Oral H1 Blockers
Medication | Available Preparations |
|---|---|
First-generation* | |
Brompheniramine† | Available only as combination products with a decongestant or an antitussive, which are not recommended for children < 6 years 4-, 8-, and 12-mg tablets 2 mg/5 mL elixir 8- and 12-mg tablets (sustained-release, single-entity) |
Chlorpheniramine† | Available only as combination products with a decongestant or an antitussive, which are not recommended for children < 6 years 2-mg chewable tablets 4-, 8-, and 12-mg tablets Extended-release: 12-mg tablets or capsules 2 mg/5 mL syrup |
Clemastine | 1.34- and 2.68-mg tablets 0.67 mg/5 mL syrup |
Cyproheptadine | 4-mg tablets 2 mg/5 mL syrup |
Dexchlorpheniramine | 2-mg tablets 2 mg/5 mL syrup 4- and 6-mg tablets (extended-release) |
Diphenhydramine | 25- and 50-mg capsules or tablets 12.5-mg chewable tablet 12.5 mg/5 mL elixir 12.5 mg/mL syrup |
Hydroxyzine | 25-, 50-, and 100-mg capsules 10-, 25-, 50-, and 100-mg tablets 10 mg/5 mL syrup 25 mg/5 mL oral suspension |
Promethazine | Safer alternatives preferred for allergic disorders in children 12.5-, 25-, and 50-mg tablets 6.25 mg/5 mL and 25 mg/5 mL syrup |
Second-generation | |
Bilastine‡ | 20-mg tablet 10-mg disintegrating oral tablets 2.5 mg/mL syrup |
Cetirizine | 5- and 10-mg tablets 1 mg/mL syrup |
Desloratadine | 5-mg tablets 0.5 mg/mL syrup |
Ebastine‡ | 10-mg tablets 20-mg tablets 20-mg disintegrating oral tablets 1 mg/mL oral solution |
Fexofenadine | 30-, 60-, and 180-mg tablets 30-mg orally disintegrating tablets 6 mg/mL oral suspension |
Levocetirizine | 5-mg tablets 0.5 mg/mL oral solution |
Loratadine | 10-mg tablets and capsules 5-mg chewable tablets 5- and 10-mg disintegrating oral tablets 1 mg/mL syrup 1 mg/mL oral solution |
Mizolastine‡ | 10-mg tablets |
Rupatadine‡ | 10-mg tablets 1 mg/mL oral solution |
Cetirizine/pseudoephedrine | 5-mg cetirizine plus 120-mg pseudoephedrine tablets |
Fexofenadine/pseudoephedrine | 60-mg fexofenadine plus 120-mg pseudoephedrine tablets 180-mg fexofenadine plus 240-mg pseudoephedrine tablets |
Loratadine/pseudoephedrine | 5-mg loratadine plus 120-mg pseudoephedrine tablets 10-mg loratadine plus 240-mg pseudoephedrine tablets |
Acrivastine/pseudoephedrine‡ | 8-mg acrivastine plus 60-mg pseudoephedrine capsules |
* Most first-generation antihistamines have strong anticholinergic properties. Generally, they should not be used in older adults or in patients with glaucoma, benign prostatic hyperplasia, constipation, delirium, dementia, or orthostatic hypotension. These medications commonly cause sedation, dry mouth, blurred vision, urinary retention, constipation, and orthostatic hypotension. Long-term use of some first-generation antihistamines has been linked to cognitive decline and dementia. In children, first-generation antihistamines should be used only as needed given their potential adverse effects, particularly when combined with other medications; second-generation antihistamines are preferred for allergic rhinitis. | |
† Usually, brompheniramine and chlorpheniramine are available only in combination with other medications (eg, decongestants, cough suppressants). Brompheniramine and chlorpheniramine combined with other medications (eg, dextromethorphan, phenylephrine) should not be used in children < 6 years. | |
‡ Not available in the United States. | |
