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Home > Pre-Reg Pharmacist > Sedating Antihistamines and Non-Sedating Antihistamines

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Sedating Antihistamines and Non-Sedating Antihistamines

Antihistamines are classified into two groups – the first-generation (“sedating”) and second-generation (“non-sedating”). Sedating antihistamines cause sedation as they are highly lipid soluble and readily cross the blood brain barrier. This sedating activity is sometimes used in managing conditions such as eczema where sleep maybe disturbed due to pruritus. Sedating antihistamines also have significant antimuscarinic activity and should be used with caution in patients with prostatic hypertrophy, urinary retention and angle-closure glaucoma.

Examples of sedating antihistamines:

  • Alimemazine
  • Chlorphenamine
  • Clemastine
  • Cyproheptadine
  • Hydroxyzine
  • Ketotifen
  • Promethazine

Sedation is rare with non-sedating antihistamines, however patients should be made aware that a sedative effect may occur and performance of skilled tasks such as operating machinery or driving maybe affected.

Examples of non-sedating antihistamines:

  • Acrivastine
  • Bilastine
  • Cetirizine
  • Desloratadine
  • Fexofenadine
  • Levocetirizine
  • Loratadine
  • Mizolastine
  • Rupatadine


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