastin does not accumulate in the blood serum, which prevents the possibility of an overdose of the drug. The effect develops quite quickly, but to prolong it it is necessary to combine Suprastin with other drugs. The low cost of the drug is also its undoubted advantage, since it is extremely difficult to choose a high-quality and inexpensive drug on the modern drug market.
In the ranking of the best antiallergic drugs, Suprastin receives 9 points out of 10. Its use is prohibited during pregnancy, lactation, in children under 1 month, in persons with individual intolerance to chloropyramine, as well as during an acute attack of bronchial asthma.
Standing guard from time immemorial... - Diphenhydramine
Diphenhydramine (Diphenhydramine) is a drug of the first generation of antihistamines, the founder of this group of drugs.
It is one of the cheapest antiallergic drugs. Its cost ranges from 15 to 70 rubles.
One of the antiallergic drugs that were invented first. It has a fairly strong antihistamine effect.
Diphenhydramine is used to eliminate the manifestations of most allergic processes. It is produced primarily in the form of products applied topically (in the form of an ointment), but can also be used for systemic treatment. It is part of the so-called triad due to its anti-inflammatory effect.
Diphenhydramine has a pronounced antiallergic effect: the effect develops quickly, but ends just as quickly. Thanks to its low cost, anyone can buy it.
In the drug rating, Diphenhydramine receives a rating of 8 out of 10. Despite its effectiveness in treating allergies, Diphenhydramine has a number of side effects, among which the most pronounced are drowsiness after using the drug, mild confusion with a sedative effect, anemia, and heart rhythm disturbances.
Results... Which allergy medicine is best?
Having understood in detail the principles of action, effectiveness and degree of safety of each of the above drugs, we should once again mention the crowned Cetrin. Due to its safety and effectiveness, it takes first place in our rating, and can be recommended for a home medicine cabinet.
This drug deserves a huge plus for its lack of effect on a person’s attention and concentration. You can take it without worrying about side effects and your psycho-emotional state.
Of course, before taking it, it is best to consult with an allergist and study the instructions.
Be healthy and don't sneeze...
www.expertcen.ru
Brief description of antihistamines:
* 1st generation antihistamines
* 2nd generation antihistamines
* 3rd generation antihistamines
* Classification of antihistamines.
Characteristics of modern 3rd generation antihistamines:
* use in children and women during pregnancy and lactation
* effect of the drug
*adverse events
* application to specific patient populations
Criteria for choosing antihistamines:
* The need to choose a drug that has an additional antiallergic effect
* Indicated for use by women during pregnancy and lactation, and children
* The patient has specific problems
In recent years, the number of patients with atopic asthma, allergic rhinitis, and atopic dermatitis has been increasing. These conditions are generally not life-threatening, but require active therapeutic intervention that is effective, safe and well tolerated by patients.
The advisability of using antihistamines for various allergic diseases (urticaria, atopic dermatitis, allergic rhinitis and conjunctivitis, allergic gastropathy) is due to the wide range of histamine effects. The first drugs that competitively block histamine receptors were introduced into clinical practice in 1947. Antihistamines suppress symptoms associated with the endogenous release of histamine, but do not affect the sensitizing effect of allergens. In the case of late prescription of antihistamines, when the allergic reaction is already significantly expressed and the clinical effectiveness of these drugs is low.
Efficiency first generation antihistamines in the treatment of allergic diseases has been established for a long time. Although all of these drugs quickly (usually within 15-30 minutes) alleviate allergy symptoms, most of them have a pronounced sedative effect and can cause unwanted reactions in recommended doses, as well as interact with other drugs. 1st generation antihistamines are used primarily to relieve the following acute allergic reactions:
- acute allergic urticaria;
- anaphylactic or anaphylactoid shock, allergic Quincke's edema (parenteral, as an additional remedy);
- treatment of allergic and pseudoallergic reactions caused by drugs;
- seasonal allergic rhinitis (episodic symptoms);
- acute allergic reactions to food;
- serum sickness.
Some 1st generation drugs may also be effective in the following situations:
- For ARVI (drugs with anticholinergic effects have a “drying” effect on the mucous membranes):
- Pheniramine ( Avil);
Fervex). - Promethazine ( Pipolphen, Diprazin);
+ paracetamol + dextromethorphan ( Coldrex Nite). - Chloropyramine ( Suprastin).
- Chlorphenamine;
+ paracetamol + ascorbic acid ( Antigrippin);
+ paracetamol + pseudoephedrine ( Theraflu, Antiflu);
+ biclotymol + phenylephrine ( Hexapneumine);
+ phenylpropanolamine ( CONTAC 400);
+ phenylpropanolamine + acetylsalicylic acid ( HL-cold). - Diphenhydramine ( Dimedrol).
- Pheniramine ( Avil);
- For cough suppression:
- Diphenhydramine( Dimedrol)
Promethazine ( Pipolphen, Diprazin) - To correct sleep disorders(improves falling asleep, depth and quality of sleep, but the effect lasts no more than 7-8 days):
- Diphenhydramine( Dimedrol);
+ paracetamol ( Efferalgan Nightcare). - To stimulate appetite:
- Cyproheptadine ( Peritol);
Astemizole ( Hismanal). - To prevent nausea and dizziness caused by labyrinthitis or Meniere's disease, as well as to reduce the symptoms of motion sickness:
- Diphenhydramine( Dimedrol)
Promethazine ( Pipolphen, Diprazin) - To treat vomiting during pregnancy:
- Diphenhydramine( Dimedrol)
- To potentiate the action of analgesics and local anesthetics (premedication, component of lytic mixtures):
- Diphenhydramine( Dimedrol)
Promethazine ( Pipolphen, Diprazin) - For the treatment of minor cuts, burns, insect bites(the effectiveness of topical use of drugs has not been strictly proven; use is not recommended for > 3 weeks due to an increased risk of local irritation):
- Bamipin ( Soventol).
To the advantages 2nd generation antihistamines include a wider range of indications for use. However, ideas about the clinical effectiveness of 2nd generation antihistamines in the treatment of bronchial asthma and atopic dermatitis are based on a small number of uncontrolled studies. The effect of the drug develops quite slowly (within 4-8 weeks), and the pharmacodynamic effects of 2nd generation drugs have been proven only mainly in vitro.
Recently created 3rd generation antihistamines, which have significant selectivity and do not have side effects on the central nervous system. The use of 3rd generation antihistamines is more justified when carrying out long-term therapy of allergic diseases:
- seasonal allergic rhinitis (conjunctivitis) with seasonal exacerbations lasting > 2 weeks;
- chronic urticaria;
- atopic dermatitis;
The pharmacokinetic properties of antihistamines vary significantly. Modern 3rd generation antihistamines have a longer duration of action (12-48 hours). Astemizole has a maximum half-life (about 10 days), which inhibits skin reactions to histamine and allergens for 6-8 weeks. Serious cardiotoxic side effects in the form of severe cardiac arrhythmias have been described for two 3rd generation antihistamines (terfenadine and astemizole). The likelihood of developing these side effects increases with simultaneous administration of drugs with macrolides (erythromycin, oleandomycin, azithromycin, clarithromycin), antifungals (ketocanozole and intrakanozol), antiarrhythmics (quinidine, procainamide, disopyramide), some antidepressants, as well as in patients with chronic liver diseases and hyperkalemia. If it is necessary to use terfenadine or astemizole simultaneously with the above groups of drugs, preference is given to antifungal drugs fluconazole (Diflucan) and terbenafine (Lamisil), antidepressants paroxetene and sertraline, antiarrhythmics and antibiotics of other groups.
Topical antihistamines, in particular acelastine (allergodil), have a rapid (within 20-30 minutes) symptomatic effect, improve mucociliary clearance, and have no significant systemic side effects.
The most promising oral antihistamines are loratadine and cetirizine.
Loratadine (Claritin) is an antihistamine that does not have a sedative effect or significant drug interactions, and is recommended for use by patients of all age groups. The excellent safety profile of Claritin allowed the drug to be included in the list of over-the-counter drugs.
Cetirizine (Zyrtec) is a basic antihistamine, especially in young children, when the inhalation route of drug administration is difficult. It has been shown that long-term administration of cetirizine to children with early atopic syndrome can reduce the risk of progression of atopic conditions in the future.
Classification of antihistamines.
1st generation- act on peripheral and central H 1
-histamine receptors, cause a sedative effect, do not have additional antiallergic effect.
- bamipin ( Soventol, ointment)
- dimethindene ( Fenistil)
- diphenhydramine ( Dimedrol, Benadryl)
- clemastine ( Tavegyl)
- mebhydrolin ( Diazolin, Omeril)
- oxatomide ( Tinset)
- promethazine ( Pipolphen, Diprazin)
- pheniramine ( Avil)
- hifenadine ( Phencarol)
- chloropyramine ( Suprastin)
- dimebon ( Dimebone)
- setastin ( Loderix)
- cyproheptadine ( Peritol)
with antiserotonin action
2nd generation- act on histamine receptors and stabilize the mast cell membrane.
- ketotifen ( Zaditen and etc.)
3rd generation- act only on peripheral H 1 -histamine receptors, do not cause a sedative effect, stabilize the mast cell membrane and have an additional antiallergic effect.
- acrivastine ( Semprex)
- astemizole ( Hismanal, Histalong, Astemisan, Astelong)
- terfenadine ( Trexyl, Teridin, Tofrin)
- fexofenadine ( Telfast)
- loratadine ( Claritine)
- cetirizine ( Zyrtec)
- desloratadine ( Erius, other names: Alergostop, Delot, Dezal, Claramax, Clarinex, Larinex, Loratek, Lordestin, NeoClaritin, Eridez, Eslotin, Ezlor)
- ebastine ( Kestine)
- acelastine ( Allergodil)
- levocabastine ( Histimet)
Characteristics of modern antihistamines.
| astemizole HISMANAL |
terfenadine TREXYL |
fexofenadine TELFAST |
loratadine CLARITINE |
cetirizine ZYRTEC |
ebastine KESTINE |
|
| use in children and women during pregnancy and lactation | ||||||
| Possibility of use in children | from 1 year | from 3 years | from 12 years old | from 2 years | from 2 years | from 12 years old |
| Use in pregnant women | Maybe | contraindicated | Maybe | Maybe | undesirable | contraindicated |
| Use during lactation | contraindicated | contraindicated | contraindicated | contraindicated | contraindicated | contraindicated |
| effect of the drug | ||||||
| Duration of action | 24 hours | 18 - 24 hours | 24 hours | 24 hours | 24 hours | 48 hours |
| Effect onset time | 1 hour | 1 hour | 1 hour | 0.5 hours | 1 hour | 1 hour |
| Dosing frequency | 1 r/d | 1-2 times per day | 1 r/d | 1 r/d | 1 r/d | 1 r/d |
| adverse events | ||||||
| QT prolongation | YES | YES | No | No | No | No |
| Sedative effect | No | No | No | No | RARELY | No |
| Increased effects of alcohol | No | No | No | No | YES | No |
| Side effects when used together with ketoconazole and erythromycin | YES | YES | No | No | No | YES |
| Weight gain | YES | No | No | No | No | No |
| use in specific patient populations | ||||||
| The need to reduce the dose in renal failure | No | No | YES | No | YES | YES |
| The need to reduce the dose in case of liver dysfunction | contraindicated | contraindicated | No | No | No | contraindicated |
Criteria for choosing antihistamines
The need to choose a drug that has an additional antiallergic effect:
- year-round allergic rhinitis;
- seasonal allergic rhinitis (conjunctivitis) with seasonal exacerbations lasting up to 2 weeks;
- chronic urticaria;
- atopic dermatitis;
- allergic contact dermatitis;
- early atopic syndrome in children.
Indicated for use in children:
- children under 12 years old:
- loratadine ( Claritine)
- cetirizine ( Zyrtec)
- terfenadine ( Trexyl)
- astemizole ( Hismanal)
- dimethindene ( Fenistil)
- cetirizine ( Zyrtec)
- loratadine ( Claritine)
- desloratadine ( Erius)
children 1-4 years old with early atopic syndrome:
Indicated for use by women during pregnancy and lactation:
- loratadine ( Claritine)
- cetirizine ( Zyrtec)
- desloratadine ( Alergostop, Delot, Dezal, Claramax, Clarinex, Larinex, Loratek, Lordestin, NeoClaritin, Eridez, Erius, Eslotin, Ezlor)
- fexofenadine ( Telfast, Allegra)
- pheniramine ( Avil)
When choosing antihistamines (or any other medications) during lactation, it is better to be guided by the data on the website http://www.e-lactancia.org/en/, where you just need to search for the English or Latin name of the drug or the main substance. On the website you can find information and the degree of risk of taking the drug for a woman and child during lactation (breastfeeding). Since manufacturers often play it safe and do not recommend using the drug during pregnancy and lactation (who will allow them to conduct research on the effect of the drug on pregnant and lactating women, but no research means no permission).
The patient has specific problems:
- patients with renal failure:
- loratadine ( Claritine)
- astemizole ( Hismanal)
- terfenadine ( Trexyl)
- loratadine ( Claritine)
- cetirizine ( Zytrec)
- fexofenadine ( Telfast)
patients with liver dysfunction:
www.e-mama.ru
Impact on the body
To understand how 4th generation antihistamines differ, you need to understand the mechanism of action of antiallergic drugs.
These medications block H1 and H2 histamine receptors. This helps reduce the body's reaction to the mediator histamine. Thus, the allergic reaction is relieved. In addition, these drugs serve as an excellent prevention of bronchospasms.
Let's consider antihistamines of all generations. This will allow you to understand the advantages of modern means.
First generation drugs
This category includes sedative drugs. They block H1 receptors. The duration of action of these drugs is 4-5 hours. Medicines have an excellent antiallergic effect, but have a number of disadvantages, including:
- pupil dilation;
- dry mouth;
- blurred vision;
- drowsiness;
- decreased tone.
Common first generation medications are:
- "Diphenhydramine";
- "Diazolin";
- "Tavegil";
- "Suprastin";
- "Peritol";
- "Pipolfen";
- "Fenkarol".
These drugs are usually prescribed to people suffering from chronic diseases that cause difficulty breathing (bronchial asthma). In addition, they will have a beneficial effect in case of acute allergic reaction.
2nd generation drugs
These medications are called non-sedatives. Such products no longer have an impressive list of side effects. They do not provoke drowsiness or decreased brain activity. Medicines are in demand for allergic rashes and itchy skin.
The most popular drugs:
- "Claritin";
- "Trexyl";
- "Zodak";
- "Fenistil";
- "Gistalong";
- "Semprex."
However, the big disadvantage of these drugs is their cardiotoxic effects. That is why these drugs are prohibited for use by people suffering from cardiovascular pathologies.
3rd generation drugs
These are active metabolites. They have excellent antiallergic properties and have a minimal list of contraindications. If we talk about effective antiallergic drugs, then these drugs are precisely modern antihistamines.
Which drugs from this group are the most popular? These are the following medications:
- "Zyrtec";
- "Cetrin";
- Telfast.
They do not have a cardiotoxic effect. They are often prescribed for acute allergic reactions and asthma. They provide excellent results in the fight against many dermatological diseases.
4th generation drugs
Recently, specialists have invented new medicines. These are 4th generation antihistamines. They are distinguished by their rapid action and long-lasting effect. Such drugs perfectly block H1 receptors, eliminating all unwanted allergy symptoms.
The great advantage of such medications is that their use does not harm the functioning of the heart. This allows us to consider them quite safe means.
However, we should not forget that they have contraindications. This list is quite small, mainly children and pregnancy. But it is still recommended to consult a doctor before use. It would be useful to study the instructions in detail before using 4th generation antihistamines.
The list of such drugs is as follows:
- "Levocetirizine";
- "Erius";
- "Desloratadine";
- "Ebastine";
- "Fexofenadine";
- "Bamipin";
- "Fenspiride";
- "Cetirizine";
- "Xyzal."
The best drugs
It is quite difficult to identify the most effective drugs from the 4th generation. Since such drugs were developed not so long ago, there are few new antiallergic drugs available. In addition, all drugs are good in their own way. Therefore, it is not possible to identify the best 4th generation antihistamines.
Medicines containing fenoxofenadine are in great demand. Such drugs do not have a hypnotic or cardiotoxic effect on the body. These drugs today rightfully occupy the place of the most effective antiallergic medications.
Cetirizine derivatives are often used to treat skin manifestations. After taking 1 tablet, the result is noticeable after 2 hours. At the same time, it persists for quite a long time.
The active metabolite of the famous Loratadine is the drug Erius. This drug is 2.5 times more effective than its predecessor.
The medicine “Xyzal” has earned great popularity. It perfectly blocks the process of releasing inflammatory mediators. As a result of this effect, this remedy reliably eliminates allergic reactions.
Medicine "Cetirizine"
This is a fairly effective remedy. Like all modern 4th generation antihistamines, the medicine is practically not metabolized in the body.
The drug has proven itself to be highly effective for skin rashes, as it is able to penetrate perfectly into the epidermis. Long-term use of this medication in children suffering from early atopic syndrome significantly reduces the risk of progression of such conditions in the future.
2 hours after taking the tablet, the desired lasting effect occurs. Since it lasts for a long time, taking 1 pill per day is enough. Some patients can take 1 tablet every other day or twice a week to achieve the desired result.
The medicine has a minimal sedative effect. However, patients suffering from kidney pathologies should use this remedy with extreme caution.
The drug in the form of a suspension or syrup is approved for use in children from two years of age.
Medicine "Fexofenadine"
This drug is a metabolite of terfenadine. This medication is also known as Telfast. Like other 4th generation antihistamines, it does not cause drowsiness, is not metabolized and does not affect psychomotor functions.
This remedy is one of the safe, but at the same time extremely effective drugs among all antiallergic medications. The drug is in demand for any manifestations of allergies. Therefore, doctors prescribe it for almost all diagnoses.
Antihistamine tablets "Fexofenadine" are prohibited for use by children under 6 years of age.
The drug "Desloratadine"
This medicine is also a popular antiallergic drug. It can be used for any age groups. Since medical pharmacologists have proven its high safety, this drug is sold in pharmacies without a prescription.
The drug has a slight sedative effect, does not have a detrimental effect on cardiac activity, and does not affect the psychomotor sphere. Often the medicine is well tolerated by patients. In addition, it does not interact with other medications.
One of the most effective medications from this group is the drug “Erius”. This is a fairly powerful antiallergic medicine. However, it is contraindicated during pregnancy. In syrup form, the medicine is approved for use by children from 1 year of age.
The drug "Levocetirizine"
This remedy is better known as “Suprastinex”, “Cesera”. This is an excellent drug that is prescribed to patients suffering from an allergic reaction to pollen. The remedy is prescribed in case of seasonal manifestations or year-round. The drug is in demand in the treatment of conjunctivitis and allergic rhinitis.
Conclusion
New generation drugs are active metabolites of previously used drugs. Undoubtedly, this property makes 4th generation antihistamines extremely effective. Medicines are not metabolized in the human body, but they give a long-lasting and pronounced result. Unlike previous generations of drugs, such drugs do not have a detrimental effect on the liver.
Allergy tablets for nursing mothers
