Some Antihistamines
Medication | Degree of Anticholinergic Effects* | Degree of Drowsiness† |
|---|---|---|
Nonprescription (over-the-counter) | ||
Azelastine‡, § | Few to none | Some |
Brompheniramine | Moderate | Some |
Cetirizine‡ | Few to none | Little to none in most people and moderate in some people |
Chlorpheniramine | Moderate | Some |
Clemastine | Strong | Moderate |
Desloratadine‡ | Few to none | Little to none |
Diphenhydramine | Strong | Extreme |
Fexofenadine‡ | Few to none | Little to none |
Levocetirizine‡ | Few to none | Little to none |
Loratadine‡ | Few to none | Little to none |
Prescription | ||
Acrivastine‡, ¶ | Few to none | Little to none |
Bilastine¶ | Few to none | Little to none |
Cyproheptadine | Moderate | Some |
Dexchlorpheniramine | Moderate | Some |
Ebastine¶ | Few to none | Little to none |
Hydroxyzine | Moderate | Extreme |
Mizolastine¶ | Few to none | Little to none |
Promethazine | Strong | Extreme |
Rupatidine¶ | Few to none | Some |
* Anticholinergic effects include dry mouth, blurred vision, constipation, difficulty with urination, confusion, and light-headedness (particularly after a person stands up). Older adults are particularly susceptible to these effects. Long-term use of medications with strong anticholinergic effects has been linked to dementia. | ||
† The degree of drowsiness varies, depending on the dose, other active ingredients in the formulation (as in formulations that contain a decongestant plus an antihistamine), and the person. | ||
‡ Second-generation antihistamines. These newer medications are less likely to cause drowsiness and other side effects. | ||
§ Azelastine is also a mast cell stabilizer. | ||
¶ Acrivastine, bilastine, ebastine, mizolastine, and rupatidine are not available in the United States. Acrivastine is available only in combination with pseudoephedrine (a decongestant). The combination is taken by mouth. Such combination medications are not used in children under 12 years old. | ||
