Efficacy and safety of H1-antihistamines: an update

Antiinflamm Antiallergy Agents Med Chem. 2012;11(3):230-7. doi: 10.2174/1871523011202030230.

Abstract

H1-antihistamines are inverse agonists that combine with and stabilize inactive conformation of H1-receptors. Thus they interfere with actions of histamine at H1-receptors. They are widely used for treatment of allergic rhinitis, allergic conjunctivitis, urticaria, coughs, colds and insomnia. H1-antihistamines are classified as older 'first generation' and newer 'second generation'. First generation H1-antihistamines have poor receptor H1-receptor selectivity, and cross blood-brain-barrier. They have a lot of adverse events such as anti-muscarinic, anti-α-adrenergic, anti-serotonin, and sedative effects. In contrast, second generation H1-antihistamines were highly selective for the histamine H1-receptor, do not cross the blood brain barrier, and have minimal adverse events. The risks of first-generation H1-antihistamines have been clearly underestimated, particularly when purchased as nonprescribed over the counter medications by public. This review summarizes current literature to evaluate antihistamines including their mechanism, indications and side-effects.

Publication types

  • Review

MeSH terms

  • Aged, 80 and over
  • Anti-Allergic Agents / therapeutic use*
  • Breast Feeding
  • Central Nervous System Diseases / drug therapy
  • Child, Preschool
  • Female
  • Histamine H1 Antagonists / adverse effects
  • Histamine H1 Antagonists / pharmacology
  • Histamine H1 Antagonists / therapeutic use*
  • Humans
  • Hypersensitivity / drug therapy*
  • Lactation
  • Off-Label Use
  • Pregnancy
  • Pregnancy Complications / drug therapy
  • Technology, Pharmaceutical
  • Vestibular Diseases / drug therapy

Substances

  • Anti-Allergic Agents
  • Histamine H1 Antagonists