Ep. 151: What AllergistsThink About Antihistamines
If you have ever taken an antihistamine labeled "non-drowsy" and still ended up foggy and tired, you are not imagining it. Allergists have a lot to say about that label and about the foggy feeling that comes with allergy season in general.
In part two of our live recordings from the AAAAI conference in Philadelphia, Kortney and Dr. Payel Gupta talk to allergists from across the US about what they actually think about antihistamines.
What we cover in our episode about non-drowsy antihistamines
Non-drowsy does not mean the same thing for every antihistamine. Zyrtec, Claritin, and Allegra are all labeled non-drowsy, but some are more likely to make you sleepy than others.
Why allergists have moved away from Benadryl. First-generation antihistamines cross into the brain more easily, causing drowsiness and a range of other side effects that are far less common with newer antihistamines.
The foggy feeling might not be your medication. Congestion from untreated allergies disrupts your sleep, and poor sleep creates its own fog. Sometimes it is the disease, not the drug.
Timing your antihistamine makes a real difference. Taking it before you head out gives it the best chance to work. And if it makes you drowsy, switching to a nighttime dose is a simple fix.
Not all second-generation antihistamines are approved for pilots. Fexofenadine has the lowest penetration into the brain of any antihistamine tested, which is why the FAA cleared it as the only option pilots can take while flying.
Thank you to our allergists
A huge thank you to every allergist who stopped what they were doing at the AAAAI conference to talk to us. We could not make this episode without you.
Dr. Mansi Kotwal, Instagram
Dr. Lauren Davidson, Instagram
Dr. Joel Brooks, LinkedIn
Dr. Pratibha Vakharia, allergyv.com
Dr. Rathika Gupta
Dr. David Wertheim
We thank Opella for sponsoring this episode. While they support the show, all opinions are our own, and sponsorship doesn’t influence our content or editorial decisions. Any mention of brands is for informational purposes and not an endorsement.
Second-generation antihistamines (non-sedating or minimally sedating)
Cetirizine — Zyrtec
Loratadine — Claritin, Alavert
Fexofenadine — Allegra
Levocetirizine — Xyzal
Desloratadine — Clarinex (prescription only)
First-generation antihistamines (sedating)
Diphenhydramine — Benadryl, ZzzQuil, Unisom
Chlorpheniramine — Chlor-Trimeton
Brompheniramine — Dimetapp
Dimenhydrinate — Dramamine
Hydroxyzine — Atarax, Vistaril (prescription only)
Timestamps
Our episode asks allergists their opinions on antihistamines
01:04 What is an antihistamine
03:08 Allergist opinions on first versus second-generation antihistamines
04:33 Why we want to retire first-generation antihistamines
06:44 Is there an order of more to less sedating antihistamines
08:17 Why fexofenadine is the least sedating antihistamine
10:33 Drowsiness from antihistamine or allergic rhinitis
14:47 When to take an antihistamine
