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No Time for Lullabies Tracing down Pharmacological Effects & Uses of H1-Antihistamines in Children Younger than
Alaa Yehya1, Mohammad Numan2, Laila Matalqah1
1Yarmouk University (YU), Irbid, Jordan.
Insights
Sedating H1-antihistamines are frequently used in young children, often for off-label purposes like sleep induction. Parental awareness of cognitive side effects and off-label use remains low, despite safer alternatives being available.
Area of Science:
- Pediatric Pharmacology
- Pharmacoepidemiology
- Drug Safety
Background:
- H1-antihistamines are commonly prescribed for children.
- Understanding their usage patterns and parental awareness is crucial for optimizing pediatric care.
Purpose of the Study:
- To analyze the pharmacological uses of H1-antihistamines in children under 6 years old.
- To assess parental awareness regarding H1-antihistamine use and its effects in children.
Main Methods:
- A cross-sectional study conducted in 5 Jordanian retail pharmacies.
- Involved 516 children under 6 years old receiving H1-antihistamines.
- Data collected over 5 months (October 2019-February 2020).
Main Results:
- Over half of H1-antihistamine uses were self-medication (56.3%).
- Sedating antihistamines (77.9%), particularly Chlorpheniramine maleate (62.9%), were most common.
- Common uses included sleep induction (47.0%), flu management (21.7%), and allergic rhinitis (12.9%).
- 66.6% of uses were off-label.
- Parental awareness of sedative effects was high (80.5%), but cognitive effects (31.9%) and off-label use (79.7%) awareness was low.
Conclusions:
- Sedating H1-antihistamines remain prevalent in pediatric use despite safer options.
- Significant off-label prescribing and self-medication highlight potential safety concerns.
- Improving parental education on antihistamine risks and appropriate use is essential.
Abstract:
Objectives. To provide a qualitative and a quantitative analysis of H1-antihistamines pharmacological uses pattern among children (<6 years old) and to evaluate the parental-related awareness. Methods. A cross-sectional study was carried out at 5 retail pharmacies in Jordan over 5 months (October/2019-February/2020). Parents who requested any of H1-antihistmine agent for a child (<6 years) were invited to participate. Results. A total of 516 children, most of them were toddlers (1-3) years, received at least 1 H1-antihistamine. More than half of the cases received H1-antihistamine as self-medication (56.3%). Sedating antihistamine agents were the most frequently used among children (<6 years old) (77.9%) among which Chlorpheniramine maleate was the most commonly used agent (62.9%). About half of the children (47.0%) received H1-antihistamine to induce sleep. Whereas, 21.7% and 12.9% received them to manage flu, and allergic rhinitis (AR), respectively. Around 66.6% of the cases were classified as off-label use. Most of the parents (80.5%) were aware of the sedative adverse effects of H1-antihistamines, whereas a fewer number (31.9%) were aware of their cognitive effects. Finally, more than two thirds of parents (79.7%) were unfamiliar with off-label drug use in children. Conclusion. Despite the availability of less-sedating H1-antihistamines with a wide safety and efficacy record, the use of sedating H1-antihistamines remains popular in children.
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