So what can older adults safely take for allergy relief? Wozniak: Newer antihistamines such as Claritin® (loratadine) and Allegra® (fexofenadine) tend to be safer and better tolerated.
Loratadine, cetrizine, and fexofenadine all have excellent safety records. Their cardiovascular safety has been demonstrated in drug-interaction studies, elevated-dose studies, and clinical trials. These three antihistamines have also been shown safe in special populations, including pediatric and elderly patients.
Since Zyrtec is now an over-the-counter antihistamine and can be taken without a doctor’s knowledge, they’re just advising caution in older folks. Based on the manufacturer’s studies of Zyrtec metabolism in people over 65, they recommend that folks who are 77 years and older take only 5 mg per day (vs.
They will likely recommend a nasal steroid or some form of topical medication. If these options still aren’t relieving your loved one’s allergy symptoms, ask about using a second- or third-generation antihistamine, such as cetirizine (Zyrtec), loratadine (Claritin) or fexofenadine (Allegra).
Antihistamines don’t cause very bad side-effects very often, but sometimes they can. Older people (adults over 65) are more likely to get these very bad side-effects. Check the patient information leaflet that comes with your medicine for more information.
Which is better–loratadine or cetirizine? Loratadine has fewer sedating properties compared to cetirizine. The effectiveness of the two are more or less equal. However, cetirizine may have a quicker onset of action.
Zyrtec and Claritin are both second generation antihistamines with low risk of sedation; however, Zyrtec is more likely to cause sedation than Claritin. Zyrtec also has a quicker onset of action (one hour vs up to three hours for Claritin) but both last for 24 hours.
Research suggests that fexofenadine is the least sedating of the newer antihistamines. According to drug safety monitoring reports, loratadine and fexofenadine are less likely to cause sedation than cetirizine.
In most cases, a non-sedating antihistamine like Zyrtec and Allergra is preferred over Benadryl, which can cause drowsiness. Anti-itch creams such as topical corticosteroids may be helpful for itching in small areas.
Who shouldn’t take antihistamines?
Older adults are especially sensitive to the central nervous system- and anticholinergic-related side effects of sedating antihistamines because of decreased cholinergic neurons or receptors in the brain, reduced hepatic and renal function, and increased blood-brain permeability.
Acrivastine capsules that you buy from pharmacies and supermarkets can be taken by adults under the age of 65, and children aged 12 years and over. Acrivastine is not recommended for people over 65 because very little research on the medicine has been done in this age group.
Potential harm to the brain: Long-term anticholinergic use has been associated with increased dementia risk; diphenhydramine can impair many cognitive functions including memory.
Cetirizine is the most potent antihistamine available and has been subjected to more clinical study than any other.
In the end, Claritin, Zyrtec, and Allegra are all good antihistamine options and are generally well-tolerated.
Loratadine was superior to acrivastine for the suppres- sion of flare response whereas no difference was present for the suppression of wheal response at 24h between these two antihistamines. The inhibition in mean flare responses was 13%, 25%, 56.7% for acrivastine, lorata- dine and cetirizine, respectively.