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Related Experiment Videos

Comparative tolerability of second generation antihistamines.

F Horak1, U P Stübner

  • 1ENT-Clinic, University of Vienna, Austria. friedrich.horak@akh-wien.at.ac

Drug Safety
|May 29, 1999
PubMed
Summary

Second generation antihistamines offer improved allergy relief with fewer side effects than older drugs. While generally safe, caution is advised for specific patient groups and during pregnancy.

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Area of Science:

  • Pharmacology
  • Allergy and Immunology

Background:

  • Second-generation antihistamines are potent H1 receptor antagonists with antiallergic properties.
  • They offer a more favorable risk-benefit profile regarding central nervous system (CNS) adverse effects compared to first-generation agents.
  • Approved drugs include acrivastine, astemizole, azelastine, cetirizine, ebastine, fexofenadine, loratadine, mizolastine, and terfenadine.

Purpose of the Study:

  • To review the efficacy and safety of second-generation antihistamines.
  • To compare their adverse effect profiles with first-generation antihistamines.
  • To identify special populations and circumstances requiring careful consideration.

Main Methods:

  • Literature review and analysis of clinical data.
  • Evaluation of reported adverse effects, including CNS, cardiovascular, and carcinogenic potential.
  • Assessment of drug safety in specific patient demographics.

Main Results:

  • Second-generation antihistamines exhibit high potency and antiallergic effects with reduced CNS adverse effects.
  • While generally safe, potential cardiovascular risks exist with terfenadine and astemizole, particularly at high doses or in susceptible individuals.
  • No evidence supports a link between these agents and carcinogenicity in humans.
  • Special populations (children, elderly, renal/hepatic impairment) require individualized dosing.
  • Use during pregnancy and lactation is not recommended.

Conclusions:

  • Second-generation antihistamines represent a significant therapeutic advancement in allergy treatment.
  • Their favorable safety profile, including low CNS and cardiovascular adverse effect incidence, makes them a valuable option.
  • Careful patient selection and monitoring are essential for optimal outcomes.

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