[Medicinal drugs and automobile driving ability]

When prescribing drugs, the physician is responsible to warn his patient about potential impairment of driving capability. To do this, he needs to be aware of the duration and profile of actions, notably sedative and other effects affecting vigilance, cognitive and psychomotor functions. It is advisable to keep written records about such information. Impairment of driving capability may be more pronounced when ethanol is used during the action of drugs affecting central nervous function. The majority of published studies, particularly from epidemiological work with drivers, indicate an increased risk of accidents associated with the therapeutic use of benzodiazepines or cyclic antidepressants. Epidemiological data for other drugs available so far do not allow definite conclusions. Among antihistamines for drivers, loratadine or fexofenadine are probably preferable to ceritizine or older antihistamines. Patients with diabetes who drive should be informed about the risks and self-management of hypoglycaemia.