How do antihistamines cause drowsiness. What are the differences between first-generation and second-generation allergy medications. How can you manage sleepiness caused by allergy medicine. What are alternative treatments for allergies that don’t cause drowsiness.

The Science Behind Antihistamines and Drowsiness

Antihistamines are commonly used to treat allergies and cold symptoms, but they often come with an unwanted side effect: drowsiness. To understand why this happens, we need to delve into the role of histamine in our bodies.

Histamine is a chemical produced by our immune system to combat allergens and germs. When we encounter an allergen or catch a cold, histamine production increases, leading to symptoms like runny nose, coughing, sneezing, and itchy eyes. Antihistamines work by blocking the effects of histamine, thus alleviating these symptoms.

However, histamine also plays a crucial role in our brain, helping us stay awake and alert. When antihistamines enter the brain, they can interfere with this function, resulting in drowsiness.

How do antihistamines affect the brain?

Antihistamines can cross the blood-brain barrier, a protective mechanism that prevents many substances from entering the brain. Once inside, they block histamine receptors in the brain, which are responsible for regulating sleep-wake cycles. This interference can lead to feelings of sleepiness and reduced alertness.

First-Generation vs. Second-Generation Antihistamines

Not all antihistamines are created equal when it comes to causing drowsiness. They can be broadly categorized into two groups: first-generation and second-generation antihistamines.

First-Generation Antihistamines

First-generation antihistamines, such as diphenhydramine (Benadryl速), are more likely to cause drowsiness. These medications can easily cross the blood-brain barrier and affect histamine in the brain. While this makes them effective at treating allergy symptoms, it also increases the likelihood of sedation.

Second-Generation Antihistamines

Second-generation antihistamines, including cetirizine (Zyrtec速), fexofenadine (Allegra速), and loratadine (Claritin速), are often marketed as “non-drowsy” options. These newer medications are less likely to cross the blood-brain barrier, resulting in fewer sedating effects. Additionally, they tend to last longer than their first-generation counterparts.

Managing Drowsiness from Allergy Medications

If you find yourself feeling sleepy after taking allergy medicine, there are several strategies you can employ to manage this side effect:

• Take your medication in the evening instead of the morning
• Try different types of antihistamines to find one that works best for you
• Consider using nasal spray antihistamines, which are less likely to cause drowsiness
• Explore non-drowsy allergy medicines, such as second-generation antihistamines
• Avoid alcohol when taking antihistamines, as it can increase sedation

Can you build a tolerance to the drowsy effects of antihistamines?

While some people may develop a tolerance to the sedating effects of antihistamines over time, this is not guaranteed and can vary from person to person. It’s important to monitor your body’s response to the medication and consult with a healthcare professional if drowsiness persists or interferes with your daily activities.

Antihistamines in Cold and Flu Medications

Many people may not realize that cold and flu medications often contain first-generation antihistamines. These are included because they are effective at treating cold symptoms and drying up runny noses. However, this also means that these medications can cause significant drowsiness.

Why are sedating antihistamines used in cold medicines?

First-generation antihistamines are often more effective at treating cold symptoms than newer, less sedating types. Their ability to dry up nasal secretions and reduce sneezing makes them valuable ingredients in cold and flu remedies. However, due to their sedating effects, these medications are typically labeled for nighttime use.

Alternative Treatments for Allergies

If you find that antihistamines are causing too much drowsiness or other unwanted side effects, there are alternative treatment options available:

1. Intranasal corticosteroids: These nasal sprays can effectively reduce allergy symptoms without causing drowsiness. Some are available over-the-counter, while others require a prescription.
2. Allergen immunotherapy: This treatment involves gradually exposing your body to small amounts of allergens to build tolerance over time.
3. Leukotriene inhibitors: These medications block the action of leukotrienes, chemicals that cause allergy symptoms.
4. Natural remedies: Some people find relief with options like saline nasal rinses, butterbur, or quercetin supplements.

Are there any non-medicinal ways to manage allergies?

Yes, there are several non-medicinal approaches to managing allergies:

• Use air purifiers with HEPA filters to remove allergens from the air
• Keep windows closed during high pollen days
• Shower and change clothes after spending time outdoors
• Use dust-mite proof covers on pillows and mattresses
• Regularly clean and vacuum your living space

The Importance of Proper Allergy Diagnosis

While over-the-counter antihistamines can provide relief for many people, it’s crucial to understand the root cause of your allergy symptoms. If your symptoms persist for more than two weeks or are not adequately controlled with OTC medications, it’s time to consult a board-certified allergist.

What can an allergist do that I can’t do on my own?

An allergist can provide several benefits:

• Conduct comprehensive allergy testing to identify specific triggers
• Develop a personalized treatment plan tailored to your needs
• Prescribe stronger medications or alternative treatments if necessary
• Offer guidance on allergen avoidance strategies
• Monitor your progress and adjust treatment as needed

Smart Use of Allergy Medications

To get the most benefit from your allergy medications while minimizing side effects, it’s essential to use them smartly:

• Read labels carefully and follow dosage instructions
• Be aware of potential side effects and monitor how your body responds
• Don’t mix different antihistamines or supplement multi-symptom medications with additional antihistamines
• Consider keeping a symptom diary to track the effectiveness of different treatments
• Consult with a healthcare professional if you have concerns or questions about your medication

How can I determine which antihistamine is right for me?

Finding the right antihistamine may require some trial and error. Consider these factors:

• The severity and type of your allergy symptoms
• Your sensitivity to drowsiness and other side effects
• The duration of relief you need (some antihistamines last longer than others)
• Any other medications you’re taking that might interact with antihistamines
• Your daily schedule and activities (e.g., if you need to drive or operate machinery)

The Future of Allergy Treatments

As our understanding of allergies and the immune system continues to grow, researchers are working on developing new treatments that may provide relief without the side effect of drowsiness.

What new allergy treatments are on the horizon?

Some promising areas of research include:

• Targeted biologics that block specific components of the allergic response
• Improved immunotherapy techniques, including sublingual and epicutaneous methods
• Gene therapy approaches to modify the immune system’s response to allergens
• Novel drug delivery systems that could reduce systemic side effects
• Personalized medicine approaches based on an individual’s genetic profile

As we continue to advance our understanding of allergies and their treatments, it’s important to stay informed about the latest developments. Always consult with a healthcare professional before making significant changes to your allergy management routine, and remember that what works best for one person may not be ideal for another. By understanding the science behind antihistamines and their effects on the body, you can make more informed decisions about your allergy treatment and find the best balance between symptom relief and managing side effects like drowsiness.

When Allergy or Cold Medication Makes You Drowsy

Tips for Staying Alert

By Purvi Parikh, MD

In treating allergies or a cold with antihistamines, you may experience drowsiness, a common side effect of the medication.

How does this happen? Histamine is a chemical produced by the immune system to fight off allergens and germs. When there is a threat of allergies or infection (such as the common cold), histamine is even more active. In its search-and-destroy process, it can cause allergy or cold symptoms such as runny nose, coughing, sneezing and itch eyes. Antihistamine medications relieve these symptoms by blocking the unwanted effects of histamine.

Unrelated to the immune system, histamine is also produced in the brain, where it plays an important part in feeling awake. Antihistamines used to treat respiratory symptoms can get into the brain and interrupt this work, making you feel drowsy.

What can you do about drowsiness from allergy medicines?

Some antihistamines are less likely to cause drowsiness than others. Reactions vary considerably from one person to another. What relieves your symptoms without making you sleepy may be different from what works for someone else.

When you find one that works for you, stick with it – check chemical ingredients and dosages before changing brands or generics. On the other hand, if one doesn’t work for you, try another type.

Does diphenhydramine (Benadryl®) make you sleepy? First-generation antihistamines such as diphenhydramine (Benadryl®) usually cause drowsiness because they are less likely to affect the histamine produced in the brain or have other unwanted effects in the brain. Currently, there is no non-drowsy Benadryl® on the market.

Non-drowsy allergy medicines do exist. Newer, second-generation antihistamines such as cetirizine (Zyrtec®), fexofenadine (Allegra®) and loratadine (Claritin®) – marketed as “nonsedating” – usually cause less drowsiness. An added benefit is that second-generation antihistamines last longer than Benadryl. Allegra is generally the least sedating.

Nasal spray antihistamines are also somewhat less likely to make you sleepy, since they target nasal passages directly rather than sending medicine throughout your body in the bloodstream. These are available only by prescription.

Regular use of an intranasal corticosteroid is not only safe but also an effective way to reduce use of antihistamines. They take a few days to start working, so you need to be patient. Ask your doctor or pharmacist about using an antihistamine with an intranasal corticosteroid the first few days. Some intranasal corticosteroids are available over-the-counter, while others are available as prescription medication.

To avoid daytime drowsiness, take an antihistamine in the evening rather than in the morning. It may help you sleep, with drowsy effects wearing off by the next morning. Be aware that drowsiness can last longer than you might expect – and that some antihistamines can cause vivid dreams.

Don’t drink alcohol when taking antihistamines, as it will increase the sedation.

What about antihistamines in cold and flu medications?

What many people may not know is that cold and flu medicines marketed to treat runny nose and sneezing usually include first-generation antihistamines – the more sedating types. That’s because they are often better at treating cold symptoms and drying up runny nose than the newer types.

Because of their sedating effect, cold medicines with antihistamines are labeled for nighttime use. Take this labeling seriously, as some include medications like doxylamine that are more sedating than others. Check labels for dosages as well, as these may vary, even within brands.

More is not better – read labels carefully and take only as recommended. Don’t supplement a multi-symptom cold medication with another single-ingredient antihistamine.

Be smart, be aware of allergy medication side effects

Smart use of allergy medications – knowing how they treat symptoms of an allergic reaction, being aware of potential unwanted side effects and, most important, monitoring their effect on you and your health – is just one step toward controlling allergy and cold symptoms. Even more important: knowing what you are allergic to and taking steps to prevent or reduce exposure.

If your allergy symptoms tend to last longer than two weeks or are not adequately controlled with over-the-counter medications, schedule an appointment with a board-certified allergist for a full diagnosis.

Antihistamines and intranasal corticosteroids are intended for symptom relief. If antihistamines or intranasal corticosteroids are causing side effects such as drowsiness or other problems, there are other treatment options your doctor can offer for relief from allergic reactions. These options include allergen immunotherapy and non-drowsy allergy medicines like second-generation antihistamines or nasal sprays.

Reviewed by:
Dennis Williams, PharmD, is an Associate Professor at the University of North Carolina Eshelman School of Pharmacy. He practices at UNC Medical Center with the pulmonary medicine medical service. He has served as a member of the National Asthma Education Program Coordinating Committee and the National Asthma Educator Certification Board. He serves on Allergy & Asthma Network’s Board of Directors.

Antihistamine Medications | Why do Antihistamines Make You Sleepy

Drowsiness is one of the main side effects of some antihistamines, such as diphenhydramine, which can be found in Benedryl and doxylamine succinate, which is found in Nyquil. And because of their powerful sedating abilities, antihistamines are also the main ingredients that are found in many over-the-counter sleep aids. But why do antihistamine medications make us sleepy? The answer to this question starts with histamines.

What are Histamines?

Histamines are chemical compounds that play a couple of roles in the body. They are best known for being involved in the body’s local immune responses. Histamine is a natural chemical in the body that performs numerous functions such as playing a part in the allergy response.

Allergies occur when your immune system mistakenly thinks a harmless foreign substance, such as pollen or pet dander, is actually dangerous. Histamines will jump to action, which will cause the range of symptoms associated with allergies such as sneezing, itchy eyes, chest congestion, wheezing, and more.

When you get injured or your immune system detects a potentially dangerous foreign substance, certain white blood cells and tissue cells release histamines that pursue and attach to other cells that have a histamine receptor. The histamines induce an inflammatory response, where they will dilate the blood vessels that will increase the blood flow to the site of injury or invasion. There are some side effects that come along with this healing process. An example is when you’re fighting off a cold, histamines will widen the blood vessels in your nasal cavity which will cause nasal congestion.

What are Antihistamines?

Antihistamines are usually used to ease allergy symptoms. They work by blocking histamines attachment to receptors, which prevent the compounds from carrying out their functions. They can cross the blood-brain barrier and inhibit one of the other functions of histamines, which is the role they play in regulating sleep and wakefulness. This disruption of the action of histamines in the brain results in drowsiness.

Older Antihistamines

Because first-generation antihistamines, such as diphenhydramine (Benadryl) or hydroxyzine (Atarax), block the action of histamine at this receptor, they block histamine’s effect on wakefulness. When the histamine is blocked from triggering the receptor and participating in the sleep-wake cycle, the brain sees this as the “sleep mode” of the receptor, and you will feel drowsy. These older antihistamines don’t discriminate between which histamine receptors they block.

Older antihistamines have a sedating effect because the medication penetrates the blood-brain barrier, which means that the medication not only works in treating an allergy but also affects the brain. This results in a feeling of lethargy. In fact, some older antihistamines are prescribed specifically because they help with sleep and relaxation. However, this can be an unwanted and serious side effect for someone who needs to drive or operate heavy machinery.

Newer Antihistamines

Newer antihistamine medications, such as loratadine (Claritin) or desloratadine (Aerius), have different chemical structures that don’t allow them to readily enter the brain. Even though they have action at the h2 receptor, they can’t access the receptors that are present in the brain, which means they do not cause drowsiness. This is also the reason why newer and different antihistamines have less drowsiness effects associated with them. Newer, once-a-day antihistamine medications have no effect on the brain and just function in decreasing allergy symptoms. They block the histamines which cause inflammation, mucous, itching and hives. However, they can still cause drowsiness in a small percent of people who take them. If this is the case for you, you should talk to your doctor about other approaches you may be able to take.

Treatment with Dr. Shukla

Dr. Shukla of Brooklyn New York has been in practice for more than 15 years. He has provided the answers and treatments to many children suffering from asthma, allergies, sleep apnea. Here at the Asthma, Allergy and Sleep Center of New York, we provide you with a personalized, boutique approach to health care and pediatric pulmonology all under one roof. We emphasize prevention and use our advanced diagnostic technologies to give you and your child the best possible care. Whether you need to see a sleep doctor, need allergy treatment or need a pulmonologist, contact Dr. Shukla’s New York offices today for an appointment.

How to choose the best remedy for allergies – an article on the site Aptechestvo, Nizhny Novgorod

Allergy is a protective reaction of the immune system, aimed at combating substances foreign to the body. Symptoms of the disease are manifested due to the erroneous perception of a harmless foreign material as dangerous to the body. To get rid of such a reaction, you need to know what is best to take from allergies.

Allergy symptoms

The protective reaction of the body can cause severe discomfort or be dangerous to human life and health. The main symptoms of allergies include:

• sneezing, watery eyes, runny sinus discharge;

• dry cough, breathing becomes difficult and intermittent;

• shortness of breath caused by swelling of the respiratory system;

• rashes and redness on the skin, itching.

The best drug for allergies can block the effects of foreign bodies on the human body.

Classification of preparations

Allergy medicines are divided into 3 large groups. Classification is carried out according to the method of exposure:

• Antihistamines – block the formation of histamine in the human body. They are considered the best allergy medicine, as they act on the cause of the reaction, and do not eliminate the symptoms.

• Steroids – reduce the inflammatory process, are prescribed when the disease affects the human respiratory system.

• Decongestants – reduce swelling in the sinuses, are used as additional treatments aimed at relieving symptoms.

First generation drugs

The main active substance penetrates directly into the nervous system, which allows you to quickly stop the symptoms of the disease.

Pros:

Flaws:

• with prolonged use, they are addictive, therefore they are suitable only for a one-time removal of symptoms.

• cause an adverse reaction in the form of drowsiness, lethargy, headache.

The best 1st generation allergy pills:

• Diphenhydramine – used to provide quick relief during an attack, not suitable for children;

• Suprastin – in comparison with other drugs of the group, it has the least number of adverse reactions;

• Tavegil – the time of action of the active substance is 8 hours, which is much longer than other tablets belonging to the 1st generation.

Medicines of the 1st generation quickly act on the focus of the disease and help relieve allergy symptoms in the shortest possible time.

Second generation drugs

Antihistamines belonging to the 2nd generation are devoid of the shortcomings of the previous version of the drugs.

Pros:

• restore the immune system, can be used for a single dose or course therapy, are not addictive;

• do not cause adverse reactions of the body, characteristic of the 1st generation of drugs;

• block allergy symptoms for 24 hours.

Flaws:

When answering the question which allergy pills are better, it is worth considering the following 2nd generation drugs:

• Fenistil – available in the form of drops or gel, which allows you to take the drug orally or use it for local exposure;

• Claritin is a safe drug with a mild effect on the body. Suitable for children from 3 years old, adults and the elderly. Does not cause impaired concentration, drowsiness;

• Histalong – has a long-term effect, suitable for course treatment of the chronic form of the disease.

Medicines of the second group are an improved analogue of the first anti-allergy drugs.

3rd generation drugs

Officially, 3 generations of antihistamines do not exist. However, modern drugs of the second group are considered the best remedies for allergies today.

Pros:

• allowed for children, the elderly. Do not affect the cardiovascular system;

• have the least number of adverse reactions, are compatible with driving cars;

• the action occurs 2 hours after ingestion, lasts up to 48 hours.

Minuses:

Medicines of the 3rd generation:

• Zodak – the best drops for allergies, which quickly eliminate symptoms and act for 2 days. Also available in tablet form;

• Cetrin – effectively relieves swelling and other symptoms of the disease;

• Erius – the effect of the drug begins within a few minutes after ingestion, which allows you to quickly remove an allergic reaction.

It is impossible to single out the best allergy pills unambiguously. Each generation of drugs is used for different purposes. For course administration and elimination of symptoms, it is recommended to choose the latest generation of drugs. You can choose effective tablets or drops in consultation with your doctor.

What allergy remedies are available? – article on the website Aptechestvo, Nizhny Novgorod

Allergy is a condition caused by an overreaction of the immune system to substances that are normally pathogens. Accompanied by a high reaction to substances that do not have a harmful effect on the body. The reasons have not yet been identified by scientists, so until now it has not been possible to develop drugs to cure unpleasant reactions, such as sneezing, tearing, itching, etc. But in pharmacies there are allergy medications that relieve symptoms and help relieve exacerbation. Means of the first, second and third generation can be purchased at our online pharmacy, but it is worth studying the features and indications.

Symptoms

Allergies in mild forms go unnoticed and do not require medical treatment. But unpleasant conditions can become brighter and stronger depending on the type of allergen.

The following signs are observed:

• Sneezing, it may get worse;

• Manifestations of cough, it may be accompanied by frequent and problematic breathing;

• Lack of air;

• There may be itching in the nasal region, a severe runny nose;

• Increased tearing;

• Skin itching;

• The appearance of red spots on the skin (urticaria).

First generation drugs

Means of an antihistamine type, which belong to the first generation, when taken, enter the region of the nervous system. They quickly eliminate unpleasant symptoms. But the effect does not last long, and with prolonged use, addiction is observed. When they are used, a feeling of drowsiness, weakness, headaches, dizziness, and slow reactions may occur.

Below you can consider the most effective and inexpensive allergy remedies:

• Diazolin. Does not cause severe drowsiness. It is recommended to use for prevention. Will not be able to help during severe exacerbations, severe manifestations;

• Suprastin. When used, severe drowsiness does not occur, quick help to the body with allergies. The drug is approved for use in adults and children from 3 years.

Second generation drugs

Antihistamine drugs of the second generation have a large spectrum of action. If you follow the rules when taking, there are practically no side effects. Funds are valid 24 hours. With prolonged use, there is no addiction.

Antiallergic drugs of the second group:

• Fenistil. Allergy medicine, which is available in the form of a gel, drops. Options in the form of a gel are intended for application to the surface of the skin, if there are rashes, irritations. They have a cooling, analgesic effect. Drops are more convenient to use, unlike the gel, it is convenient to take with you, they are not addictive;

• Claritin. Has a wide application. When used, there is no feeling of drowsiness, concentration of attention does not decrease. Suitable for adults, it can be used by children from 3 years old. The allergy remedy can be used for a long time;

• Tsetrin. The allergy remedy is highly effective, the tablets relieve unpleasant symptoms, relieve exacerbation. There is a form of syrup, it is suitable for children from 2 years. The action persists throughout the day. Helps relieve swelling. The syrup can be included in complex therapy, relieves spasms during bronchial asthma. The drug has no contraindications;

• Xizal (Zodak). The drug is available in several forms – in the form of tablets and syrup. It has an anti-inflammatory effect. Relieves swelling, itching, redness. The action is noted for two days. Do not use in renal failure, the drug is contraindicated in children under 6 years of age;

Third generation drugs

You can buy medicines for allergic reactions of the third generation from us. The group often includes improved second-generation drugs. They act quickly and are effective. They have few side effects, sometimes intolerance may occur.

Effective medicines include:

• Erius. The medicine is sold in the form of tablets and syrup. It has a long lasting effect. The action can last for days. When used, the manifestations of allergies are quickly eliminated;

• Fexofast When used, the manifestations of reactions are quickly eliminated. The action is observed within 12 hours. Suitable for prevention. The medicine is contraindicated in children under 12 years of age.