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Related Experiment Videos

Second-generation antihistamines: a comparative review

J W Slater1, A D Zechnich, D G Haxby

  • 1College of Pharmacy, Oregon State University, Portland, USA.

Drugs
|February 10, 1999
PubMed
Summary

Second-generation antihistamines offer reduced side effects compared to older drugs. While effective for allergic rhinitis, specific agents like cetirizine and mizolastine show superior results for urticaria and pruritus in atopic dermatitis.

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Area of Science:

  • Pharmacology
  • Allergy and Immunology

Background:

  • Second-generation H1 antihistamines were developed to minimize sedation and anticholinergic effects of older agents.
  • These newer antihistamines may also influence other allergic mediators, though clinical significance is unproven.

Purpose of the Study:

  • To evaluate second-generation antihistamines for features influencing clinical choice.
  • To compare efficacy in allergic rhinitis, urticaria, and atopic dermatitis.

Main Methods:

  • Review of second-generation antihistamines: acrivastine, astemizole, azelastine, cetirizine, ebastine, fexofenadine, ketotifen, loratadine, mizolastine, terfenadine.
  • Assessment of mechanisms of action, metabolism, and adverse effects, including QT interval prolongation risk.

Main Results:

Related Experiment Videos

  • All reviewed agents are effective for allergic rhinitis; choice depends on other factors.
  • Cetirizine and mizolastine showed superior wheal and flare suppression in urticaria.
  • Cetirizine, ketotifen, and loratadine were effective as adjunctive therapy for pruritus in atopic dermatitis.
  • Astemizole, ebastine, and terfenadine carry a risk of QT prolongation; others do not.

Conclusions:

  • Choice of second-generation antihistamine for allergic rhinitis is multifactorial.
  • Cetirizine and mizolastine are preferred for urticaria, while cetirizine, ketotifen, and loratadine aid atopic dermatitis pruritus.
  • These agents are beneficial for asthmatics with coexisting allergic conditions.