Kestin what generation. New generation antihistamines are the most effective drugs in the treatment of allergies. Antihistamines and pregnancy, lactation

Allergy is the scourge of the XXI century. The disease, the prevalence of which has been growing rapidly in recent decades, especially in the developed countries of the world, still remains incurable. World statistics, showing the number of people suffering from various manifestations of an allergic reaction, strikes even the most daring imagination. Judge for yourself: 20% of the population annually suffer from allergic rhinitis, 6% are forced to diet and take allergy pills, about 20% of the world's inhabitants experience symptoms of atopic dermatitis. No less impressive are the numbers that reflect the number of people suffering from even more severe pathologies of allergic origin. Depending on the country of residence, about 1-18% of people cannot breathe normally due to asthma attacks. Approximately 0.05-2% of the population experience or have experienced in the past a life-threatening anaphylactic shock.

Thus, at least half of the population is faced with allergic manifestations, and it is concentrated for the most part in countries with developed industry, and, therefore, in the Russian Federation. At the same time, the help of allergists, alas, does not cover all Russians in need, which, of course, aggravates the situation and contributes to the further progression of the disease. The obviously insufficient control over the release of prescription antiallergic drugs in domestic pharmacies also contributes to the not very favorable state of affairs with the treatment of allergies in Russia. This trend contributes to aggressive self-treatment, including with the help of hormonal allergy medications, which can sometimes lead patients into a blind corner and bring the development of severe stages of the disease closer.

We have drawn such an unsightly picture not to frighten the reader. We just want every person who has encountered an allergy to understand both the severity of the disease and the prognosis in case of unsuccessful treatment, and not to rush to buy the first pills “peeped” in the commercial. We, in turn, will devote a detailed article to the description of allergies, which, we hope, will help to understand the features of the disease, its therapy and the features of various drugs used for this purpose. Understand and continue to be treated only correctly.

What is an allergy?

And we will start with the basics, without which it is impossible to understand how allergy pills work. Allergy is defined as a range of conditions caused by hypersensitivity of the immune system to a substance. At the same time, most people perceive these same substances as safe and do not react to them at all. Now let's try to describe this process in a more popular way.

Imagine an army guarding the borders of a state. She is well armed and always ready for battle. Every day, enemies try to storm the carefully controlled border, but invariably receive a worthy rebuff. One fine day, confusion occurs in the ranks of our army for unknown reasons. Her experienced and courageous warriors suddenly make a serious mistake, mistaking a friendly delegation, which has always crossed the border unhindered, for an enemy. And by this, unwittingly, they cause irreparable damage to their country.

Approximately the same events develop during an allergic reaction.

The immune system of the body, which every day is on its defense against hundreds of bacteria and viruses, suddenly begins to perceive harmless substances as mortal enemies. As a result, a military operation begins, which is too expensive for the organism itself.

How does an allergic reaction develop?

First, the body begins to produce special antibodies that are not synthesized normally - class E immunoglobulins. Looking ahead, let's say that a blood test for the presence of IgE allows you to reliably establish that a person suffers from allergies and needs medicines for it. The task of immunoglobulins E is to bind a substance that is mistaken for an aggressive toxin - an allergen. As a result, a stable antigen-antibody complex is formed, which should neutralize the enemy. However, unfortunately, it is impossible to “neutralize” without consequences in case of an allergic reaction.

The formed antigen-antibody combination settles on the receptors of special cells of the immune system called mast cells.

An antigen is a molecule that is capable of binding to an antibody.

They are located in connective tissue. There are especially many mast cells under the skin, in the region of the lymph nodes and blood vessels. Inside the cells are various substances, including histamine, which regulates many physiological processes in the body. However, along with a positive role, histamine can also play a negative one - it is he who is a mediator, that is, a substance that triggers allergic reactions. As long as histamine is inside the mast cells, it does not pose a danger to the body. But if an antigen-antibody complex is attached to the receptors located on the surface, the mast cell wall is destroyed. Accordingly, all the contents come out, including histamine. And then his finest hour comes, and hitherto unaware of the complex processes taking place in their bodies, citizens seriously think about what kind of pills they should buy for allergies. But there is no need to rush - you should first find out what kind of allergic reaction will take on.

What is an allergy?

And there may be several options depending on the allergen and individual sensitivity. Most often, allergies develop on the pollen of grasses and flowers. In this case, they talk about hay fever, or hay fever. Symptoms that indicate a disease and require the appointment of tablets or allergy sprays include:

• manifestations of allergic rhinitis - runny nose, sneezing, itching in the nose, rhinorrhea;
• manifestations of allergic conjunctivitis - lacrimation, itching in the eyes, redness of the sclera;

Much less often, treatment with tablets or ointments for allergies requires dermatitis that is allergic in nature. These include a number of diseases, including:

• atopic dermatitis, characterized by excessive dryness and irritation of the skin;
• contact dermatitis develops as a reaction to contact with materials that cause allergies. Most often it is latex (latex gloves), less often - metal products and jewelry;
• urticaria, may appear due to reactions to various foods.

Severe chronic disease of allergic nature - bronchial asthma. Even more dangerous conditions associated with a risk to life are Quincke's edema and anaphylactic shock. They are immediate allergic reactions, have a fulminant onset and require immediate medical attention. Well, now let's start describing the drugs that are used to treat various types allergies.

Antihistamines as Allergy Drugs: Popular and Economical

Means of this group are among the most well-known and commonly used drugs for the treatment of food, seasonal allergies, various dermatitis, less often - emergency conditions.

The mechanism of action of antihistamines is to block the receptors to which the main mediator of allergy, histamine, binds. They are called H1-histamine receptors, and drugs that inhibit them, respectively, blockers of H1-histamine receptors, or H1-antihistamines.

To date, three generations of antihistamines are known, used both for the treatment of allergies and for some other conditions.

Here is a list of the most famous antihistamines that are used against allergies.

Table 1. Three generations of antihistamine antiallergic drugs

First generation antihistamines

They have been used for several decades and, nevertheless, still have not lost their relevance. Distinctive features these drugs are:

• sedative, that is, a sedative effect. It is due to the fact that drugs of this generation can bind to H1 receptors located in the brain. Some drugs, such as Diphenhydramine, are much better known for their sedative than antiallergic properties. Other pills that could theoretically be prescribed for allergies have found use as a safe sleeping pill. We are talking about doxylamine (Donormil, Somnol);
• anxiolytic (mild tranquilizing) action. It is associated with the ability of certain drugs to suppress activity in certain areas of the central nervous system. As a safe tranquilizer, the first generation antihistamine tablets hydroxyzine, known under the trade name Atarax, are used;
• anti-sickness and antiemetic action. It is manifested, in particular, by diphenhydramine (Dramina, Aviamarin), which, along with the H-histamine blocking effect, also inhibits m-cholinergic receptors, which reduces the sensitivity of the vestibular apparatus.

Another distinguishing feature of first-generation antihistamine tablets for allergies is a quick, but short-term anti-allergic effect. In addition, the first generation drugs are the only antihistamines that are available in injectable form, that is, in the form of injection solutions (Diphenhydramine, Suprastin and Tavegil). And if the solution (and tablets, by the way, too) of Dimedrol has a rather weak anti-allergic effect, then the injection of Suprastin and Tavegil allows you to quickly provide first aid for an immediate type of allergy.

In case of an allergic reaction to insect bites, urticaria, Quincke's edema, intramuscular or intravenous Suprastin or Tavegil are used along with injections of a glucocorticosteroid drug, most often Dexamethasone, as a powerful antiallergic agent.

Second generation antihistamines

Preparations of this series can be called modern new-generation allergy pills that do not cause drowsiness. Their names often appear in TV commercials and media brochures. They are characterized by several properties that distinguish among other H1-histamine blockers and antiallergic drugs in general, including:

• rapid onset of antiallergic effect;
• duration of action;
• minimal or complete absence of a sedative effect;
• lack of injection forms;
• the ability to have a negative effect on the heart muscle. By the way, we can dwell on this effect in more detail.

Do allergy pills work on the heart?

Yes, indeed, some antihistamines can adversely affect the functioning of the heart. This is due to blockage of the potassium channels of the heart muscle, leading to a prolongation of the QT interval on the electrocardiogram and a violation of the heart rhythm.

The likelihood of developing a similar effect increases when second-generation antihistamines are combined with a number of other drugs, in particular:

• the antifungals ketoconazole (Nizoral) and itraconazole (Orungal);
• macrolide antibiotics erythromycin and clarithromycin (Klacid);
• antidepressants fluoxetine, sertraline, paroxetine.

In addition, the risk negative impact second-generation antihistamines on the heart increases if allergy pills are combined with the use of grapefruit juice, as well as in patients suffering from liver diseases.

Among the wide range of second-generation antiallergic drugs, several drugs should be distinguished that are considered relatively safe for the heart. First of all, it is dimethindene (Fenistil), which can be used for children from 1 month of age, as well as inexpensive loratadine tablets, which are also widely used for allergy therapy in pediatric practice.

third generation antihistamine

And finally, we come to the smallest, latest generation of drugs prescribed for allergies, from the group of H1-histamine blockers. They fundamentally differ from other drugs in the absence of a negative effect on the heart muscle against the background of a powerful anti-allergic effect, fast and prolonged action.

The drugs in this group include Cetirizine (Zyrtec), as well as Fexofenadine (trade name Telfast).

About metabolites and isomers

IN last years two new H1-histamine blockers, which are close "relatives" of already well-known drugs of the same group, have gained popularity. We are talking about desloratadine (trade names Erius, analogues Lordestin, Ezlor, Edem, Eliza, Nalorius) and levocetirizine, which belong to a new generation of antihistamines and are used to treat allergies of various origins.

Desloratadine is the primary active metabolite of loratadine. Just like its predecessor, desloratadine tablets are prescribed once a day, preferably in the morning for allergic rhinitis (both seasonal and year-round) and chronic urticaria for the treatment of adults and children over one year old.

Levocetirizine (Xyzal, Suprastinex, Glenset, Zodak Express, Cezera) is a levorotatory isomer of cetirizine, used for allergies of various origins and types, including those accompanied by itching and rashes (dermatoses, urticaria). The drug is also used in pediatric practice for the treatment of children older than 2 years.

It should be noted that the appearance of these two drugs on the market was enthusiastically received. Many experts believed that levocetirizine and desloratadine would finally help to effectively solve the problem of insufficient response to traditional antihistamine therapy, including severe allergy symptoms. However, in fact, expectations, alas, did not materialize. The effectiveness of these drugs did not exceed the effectiveness of other H1-histamine blockers, which, by the way, is almost identical.

The choice of antihistamine is often based on the patient's tolerance and price preferences, as well as ease of use (ideally, the drug should be used once a day, such as Loratadine).

When are antihistamines used for allergies?

It should be noted that antihistamines are distinguished by a rather large variety of active substances and dosage forms. They can be produced in the form of tablets, solutions for intramuscular and intravenous injections and external forms - ointments and gels, and all are used for various types of allergies. Let's figure out in which cases the advantage is given to one or another medicine.

Hay fever, or polynosis, food allergy

The drugs of choice for allergic rhinitis (inflammation of the nasal mucosa of an allergic nature) are allergy pills II or the last, III generation ( full list is given in table 1). When it comes to allergies in a small child, dimethindene (Fenistil in drops), as well as Loratadine, Cetirizine in children's syrups or solutions are often prescribed.

Skin manifestations of allergies (food, various types of dermatitis, insect bites)

In such cases, it all depends on the severity of the manifestations. With mild irritation and a small area of ​​​​lesion, external forms can be limited, in particular, Psilo-balm gel preparations (Dimedrol is included) or Fenistil gel (external emulsion). If the allergic reaction in an adult or child is strong enough, accompanied by severe itching and / or a significant area of ​​​​the skin is affected, tablets (syrups) for allergies of the H1-histamine blockers group can be prescribed in addition to local drugs.

allergic conjunctivitis

With inflammation of the mucous membrane of the eye of an allergic nature, eye drops are prescribed and, with insufficient effect, tablets. The only eye drops today that contain exactly the antihistamine component are Opatanol. They contain the substance olapatadin, which provides a local anti-allergic effect.

Mast Cell Membrane Stabilizers: Allergy Pills Are Not for Everyone

Another group of allergy drugs acts by preventing calcium ions from entering mast cells and thus inhibiting the destruction of cell walls. Thanks to this, it is possible to prevent the release of histamine into the tissues, as well as some other substances involved in the development of an allergic and inflammatory reaction.

Only a few allergy remedies for this group are registered on the modern Russian market. Among them:

• ketotifen, an allergy drug in tablets;
• cromoglycic acid and sodium cromoglycate;
• lodoxamide.

All preparations containing cromoglycic acid and sodium cromoglycate are conditionally called cromoglycates in pharmacology. Both active ingredients have similar properties. Let's consider them.

cromoglycates

These drugs are available in several forms of release, which, in turn, are indicated for various types of allergies.

Dosed nasal spray (Kromoheksal) is prescribed for seasonal or year-round allergic rhinitis. It is prescribed for adults and children over five years of age.

It should be noted that the noticeable effect of the use of cromoglycates in the spray occurs after one week of continuous use, reaching a peak by four weeks of continuous treatment.

Inhalations are used to prevent asthma attacks. An example of inhalation agents against allergies, which was complicated by bronchial asthma, are Intal, KromoGeksal, Kromogen Easy Breathing. The mechanism of action of drugs in such cases is aimed at interrupting the allergic reaction, which is a "trigger" in the pathogenesis of bronchial asthma.

Capsules of cromoglycic acid (KromoGeksal, Cromolyn) are prescribed for food allergies and some other diseases, one way or another associated with allergies.

Eye drops with cromoglycates (Allergo-Komod, Ifiral, Dipolkrom, Lekrolin) are the most prescribed anti-allergic drugs for conjunctivitis caused by sensitivity to plant pollen.

Ketotifen

A tableted remedy for allergies, from the group of mast cell stabilizers. Just like cromoglycates, it prevents or at least slows down the release of histamine and other biologically active substances that provoke inflammation and allergies from mast cells.

It has a fairly low price. In the Russian Federation, several preparations containing ketotifen are registered, and one of the highest quality is the French Zaditen. By the way, it is available in the form of tablets, as well as syrup for children and eye drops, which are prescribed for allergies of various origins and types.

It should be borne in mind that Ketotifen is a drug that exhibits a cumulative effect. With its constant use, the result develops only after 6-8 weeks. Therefore, Ketotifen is prescribed preventively, for the prevention of allergies in bronchial asthma, allergic bronchitis. In some cases, cheap Ketotifen tablets are used to prevent the development of seasonal allergic rhinitis, as indicated in the instructions for the drug. However, it is important to start taking the medication in advance, ideally at least 8 weeks before the expected start of the allergen bloom, and, of course, not stop the course of therapy until the season is over.

lodoxamide

This active substance is produced as part of eye drops, which are prescribed for allergic conjunctivitis, Alomida.

Glucocorticosteroids in tablets and injections in the treatment of allergies

The most important group of drugs that are used to relieve the symptoms of allergies are steroid hormones. Conventionally, they can be divided into two large subgroups: local agents that are used to irrigate the nasal cavity, tablets and injections for oral administration. There are also eye and ear drops with corticosteroids, which are used for ENT pathologies of various origins, including allergic conjunctivitis and otitis media, as well as ointments and gels sometimes used to treat allergic dermatitis. However, in the treatment of these diseases, corticosteroids are far from the first place: rather, they are prescribed as a means of temporary relief, for the rapid relief of symptoms, after which they switch to therapy with other antiallergic drugs. Means for local (nasal sprays) and internal use (tablets), on the contrary, are used quite widely for the treatment of various diseases of an allergic nature, and it is worth talking about them in more detail.

The difference between these categories of drugs, first of all, is tolerability. If local and external preparations have bioavailability close to zero and are practically not absorbed into the systemic circulation, exerting only an effect at the site of application (application), then injection and tablet, on the contrary, in as soon as possible penetrate into the blood, and, therefore, exhibit systemic effects. Therefore, the safety profile of the first and second is fundamentally different.

Despite such significant differences in the characteristics of absorption and distribution, the mechanism of action of both local and internal glucocorticosteroids is the same. Let's talk in more detail, due to which tablets, sprays or ointments containing hormones have a therapeutic effect in case of allergies.

Hormonal steroids: mechanism of action

Corticosteroids, glucocorticosteroids, steroids - all these names describe a category of steroid hormones that are synthesized by the adrenal cortex. They exhibit a very powerful triple healing effect:

Due to these abilities, corticosteroids are indispensable drugs used for a wide variety of indications in different fields of medicine. Among the diseases in which corticosteroid preparations are prescribed are not only allergies, regardless of origin and type, but also rheumatoid arthritis, osteoarthritis (with a pronounced inflammatory process), eczema, glomerulonephritis, viral hepatitis, acute pancreatitis, as well as shock, including anaphylactic.

However, unfortunately, despite the severity and variety of therapeutic effects, not all glucocorticosteroids are equally safe.

Side effects of hormonal steroids

It was not for nothing that we immediately made a reservation about the different safety profile of glucocorticosteroids for internal and local (external) use.

Oral and injectable hormonal preparations have many side effects, including serious ones, sometimes requiring drug withdrawal. We list the most common of them:

• headache, dizziness, blurred vision;
• hypertension, chronic heart failure, thrombosis;
• nausea, vomiting, gastric ulcer (duodenal ulcer), pancreatitis, loss of appetite (both improvement and deterioration);
• decreased function of the adrenal cortex, diabetes mellitus, disorders menstrual cycle, growth retardation (in childhood);
• muscle weakness and/or pain, osteoporosis;
• acne disease.

“Good,” the reader will ask. “Why are you describing all these terrible side effects?” Just so that a person who is going to treat allergies with the same Diprospan thinks about the consequences of such a “treatment”. Although this should be discussed in more detail.

Diprospan for allergies: a hidden danger!

Many experienced allergy sufferers know: the introduction of one (two, or even more) ampoules of Diprospan or its analogue, for example, Flosteron or Celeston, saves from severe symptoms of seasonal allergies. They advise this "magic remedy" to acquaintances and friends who are desperate to find a way out of the allergic vicious circle. And they do them oh what a disservice. “Well, why bearish? - the skeptic will ask. “It’s getting easier, and fast.” Yes, it does, but at what cost!

The active substance of Disprospan ampoules, which are often used to relieve allergy symptoms, including without a doctor's prescription, is a classic glucocorticosteroid betamethasone.

It exhibits a powerful and rapid anti-allergic, anti-inflammatory and antipruritic effect, indeed in a short time alleviating the condition with allergies of various origins. What happens next?

The further scenario largely depends on the severity of the allergic reaction. The fact is that the effects of Diprospan cannot be called long-term. They can last for several days, after which their severity weakens and finally disappears. A person who has already managed to feel a significant relief of allergy symptoms naturally tries to continue the “treatment” with another Diprospan ampoule. He does not know or does not think about the fact that the likelihood and severity of side effects of glucocorticosteroids depend on their dose and frequency of use, and, therefore, the more often Diprospan or its analogues are administered to correct allergy manifestations, the higher the risk of experiencing the full force of its side effects. actions.

There is another extremely negative side of the use of glucocorticosteroids for internal use in seasonal allergies, which most patients have no idea about - a gradual decrease in the effect of classic antiallergic tablets or sprays. Applying Diprospan, especially from year to year, regularly during the manifestation of allergies, the patient literally leaves no alternative for himself: against the background of a strong, powerful effect shown by an injectable glucocorticosteroid, the effectiveness of antihistamine tablets and, moreover, mast cell membrane stabilizers, decreases catastrophically. The same picture persists after the end of the action of steroids.

Thus, a patient who uses Diprospan or its analogues to alleviate allergy symptoms practically dooms himself to constant hormone therapy with all its side effects.

That is why doctors are categorical: self-medication with injectable steroids is dangerous. "Passion" for drugs of this series is fraught not only with resistance to therapy with safe drugs, but also with the need for a constant increase in the dose of hormones to achieve an adequate effect. However, in some cases, treatment with corticosteroids is still necessary.

When are steroid pills or injections used to treat allergies?

First of all, tablets or injections of Dexamethasone (less often, Prednisolone or other glucocorticosteroids) are used to stop an acute allergic reaction. So, with anaphylactic shock or Quincke's edema, it is advisable to administer the hormone intravenously, in less urgent cases - intramuscularly or orally. In this case, the doses of the drug can be high, approaching the highest daily or even exceeding it. Such a tactic justifies itself with a single use of drugs, one or two times, which, as a rule, is sufficient to obtain the desired effect. In such cases, you should not be afraid of the notorious side effects, because they begin to manifest themselves in full force only against the background of a course or regular administration.

There is another important indication for the use of hormones in tablets or injections as drugs for the treatment of allergies. These are severe stages or types of the disease, for example, bronchial asthma in the acute stage, severe allergies that are not amenable to standard therapy.

hormone therapy in allergic diseases, only a doctor who can evaluate both the benefits and risks of treatment can prescribe. He carefully calculates the dose, controls the patient's condition, side effects. Only under the vigilant supervision of a doctor, corticosteroid therapy will bring real results and will not harm the patient. Self-medication with hormones for oral administration or injection is strictly unacceptable!

When should you not be afraid of hormones?

As dangerous as glucocorticosteroids can be for systemic use, steroids intended for injection into the nasal cavity are just as innocent drugs. Their field of activity is limited exclusively to the mucous membrane of the nasal cavity, where they, in fact, should work in the case of allergic rhinitis.

“However, some of the medicine can be accidentally swallowed!” - the meticulous reader will say. Yes, this possibility is not excluded. But in gastrointestinal tract absorption of intranasal steroids (absorption) is minimal. Most of the hormones are completely "neutralized" when passing through the liver.

Having an anti-inflammatory and powerful anti-allergic effect, nasal corticosteroids quickly stop the symptoms of allergies, stopping the pathological reaction.

The effect of intranasal steroids appears 4-5 days after the start of therapy. The peak effectiveness of this group of drugs for allergies is achieved after a few weeks of continuous use.

Today, there are only two hormonal corticosteroids on the domestic market, which are available in the form of intranasal sprays:

• Beclomethasone (trade names Aldecin, Nasobek, Beconase)
• Mometasone (trade name Nasonex).

Beclomethasone preparations are prescribed for the treatment of mild to moderate allergies. They are approved for use by children over 6 years of age and adults. As a rule, beclomethasone is well tolerated and does not cause side effects. However, in some (fortunately extremely rare) cases, especially with long-term treatment, damage (ulceration) of the nasal septum is possible. To minimize its risk, it is necessary, when irrigating the nasal mucosa, not to direct the jet of the drug to the nasal septum, but to spray the medicine on the wings.

Occasionally, the use of beclomethasone spray can lead to minor nosebleeds, which is not dangerous and does not require discontinuation of the drug.

"Heavy artillery"

I would like to pay special attention to the next representative of hormonal corticosteroids. Mometasone is recognized as the most powerful drug for the treatment of allergies, which, along with a very high efficiency It also has an extremely favorable safety profile. Mometasone, the original Nasonex spray, has a powerful anti-inflammatory and anti-allergic effect, practically not absorbed into the blood: its systemic bioavailability does not exceed 0.1% of the dosage.

The safety of Nasonex is so high that in some countries of the world it is approved for use in pregnant women. In the Russian Federation, mometasone is officially contraindicated during pregnancy due to the absence of clinical research studying its use in this category of patients.

It should be noted that not a single tablet or spray that is used to treat allergies in a wide range of patients is approved for use during pregnancy - expectant mothers suffering from hay fever or other types of allergies are advised to avoid the action of the allergen, for example, leaving for another climatic zone at the time of flowering. And to the frequent question: which allergy pills can be taken during pregnancy, there is only one correct answer - none, during this crucial period you will have to do without medication. But the nursing ones were more fortunate. For allergies while breastfeeding, you can take some pills, but before starting treatment, it is better to consult a doctor.

But the drug is widely used in pediatric practice for the treatment and prevention of allergies in children over the age of 2 years.

Mometasone begins to act 1-2 days after the start of treatment, and its maximum effect is achieved after 2-4 weeks of continuous use. The drug is prescribed for the prevention of seasonal allergies, starting to irrigate the nasal mucosa a few weeks before the expected period of pollination. And, of course, mometasone is one of the most "favorite" and frequently prescribed drugs for the treatment of allergies. As a rule, treatment with them is not accompanied by side effects, only in rare cases, dryness of the nasal mucosa and the occurrence of minor nosebleeds may occur.

Allergy treatment with pills and more: a stepwise approach

As you can see, there are quite a lot of drugs with anti-allergic properties. Most often, patients select pills for the treatment of allergies, based on the reviews of friends, advertising statements that sound on TV screens and pour from the pages of magazines and newspapers. And, of course, it is quite difficult to get in this way “with a finger in the sky”. This leads to the fact that a person suffering from allergies seems to be treated by taking pills or a spray, but does not see the result and continues to suffer from a runny nose and other symptoms of the disease, complaining that the medicines do not help. In fact, there are quite strict rules of treatment, the observance of which largely depends on the effectiveness.

First of all, the treatment regimen for allergies (we will speak on the example of its most common form, allergic rhinitis) is based on an assessment of the severity of the disease. There are three levels of severity: mild, moderate and severe. What drugs are used for each of them?

1. Step one.
   Treatment of mild allergies.
   As a rule, therapy begins with the appointment of an antihistamine of the II or III generation. Most often, Loratadine (Claritin, Lorano) or Cetirizine (Cetrin, Zodak) tablets are used as first-line drugs for allergies. They are quite inexpensive and easy to use: they are prescribed only once a day. In the absence of a clinical effect or an insufficient result, they proceed to the second stage of allergy therapy.
2. Step two.
   Treatment of moderate allergies.
   An intranasal corticosteroid (Baconase or Nasonex) is added to the antihistamine.
   If symptoms of allergic conjunctivitis remain during treatment, antiallergic eye drops are prescribed. Insufficient effect on the combined treatment regimen is the basis for more thorough diagnosis and therapy, which should be dealt with by an allergist.
3. Step three.
   Treatment of severe allergies.
   Additional drugs may be added to the therapy regimen, for example, leukotriene receptor inhibitors (Montelukast). They block the receptors to which inflammatory mediators bind, thus reducing the severity of the inflammatory process. The target indication for their appointment is bronchial asthma, as well as allergic rhinitis. In very severe cases, systemic glucocorticosteroids are introduced into the therapy regimen. If even then the result is not achieved, a decision is made on the need for allergen-specific immunotherapy and other methods of treatment. Only an experienced doctor should prescribe treatment. The lack of medical care in such situations can lead to uncontrolled progression of allergies and the development of its extremely severe form, bronchial asthma.

Thus, the selection of tablets, sprays and other anti-allergy products is not as easy as it seems after watching the next commercial. To choose the right scheme, it is better to use the help of a doctor or at least an experienced pharmacist, and not rely on the opinion of a neighbor or girlfriend. Remember: with allergies, as with most other diseases, the doctor's experience is important, individual approach and thoughtful solutions. Under these conditions, you will be able to breathe easily and freely. all year round, forgetting about the endless runny nose and other allergic "joys".

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With frequent allergies, doctors recommend taking a course of taking an antihistamine from the list, depending on the age, gender of the patient and symptoms of the disease.
For right choice it is necessary to know the variety of forms of release and generations, the degree of the disease and contraindications for use. Parents will benefit from information about antihistamines for children and expectant mothers.

Antihistamines are substances that have a complex effect on the causative agent of allergic reactions in the body. Thanks to this medicine, patients with severe allergic reactions are able to tolerate them in a mild form.

Forms of release and composition

The form of release of antihistamines is different. The range of antiallergic drugs are:

• syrups;
• pills;
• drops.

This is necessary for correct and safe administration, depending on the different ages of patients. In their composition, antihistamines contain substances that can have a sedative effect.

These include:

• difegindramin;
• clemastine;
• doxylamine;
• mepyramine;
• oxatomide;
• mizolastin.

Properties and how they work, therapeutic effects

• antihistamines stabilize the receptor, putting it into an inactive state;
• blocking of receptors occurs for 24 hours or less, depending on many individual characteristics of the patient;
• chlorpheniramine in the composition has an anti-inflammatory effect.

Indications for use

• conjunctivitis;
• various forms of dermatitis;
• edema;
• allergic reactions to dust;
• swelling and itching after a bite of various types of insects;
• drug allergy;
• allergic to different kinds flowering plants;
• with an allergic reaction to the food you eat;
• anaphylactic shock;
• eczema;
• psoriasis;
• bronchial asthma;
• severe allergic cough.

Symptoms and diagnosis of allergies

The main symptoms of allergies include:

If the patient has symptoms of an allergy, the specialist prescribes an additional examination.

An additional examination helps to identify the cause of the allergic reaction or the pathogen of the allergy.

The main studies include:

• taking a skin test. It is the fastest and most reliable source of allergy information. The procedure is carried out in several stages, by introducing various allergens into the patient's body. After the manifestation of several symptoms of an allergic reaction, the doctor confirms what exactly the patient is having an allergic reaction to.
• checking for IGE. This analysis consists in detecting antibodies in the body and thereby establishing the causes of allergies. This type analysis is the most expensive and time consuming;
• patch testing. This type of procedure consists in attaching various plates with allergic components to the patient's back.

Side effects, possible complications

In overdose, antihistamines are toxic and can lead to heart complications. Therefore, you should choose the right dosage from your doctor.

Contraindications

The list of contraindications directly depends on the age of the patient. Children under 2 years old are allowed to take antihistamines only in drops. Children from 2 to 6 years old are allowed to take the medicine in the form of a syrup.

The main contraindications for use are:

• severe renal failure;
• hypersensitivity to active ingredients;
• pregnancy;
• breastfeeding period;
• glaucoma;
• cardiovascular diseases;
• alcohol incompatibility.

Preparations of a new, latest generation. List

These antihistamines are considered the safest. The list of drugs that belong to the latest 4th generation differs from all previously released drugs in that they do not cause sleepiness and do not affect cardiac activity.

These medicines can be used for increased activity - mental or physical. Driving is allowed. Please note that only a doctor can prescribe this or that medicine with accuracy, and each, even the safest and most modern drug, can cause a negative reaction if there is intolerance to one of its components.

The most popular new generation drugs include:

• Fexofenadine (Fexofast, Fexadin, Allegra, Telfast);

Very effective in the treatment of seasonal allergic problems or pathologies. Contraindicated in persons under 6 years of age, pregnant or lactating women. Available in tablets. When used, it is not addictive.

• Levocetirizine (Suprastinex, Caesera, Glentset, Xizal);

Useful for seasonal or chronic allergies, skin itching or hives. Begins its action half an hour after ingestion. On sale you can find both tablets and drops, which are prescribed to be taken by young patients from 2 years old. Contraindicated in pregnant women, but the use of the drug is allowed with caution when breastfeeding or with kidney disease. Sometimes causes drowsiness.

It copes well with the treatment of acute and seasonal allergies. It is found in the form of tablets and syrup. The syrup is intended for patients under 12 years of age. Not applicable during pregnancy. It begins to act 30 minutes after application and continues for a day.

Third generation. List

The previous, 3rd generation, is practically devoid of contraindications and is suitable for a wider range of people. They do not have the side effects of the 1st and 2nd generation. There is some confusion, during which the products of the 4th group are often combined with the products of the 3rd. Since the difference in them is minimal, and in medicine, many adhere to the division of drugs of this type into only three parts.

The drugs of the 3rd group include analogues of drugs of the 4th group:

• Hismanal;

It is used as a prophylactic or therapeutic agent, it works for a day. Available in the form of a suspension and tablets. Suitable for patients over 2 years of age.

• Trexil;

Has a wide range. Used in the presence of glaucoma and prostate disorders.

• Telfiast (analogue of Fexofenadine);
• Feksadin (analogue of Fexofenadine);
• Fexofast (analogue of Fexofenadine);
• Levocetirizine-Teva;

A good option for the treatment and prevention of allergic diseases. May be administered from 6 years of age. Sometimes causes drowsiness.

• Ksizal (analogue of Levocetirizine);
• Erius;

It is used, among other things, for a long course of treatment, up to a year. Both adults and children from 1 year old respond well to it. In its effect, the drug is similar to Desloratadine.

• Desal.

The tool effectively fights against skin problems and runny nose. Great for children, which allows you to use it from 12 months. Available in the form of tablets and syrup. The medicine is convenient to take, regardless of the meal, once a day.

Second generation. List

2nd generation drugs are not sedative, but exert significant pressure on the heart and blood vessels, therefore they are not indicated for use in children and the elderly. They have a sufficient number of contraindications and side effects.

The most common 2nd generation drugs include:

• Dimetinden (Fenistil);

Effective for relieving minor burns, reactions to insect bites or skin rashes, other types of allergies. Not allowed during pregnancy, but allowed for children older than 1 month. Release form: gel, capsules, drops.

Treats allergic rhinitis and skin problems. It is produced in the form of a syrup, it is prescribed at the age of over 2 years, it is not allowed during pregnancy and lactation. May cause drowsiness.

• Ebastine (Kestin);

It is prescribed for urticaria or rhinitis. Interaction with ketoconazole may be fatal. It is allowed to use together with alcohol-containing medicines.

• Cyproheptadine (Peritol);

An important property is getting rid of headaches during migraines, as well as a sedative effect. It is not recommended to use without a doctor's prescription, since the main indications are chronic pancreatitis, serum sickness, neurodermatitis.

Available in the form of drops and tablets. It is prescribed for allergic rhinitis and conjunctivitis, hay fever, and other types of allergies. May be used by children over 6 months of age with caution.

• Azelastinf (Allergodil);

Suitable for the fight against rhinitis and conjunctivitis. Release form: eye drops and nasal spray. Appointed from 4 years.

Great for urticaria. It is not prescribed for patients under 12 years of age, pregnant and lactating women.

First generation. List

The most dangerous to use are these antihistamines.

List of drugs with hypnotic effect, big amount adverse reactions and a very short period of action is quite popular in the use of the entire population. May be addictive. Medicinal substances in this section are the most inexpensive among the entire antihistamine group, which explains their popularity.

The most popular drugs include:

Has a wide range of treatments. It is prescribed for adults and children over 1 month old, not suitable for use during pregnancy and lactation. Causes severe drowsiness, used as an aid to churn high temperature. Available in the form of ampoules and tablets.

• Tavegil (Clemastin);

It differs from suprastin in that it has a less not so strong hypnotic effect. Suitable for ages over 1 year old. Release form: syrup and tablets

• Fenistil (Dimetinden);

Has a wide spectrum. Causes drowsiness, which disappears after two days of treatment. A large list of side effects, but at the same time, pregnant women from 12 weeks and children older than 1 month are allowed. Release form: tablets, drops, gel, emulsion.

• Quifenadine (Fenkarol).

It is used for all types of allergic reactions in adults, children from 1 year old and pregnant women, starting from the 2nd trimester. Release form: syrup, tablets.

How to choose the best allergy remedy

For the correct choice of funds, it is necessary to build on the age and individual intolerance of the components. For competent treatment, it is necessary to identify the cause of the allergy and eliminate the allergen.

Antihistamines for children

For newborns up to 1 year old:

• Suprastin - from 1 month;
• Fenistil / Dimetindene - from 1 month;
• Reactin (eye drops) - from 1 month;
• Pipolfen - a complex remedy (parenteral form) - from 3 months;
• Cetrin / Zyrtec - from 6 months.

From 1 year - 6 years:

• Zodak - from 1 g;
• Erius - from 1 g;
• Tavegil - from 1 g;
• Quifenadine - from 1 g;
• Desal - from 1 g;
• Tsetrin - from 2 years;
• Gismanal - from 2 years old;
• Claritin - from 2 years;
• Azelastine - from 4 years;

From 6 years old - 12 years old:

• Fexofenadine - from 6 years;
• Levocetirin-Teva - from 6 years old.

Features of use in children and the elderly

Children under 12 years of age have a strong allergic reaction to certain components that are part of antihistamines for the adult generation. Therefore, it is categorically not recommended for children to prescribe an antiallergic agent on their own. Doctors recommend contacting an allergist for the right remedy.

For the elderly, it is necessary to choose non-hormonal drugs of a new generation. Since most antiallergic drugs have a strong effect on the cardiovascular system, there is a risk of stroke.

The drugs that are strictly prohibited by specialists for the use of older people include:

• Suprastin;
• Demidrol;
• Diprazine.

Antihistamines during pregnancy

During the course of pregnancy, any medicines are chosen by the doctor and are used only as directed!

• Quifenadine / Fenkarol - from the 2nd trimester;
• Fenistil / Dimitinden - from the 12th week;
• Cromolium sodium - an indirect drug - from the 2nd trimester.

Features of use during pregnancy

During pregnancy in the first trimester, it is forbidden to take any antihistamines. This is necessary for the proper development of the fetus and its proper fixation.

In the 2nd and 3rd trimester, you can use antiallergic drugs such as:

• Zyrtec;
• Suprastin;
• Eden.

Which doctor to consult

The choice of antiallergic drugs should take into account the individual characteristics and age of the patient.

If an allergic reaction is suspected, the patient should not self-medicate and take antihistamines on their own.

The list of these drugs is selected by an allergist at an individual consultation. The doctor will conduct the necessary studies, prescribe tests, identify the cause of the allergy and competently draw up a treatment regimen, prescribe anti-allergic drugs that are safe to use.

Video about allergy medications and how to take them

Better antihistamines in the treatment of allergies:

Dr. Komarovsky will tell you all about allergy medications:

Almost everyone has modern man V home first aid kit there are antihistamines that are used to relieve an allergic reaction. But not everyone who uses them knows how such drugs work, how to use them correctly, and what the concept of "histamine" means. Therefore, it is necessary to understand in what cases these drugs are prescribed, what indications and contraindications they have.

Histamine is a biologically active substance produced by cells of the immune system. It causes various physiological and pathological processes in the body by acting on receptors located in the tissues of internal organs.

Antihistamines block the production of histamine, which makes them indispensable in the treatment of allergies, gastrointestinal, neurological and other pathologies.

When are antihistamines given?

Indications for taking antihistamine formulations are the following pathological conditions:

• allergic rhinitis;
• allergic conjunctivitis;
• atopic dermatitis;
• angioedema;
• body reaction to insect bites;
• allergic reaction to house dust, pet hair;
• drug intolerance;
• anaphylactic reactions;
• exudative or allergic erythema;
• psoriasis;
• allergic to cold, heat, household chemicals and other toxic substances;
• allergic cough;
• food allergy;
• bronchial asthma.

Types of antiallergic drugs

Several types of histamine receptors are present in body tissues. These include:

• H1 (bronchi, intestines, heart vessels, central nervous system);
• H2 (gastric mucosa, arteries, central nervous system, heart, myometrium, adipose tissue, blood cells);
• H3 (CNS, cardiovascular system, digestive organs, upper respiratory tract).

Each antihistamine composition affects only certain groups of receptors, so only a doctor should prescribe them.

The first generation of antihistamine drugs block the sensitivity of H1 receptors, and also cover a group of other receptors. The active substance that is part of these drugs penetrates the blood-brain barrier, causing the development of a side effect - a sedative effect. This means that these antihistamine drugs cause a person to become drowsy, accompanied by a feeling of fatigue.

Treatment with first-generation antihistamines is not allowed if the work of the person taking them is related to concentration.

This type of antihistamine medication has other side effects. These include:

• dry mucous membranes;
• narrowing of the lumen of the bronchi;
• violation of the chair;
• violation of the heart rhythm.

These funds act very quickly, however, the effect after taking them lasts a short time. In addition, the first generation of antihistamines is addictive, so they should not be taken for more than 10 days. They are not prescribed for diseases of the stomach that occur in an acute form, as well as in combination with antidiabetic and psychotropic drugs.

First generation antihistamines include:

The development of the second generation of antihistamine drugs has eliminated most of the side effects. The benefits of these drugs include:

• lack of sedation (slight drowsiness may occur in particularly sensitive patients);
• the patient maintains normal physical and mental activity;
• duration therapeutic effect persists throughout the day;
• The therapeutic effect of the drugs persists for 7 days after withdrawal.

In general, the action of antihistamines is similar to previous drugs. But they are not addictive, and therefore the duration of the course of treatment can vary from 3 days to one year. Such drugs should be taken with caution in people suffering from cardiovascular diseases.

Second generation antiallergic drugs include:

Antihistamines of the third generation are selective and affect only H3 receptors. They have no effect on the central nervous system and therefore do not cause drowsiness and fatigue.

Although these antihistamines are derivatives of the previous ones, all existing shortcomings were taken into account in their development. Therefore, they have practically no side effects left.

With the help of this type of antihistamines, the following diseases are successfully treated:

• rhinitis;
• hives;
• dermatitis;
• rhinoconjunctivitis.

The most popular antihistamines include:

When are antihistamines not prescribed?

Allergy is a companion of many modern people, which greatly increases the popularity of antihistamine drugs. There are three generations of antihistamines on the pharmaceutical market. The last two generations have much fewer contraindications for use. Therefore, one should consider those conditions in which most antihistamine formulations are not prescribed:

• hypersensitivity or individual intolerance to the components that make up the preparations;
• the period of bearing a baby and breastfeeding;
• age restrictions;
• severe stages of liver or kidney failure.

The dosage of antihistamine drugs should be calculated individually. Therefore, before taking them, you should consult your doctor. In some diseases, the doctor may adjust the dosage of the antiallergic agent downward, which will avoid the development of side effects.

But since the greatest number of contraindications is present in first-generation drugs, they should be given special attention. These drugs are not recommended for the following conditions:

• in the first trimester of pregnancy;
• with glaucoma;
• with bronchial asthma;
• with an enlarged prostate;
• in old age.

As mentioned above, first-generation antihistamines have a pronounced sedative effect. This side effect increases if they are taken in combination with alcohol, antipsychotics, tranquilizers and other drugs.

Other side effects include the following:

• dizziness;
• tinnitus;
• decreased visual acuity;
• tremor of the limbs;
• insomnia;
• increased nervousness;
• fatigue.

Antiallergic drugs for children

To eliminate allergic manifestations in children, first-generation antiallergic drugs are used. These include:

The disadvantage of these drugs are multiple side effects, manifested in violation of the functions of digestion, activity of cardio-vascular system and CNS. Therefore, they are prescribed to children only with severe allergic reactions.

Unfortunately, many babies develop chronic forms of allergic diseases. To minimize the negative impact on the growing body, antihistamines are prescribed in the treatment of chronic allergies. medications new generation. For the youngest children, they are produced in the form of drops, and for older children - in the form of syrups.

The main antiallergic drugs were and remain to this day antihistamines. This article will discuss what antihistamines for children exist, in what cases they are used and, most importantly, how to choose a remedy.

In order to understand why antiallergic drugs for children are needed for hypersensitivity, it is important to know the mechanism of the allergic reaction.

First exposure to an allergen- a foreign protein - the immune system "gets acquainted" with it in the body, and immunoglobulins - antibodies are produced. They settle on the so-called membrane. mast cells, sticking around it from all sides - sensitization occurs.

Re-penetration of the allergen more immunoglobulins are formed, and the mast cell, unable to withstand it, bursts. Allergy mediators are distinguished - biologically active substances that in a certain way affect organs and tissues and cause the entire clinic of hypersensitivity reactions. Under the influence of these substances:

• there is an increase in the permeability of the vascular wall, which causes swelling, rash and itching;
• blood vessels dilate, causing local (and sometimes general) fever and redness;
• smooth muscles contract, causing bronchospasm;
• an active inflammatory reaction begins, which can turn into a chronic one and form a clinic of bronchial asthma.

There are many such mediators - leukotrienes, thromboxane A2, tumor necrosis factor α, adenosine, kinins, interleukins, etc. But the main one is histamine.

That is why it is so important to “bind”, to block all the histamine that is released from mast cells during an allergic reaction. Allergy preparations for children and adults are aimed precisely at this: they are not able to remove sensitization or completely prevent the release of active substances, but they do an excellent job with the process of “intercepting” histamine.

Features of drug names

It is worth noting that there is international non-proprietary name each active substance (for example, paracetamol or pantaprazole), as well as trade names- they are given by manufacturing companies (Panadol, Cefekon, Kalpol in the first case, Nolpaza, Controloc, Panum - in the second).

So it is with antihistamines: desloratadine is both Erius, and, and Alestamine, etc. Medicines are produced in the most different forms and dosages, and it is difficult to figure out which drug is right for a child. This article is a selection algorithm medicinal product.

1. The first step is to determine why the medicine is needed, what symptoms need to be removed.
2. The second is the selection of medicine in accordance with the age of the child.
3. And, finally, the third point is the choice of the form of administration of the drug.

Lists of antihistamines for symptomatic relief

Below we will consider drugs for children that will help to cope with the symptoms of a particular disease.

With urticaria

Photo: Red spots on the body of a child - an allergy to antibiotics in the form of urticaria

Symptoms: rash, itching/burning, swelling, redness.

Second and third generation antihistamines:

• desloratadine;
• loratadine;
• fexofenadine;
• cetirizine;
• levetirizine;
• lopyramine;
• dimethindene;
• denhydramine;
• ebastine

II generation:

• Eliza (syrup, tablets);
• Lordestin (tablets);
• Claritin (syrup, tablets);
• Tyrlor (tablets);
• Clargotil (tablets);
• Kestin (syrup, tablets)

III generation:

Topical preparations:

• Allergosan (ointment);
• Fenistil Gel;
• Psilo-balm (gel).

With allergic dermatitis

Photo: Atopic dermatitis

Symptoms: peeling, itching, dryness, swelling, redness, sometimes erosion.

There are no grounds for the routine use of drugs. They are used only in complex therapy, or for the correction of concomitant conditions - urticaria or rhinoconjunctivitis that disturb sleep. In this regard, first-generation drugs with a sedative effect are shown:

• chloropyramine;
• diphenhydramine;
• mebhydrolin

List of drugs by brand name

• Suprastin (solution for intravenous and intramuscular administration, tablets);
• Diphenhydramine (solution for intravenous and intramuscular injection, tablets);
• Diazolin (tablets, dragees).

For food allergies

Photo: Red rash on the cheeks as a manifestation of food allergies

Symptoms : skin manifestations, itching, angioedema

The drugs are not effective for gastrointestinal complaints (used only in complex treatment), but can help with skin allergies after eating the allergen. First generation drugs are used:

• chloropyramine;
• diphenhydramine.

As well as modern medicines of the latest generation:

• cetirizine;
• fexofenadine;
• levocetirizine.

List of drugs by brand name

1st generation:

• Suprastin;
• Diphenhydramine;

III generations:

• Zyrtec;
• Suprastinex.

With allergic conjunctivitis

Photo: Allergic conjunctivitis

Symptoms: pain or itching in the eyes, tearing, redness, blurred vision, swelling.

Both general drugs (any of the latest generation) and local remedies are used:

• levocabastine;
• azelastine.

List of drugs by brand name

• Vizin allergy (eye drops);
• Histimet (eye drops);
• Reaktin (eye drops);
• Allergodil (eye drops).

For allergic rhinitis

Symptoms: nasal congestion, difficulty in nasal breathing, rhinorrhea, itching, sneezing, swelling.

Local remedies are used - drops and sprays in the nose:

• levocabastine;
• azelastine.

List of drugs by brand name

• Tizin allergy (spray);
• Histimet (spray);
• Reactin (spray);
• Allergodil (spray).

With hay fever

Symptoms: a combination of symptoms of conjunctivitis, rhinitis, sometimes skin and food allergies.

The same drugs are used as for allergic rhinitis, as well as combined drugs, for example, a combination of diphenhydramine and naphazoline (an anticongensant is a vasoconstrictor).

List of drugs by brand name

• Polinadim (eye drops)

Other diseases

Disease	Symptoms to be addressed		Preparations	Trade names, introduction form
Bronchitis, laryngitis	cough, hoarseness, bronchospasm, itching in the larynx and chest		Inhalation administration of the drug would be optimal, however, antihistamines in the form of solutions for inhalation are not available. Therefore, oral or parenteral preparations of the 3rd generation are used. In some cases, nasal sprays are effective - as with allergic rhinitis.	Siresp (syrup); Erespal (syrup, tablets)
With bronchial asthma	For asthmatics, antihistamines are not indicated in the classical GINA therapy regimen. They can be prescribed, but only by an allergist according to individual indications.
For insect bites	itching, burning, redness, rash	Both system tools (of all generations) and local ones are used.		Suprastin; Diphenhydramine; Tyrlor; Clargotil; Allergosan (ointment); Fenistil Gel; Psilo balm.
When taking antibiotics	Prevention of drug allergies, treatment of skin and food symptoms	As a preventive measure: often, along with the first use of an antibiotic, an antihistamine of any generation is prescribed to a child. As a planned treatment: third-generation drugs. As an emergency treatment: first-generation drugs parenterally, in a hospital or SMP		Zyrtec; Allegra; Suprastin (in / m, in / in).
Before and after vaccinations	For the prevention of allergic complications	Children with a diagnosed allergy, or those who have reacted inadequately to the previous vaccination (itching, swelling, rash, etc.).		Suprastin; Zyrtec; Zodak;
For chickenpox (chickenpox)	To relieve itching	Only drugs for oral use, with a sedative effect (first generation), at night		Suprastin; Diphenhydramine; Atarax;
With adenoids	Decongestants needed	Oral medications of any generation and sprays are used		Eliza, ordestine, claritin, Tyrlor, Tizin allergy; Histimet;
When teething		No in clinical guidelines. It is advisable to replace the antihistamine with drugs with a local anesthetic effect (for example, Dentinox or Cholisal).
At a temperature		Combination of antipyretic drug, analgesic and antihistamine- this is the so-called. lytic mixture that allows you to quickly reduce the temperature. Effective when i / m or / in the introduction, can not be used at home. Allowed drugs: promethazine; chloropyramine; diphenhydramine.		Pipolfen (solution for intramuscular and intravenous administration); Suprastin (solution for intramuscular and intravenous administration); Diphenhydramine (solution for intramuscular and intravenous administration).

It is important to understand that the choice of a drug cannot be based only on reading the instructions for use.

Any medicine should be prescribed exclusively by a doctor, having previously assessed the patient's condition, individual characteristics of the body, age, setting treatment goals, "weighing" the risk and benefit.

Lists of antihistamines for children by age

There is no doubt that preparations for children are more difficult than for adults. However, modern pharmacology offers medicines for any age group literally from birth to old age.

It should be noted that there are no separate drugs for children and adults. Most often, the differences are in the form of administration and dose. And, of course, some drugs are contraindicated for children under a certain age.

0 to 1 year

Children under one year old are the most “problematic” category, since allergies occur quite often, but the body is still weak and not sufficiently formed to receive high doses of antihistamines. However, today there are drugs that can be taken almost from birth:

• Zirtek, drops for oral administration - from 6 months;
• Cetrin, drops for oral administration - from 6 months;
• Suprastin, a solution for parenteral administration - from 1 month, according to health indications in a hospital;
• Diphenhydramine, a solution for parenteral administration - from birth, according to health indications in a hospital;
• , tablets and dragees, pounded into water, milk formula or baby food - from 2 months;
• Pipolfen, solution for parenteral administration - from 2 months;
• , ointment - from birth;
• Fenistil - from 1 month for the drug in the form of a gel, drops for oral administration - from 1 month;
• Psilo-balm, gel - suitable for newborns;
• , eye drops - from 1 month.

From 1 year to 6 years

At the age of 1 year and up to 6 years, the range of drugs is expanding, although many more drugs are contraindicated:

• Suprastin, tablets, must be added in crushed form to water or food - from 3 years;
• Erius, syrup - from 1 year;
• Claritin, syrup - from 2 years old, tablets - from 3 years old;
• Tirlor, tablets - from 2 years;
• Clargotil, tablets - from 2 years;
• Zodak, drops for oral administration - from 1 year old, syrup - from 2 years old;
• Tsetrin, syrup - from 2 years;
• Suprastinex, drops for oral administration - from 2 liters;
• Azelastine, eye drops - from 4 years old.

6 to 12 years old

Starting from the age of 6, medium-sized tablets are no longer rubbed into food, but allow children to swallow on their own. The choice of drug is even greater:

• Zirtek, tablets - from 6 years;
• Zodak, tablets - from 6 years old;
• Cetrin, tablets - from 6 years;
• Suprastinex, tablets - from 6 years;
• , syrup - from 6 years;
• Tizin, nasal spray - from 6 years;
• Azelastine, nasal spray - from 6 years;
• , nasal spray - from 6 years.

From 12 years and older

At this age, almost all antihistamines are allowed. In an emergency, any remedy can be used:

• Erius, tablets - from the age of 12;
• Eliza, syrup and tablets - from 12 years old;
• Lordestin, tablets - from 12 years old;
• , tablets - from 12 years;
• Feksadin, tablets - from 12 years old;
• Allegra, tablets - from 12 years old;
• , tablets and syrup - from 12 years old;
• Vizin allergy, drops in the eyes - from the age of 12;
• Histimet, nasal spray and eye drops - from 12 years old.

The drug Kestin in tablets is prescribed from the age of 15.

Antihistamines for children: choice of form of administration

As you can see, almost all drugs have several forms of release. Most often, the choice is determined by the point of application, i.e. the area where the drug is to be delivered.

1. Pills. They are easy to use, act quickly, do not require special conditions for administration, a single dose is enough. At the same time, small children cannot swallow tablets on their own, which is why the drug has to be crushed and mixed with food or drink. In addition, they have a systemic effect, affecting the liver and kidneys, which is why they are contraindicated in people with a serious pathology of these organs.
2. Drops. Small children can take it without even noticing it. They have fewer auxiliary components. Like tablets, they have a systemic effect.
3. Syrup. It has a pleasant taste, which is a plus for young children. However, this is also a minus, since the preparation contains flavors and fragrances, which can also provoke a reaction in an allergic child. Does not require drinking, has a systemic effect.
4. Injections. Pluses - in the rapid delivery of the drug into the bloodstream and, as a result, a quick, reliable effect. But this type of administration is practically inaccessible at home, it is not carried out independently.
5. Ointments, creams, gels. The advantages of this dosage form in a "point", local action, ease of application, the ability to use even the smallest children. However, the medication must be applied several times a day. What is the difference between these types of drugs? Generally speaking - in the intensity of absorption.

Repeatedly in the text of the article there have already been references to generations of antiallergic drugs. Can we say that new generation drugs are the best antihistamines for children? To make such claims, it is necessary to study not only the list of drugs, but also their pros and cons.

Lists of antihistamines for children by generation

The first histamine-blocking drug was invented in 1936. Since then, there have been no fundamentally new products in this line, only existing ones have been improved. To date, there are three generations of antihistamines (in some literature, the 4th generation is singled out, but there are enough sources that use the division into only 2 generations).

Despite the fact that drugs may belong to the same generation, the rules for their use vary. The dosage of each drug and dosage form is its own, and individual for certain age groups.

For convenience, the generation, names of drugs, their advantages and disadvantages, forms of administration and doses of antihistamines for children are combined in the table.

1st generation

Advantages

• Good bioavailability;
• Intense fast action;
• Rapid excretion from the body;
• The drugs are interchangeable;
• Well eliminate the symptoms of respiratory allergies;
• They are the drugs of choice for emergency conditions;
• They have a sedative effect (“plus”, if it is necessary to eliminate insomnia caused by itching);
• Have some antiemetic effect;
• They have a local anesthetic effect, comparable in strength to novocaine;
• Usually inexpensive.

Flaws

• Have a sedative effect (cause drowsiness even when the situation does not require it);
• Short-term (no more than 5 hours);
• Are addictive;
• Cause dry mucous membranes, thirst, tremor, tachycardia;
• Allergenic themselves.

Representatives	Form of introduction	Dosage	Photo
Chloropyramine
Suprastin	pills	3-6 years ½ tab. 2 r / day; 6-14 ½ tab. 3 r / day; >14 years - 1 tab. 3-4 r / day
	solution for intramuscular injection	1-12 months for ¼ ampoules; 1-6 years ½ ampoule; 6-14 years ½-1 ampoules; >14 years 1-2 ampoules
	ointment	thin layer 2-3 r / day
	pills	>14 years 1 tab. 3-4 r / day
Diphenhydramine
Diphenhydramine	pills	0-12 months, 2-5 mg; 1-5 years, 5-15 mg; 6-12 years old, 15-30 mg; >12 years 30-50 mg
	solution for p / e introduction	IM 50-100 mg IV drip 20 mg
Psilo Balm	gel	thin layer 3-4 r / day
Mebhydrolin
	pills	0-24 months, 50-100 mg; 2-5 years, 50-150 mg; 5-10 years, 100-200 mg; >10 years 100-300 mg
	dragee	is the same
clemastine
	pills	6-12 years ½-1 tab 2 r / day; >12 years 1 tab 2 r/day
	solution for intramuscular injection	2 injections / day at 0.025 mg per kg of body weight
Promethazine
	solution for intramuscular injection	2 months - 16 years, 1 mg per kg of body weight 3-5 r / day

II generation

Generation Virtues

• High specificity;
• Quick effect;
• Long-term effect (a single dose is enough);
• Minimal sedation;
• Lack of addiction;
• Long-term use is possible.

Generation Disadvantages

• The risk of developing arrhythmias and other cardiac disorders;
• Dry mucous membranes, nausea, vomiting are possible.

Representatives	Form of introduction	Dosage	Photo
Loratadine
Claritin	syrup	2 months - 12 years - depending on body weight and severity of allergies; >12 years 1 tsp. syrup or 1 tab 1 r / day
	pills
Tyrlor	pills	2-12 years old ½ tab 1 r / day >12 years 1 tab 1 r/day
Clargotil	pills	2-12 years old<30 кг по ½ таб 1 р/сут 2-12 years >30 kg 1 tab 1 r/day
Dimetinden
Fenistil Gel	gel	2-4 r / day
	drops for oral administration	1 month - 12 years, 2 drops per kg of body weight; >12 years old 20-40 drops 3-4 times a day
Azelastine
	nasal spray	6-12 years 1 dose 2 r / day >12 years 2 doses 2 r / day
	eye drops	1 drop 2 r / day
Levocabastin
Vizin Alergi	eye drops	>12 years 1 drop 2 r / day
nasal spray	>6 years 2 doses 2 r / day
Histimet	eye drops	>12 years 1 drop 2 r / day
	nasal spray	>12 years 2 doses 2 r / day
	eye drops	>1 month 1 drop 2 r / day
	nasal spray	>6 years 2 doses 2 r / day
ebastine
	syrup	6-12 years old, 5 ml 1 r / day; 12-15 years old, 10 ml 1 r / day; >15 years 10-20 ml 1 r / day
	pills	>15 years 1 tab 1 r/day

III generation (new generation)

Generation Virtues

• No sedation (or minimal);
• No cardiotoxicity;
• There are no restrictions on how long children can take antihistamines;
• Fast long lasting effect.

Generation Disadvantages

• Possibility of drug allergy
• High price.

Representatives	Form of introduction	Dosage	Photo
Fexofenadine
pills	>12 years 1 tab 1 r/day
Feksadin	pills	>12 years 1 tab 1 r/day
Allegra	pills	>12 years 1 tab 1 r/day
cetirizine
Zyrtec	drops for oral administration	6-12 months, 5 drops 1 r / day; 1-2 years, 5 cap 2 r / day; 2-6 years old, 10 drops 1 r / day; >6 years 20 drops 1 r/day
	pills	>6 years 1 tab 1 r/day
Zodak	drops for oral administration	1-2 g, 5 drops 2 r / day; 2-12 years old, 10 cap 1 r / day or 5 cap 2 r / day; >12 years cap/day 1 r/day
	pills	6-12 years old, 1 tab 1 r / day or ½ tab 2 r / day; >12 years 1 tab 1 r/day
	syrup	2-6 years 1 measure. l. 1 r / day; 6-12 years old 2 measurements l. 1r / day or 1 measure.l. 2 r / day; >12 years, 2 measurements l. 1r / day;
Tsetrin (read)	drops for oral administration	6-12 months, 5 drops 1 r / day; 1-6 years, 5 cap 2 r / day; >6 years 10 drops/day 1 r/day
	pills	>6 years 1 tab 1 r/day or ½ tab 2 r/day
	syrup	2-6 years, 5 ml 1r / day; >6 years 10 ml 1 r / day or 5 ml 2 r / day
Levocetirizine
Suprastinex	drops for oral administration	2-6 years old, 5 drops 2 r / day; >6 years 20 drops 1 r/day
	pills	>6 years 1 tab 1 r/day

Contraindications and side effects. Overdose

There is not a single drug that has no contraindications and side effects. One way or another, the use of drugs is an outside interference in the body, which can have undesirable consequences.

Contraindications

Contraindications to the use of each particular drug, of course, differ, and it is necessary to consult a doctor and carefully study the instructions for each drug. However, there are situations common to all in which the application is unacceptable:

• individual intolerance to the components of the drug;
• hypersensitivity to the components of the drug;
• severe pathology of the liver and kidneys;
• severe pathology of other internal organs;
• age (individually for each remedy);
• in some cases - lactase deficiency.

Side effects

Many parents are understandably interested in what is the effect of antihistamines on a child? Do they have adverse effects, are there any side effects? In terms of the number of side effects, first-generation drugs are in the lead. Among the possible:

• drowsiness, weakness, decreased concentration, distraction of attention;
• anxiety, insomnia;
• convulsions, dizziness, loss of consciousness;
• blurred vision;
• dyspnea;
• violation of the outflow of urine;
• puffiness;
• anaphylactic shock, Quincke's edema or other allergic reactions.

Second-generation drugs give fewer unwanted effects, but they are:

• feeling of dry mouth, nausea, vomiting;
• abdominal pain;
• increased fatigue, increased excitability;
• tachycardia (very rare);
• allergic reactions.

In the development of third-generation drugs, numerous placebo-controlled studies have been conducted that have confirmed the effectiveness and safety of the drugs. However, can these drugs be harmful, if so, why are antihistamines of this generation dangerous for children? May develop:

• headache, drowsiness, dizziness (less than 10%);
• insomnia, irritability, tachycardia, diarrhea (less than 1%)
• hypersensitivity reactions (<0,1%).

Precautionary measures

The main measure to prevent complications is not to prescribe medications on your own, but to take medications only on the recommendation of a doctor. In addition, you should take into account:

• if long-term antihistamines for children are used, dosage adjustments should be made regularly;
• the possibility of drug interactions when using other drugs;
• the inadmissibility of drinking even low-alcohol drinks in conjunction with antihistamine therapy (relevant for adolescents);
• the need for strict adherence to the recommendations of the doctor, dosage, frequency of administration.

Overdose

An overdose of antihistamines in children can lead to unpleasant consequences. First-generation drugs, the dose of which is long and significantly exceeded, can cause:

• disturbances of consciousness;
• feeling of anxiety, anxiety;
• lack of coordination;
• convulsive syndrome;
• dry mouth;
• redness of the face;
• tachycardia;
• urinary retention;
• febrile phenomena;
• to whom.

An overdose of second-generation drugs entails:

• headache;
• increase in drowsiness;
• increase in heart rate over 100 beats / min.

The maximum tolerated dose of third-generation antihistamines has not been established, although there have been studies in which healthy volunteers took high doses of drugs for a long time. Among the effects they have developed are:

• dry mouth;
• dizziness;
• weakness, drowsiness.

It is important to remember: if antihistamines do not help the child, in no case should you independently increase the dose. It is necessary to clarify the diagnosis and adjust the treatment by contacting the attending physician (for example, if diathesis or prickly heat are treated with antihistamines, there will be no effect, of course).

Thus, antihistamines are the first-line treatment for allergies in children. Reviews about their use are both positive and negative. Some parents talk about the exceptional effectiveness of some drugs, others about the absolute uselessness of the same drugs.

The role in this situation is played by the individual characteristics of the child's body, the type and severity of the disease, the duration of treatment, and many other factors. Antihistamines for children today is a huge branch of pharmacology, and it is possible to choose exactly the remedy that is suitable for a particular child in each specific situation.

Drugs that block histamine receptors in the body and thereby inhibit the effects it causes are called antihistamines.

What is histamine

Histamine is a mediator that is released from the connective tissue during allergic reactions and has a negative effect on the organs and systems of the body: skin, respiratory tract, cardiovascular system, digestive tract, and others.

Antihistamines are used to suppress free histamine and are divided into 3 groups depending on the receptors they block:

1. H1-blockers - this group of drugs is used in the treatment of allergic diseases.
2. H2-blockers - are indicated for diseases of the stomach, as they have a positive effect on its secretion.
3. H3 blockers are used in the treatment of neurological diseases.

Currently, there are many antihistamines:

• Diphenhydramine
• Diazolin
• Suprastin
• Claritin
• Kestin
• Rupafin
• Lorahexal
• Zyrtec
• Telfast
• Erius
• Zodak
• Parlazin

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They are divided into three generations of drugs for the treatment of allergic diseases.

1. The first generation of antihistamines, called classic, these include:

• diphenhydramine
• diazolin
• suprastin
• fenkarol
• tavegil

The mechanism of their action is in a reversible connection with peripheral and central H1 receptors, which blocks various effects of histamine: increased vascular permeability, contraction of the muscles of the bronchi and intestines. They quickly overcome the blood-brain barrier, while binding to the receptors of the brain, hence the powerful sedative and hypnotic effect.

Pros: these drugs act quickly and strongly - after half an hour, a decrease in allergic symptoms is achieved. They also have an anti-sickness and antiemetic effect, reduce the elements of parkinsonism. They have anticholinergic and local anesthetic effects. They are quickly excreted from the body.

Cons of antihistamines consist in the short duration of the therapeutic effect (4-6 hours), the need to change the drug during long-term therapy due to a decrease in its therapeutic activity and a large number of side effects, such as: drowsiness, visual impairment, dry mouth, constipation, headache, delay urine, tachycardia and lack of appetite. They do not have additional anti-allergic effect. Interact with other drugs.

The drugs in this group are well suited for quickly achieving an effect when it is necessary to treat acute allergic manifestations, for example, urticaria, seasonal rhinitis, or an allergic reaction to food.

The second generation of antihistamines, or H1 antagonists, which entered the market at the end of the 70s of the last century, are structurally related to H1 receptors, therefore they are devoid of the spectrum of side effects inherent in 1st generation drugs and a much wider range of applications is available to them.

These include:

• clarisens
• claridol
• lomilan
• claritin
• kestin
• rupafin
• lorahexal

Their mechanism of action is carried out by the accumulation of active antihistamine metabolites in the blood in a sufficient and long-term concentration. The active substances do not cross the blood-brain barrier, acting on the mast cell membrane, so the risk of drowsiness is minimized.

• physical and mental activity does not subside
• the duration of exposure is up to 24 hours, so it is enough to take most drugs once a day
• when treatment is stopped, the therapeutic effect lasts a week
• not addictive
• active substances are not absorbed in the gastrointestinal tract

• have a cardiotoxic effect, as they block the potassium channels of the heart;

prolonged therapeutic effect

possible side effects from some drugs: gastrointestinal disorders, disorders of the nervous system, fatigue, headaches, skin rashes

caution is required when combined with other drugs;

negative effect on the liver and heart

Antihistamines of the 2nd generation are used to relieve acute and prolonged allergic diseases, mild bronchial asthma, and chronic idiopathic urticaria. Contraindicated in the elderly, patients with cardiovascular problems and diseases of the kidneys and liver. Require constant monitoring of cardiac activity.

Antihistamines of the 3rd and 4th generation, created recently, are prodrugs, that is, such initial forms that, when ingested, are converted into pharmacologically active metabolites. Unlike drugs of previous generations, they act only on peripheral H1-histamine receptors, do not cause sedation, stabilize the mast cell membrane and have additional anti-allergic effects. They have increased selectivity, do not pass the blood-brain barrier and do not affect the nervous sphere.

• zyrtec (cetirizine)
• telfast (fexofenadine)
• trexil (terfenadine)
• hismanal (astemizole)
• erius (desloratadine)
• semprex (crivastin)
• allergodil (acelastin)

Improved modern drugs have a significant duration of action - from half to two days, after completion of treatment, they have a depressing effect on histamine for 6-8 weeks.

• have no systemic significant side effects
• indicated for all age groups - some of them are classified as over-the-counter drugs
• suitable for activities that require a high concentration of attention
• indicated for the prevention of allergic diseases
• not addictive
• do not differ, with rare exceptions, in significant drug interactions

for trexil (terfenadine) and astimizan (astemizole), cases of serious cardiotoxic side effects have been described.

if the drugs are used incorrectly, dizziness, nausea, skin flushing, reactions from the gastrointestinal tract are likely;

selectively, this group of drugs should be approached by people with kidney and liver problems.

The use of the latest generation of antihistamines is justified for all population groups without exception during long-term therapy of allergic diseases - atopic dermatitis, perennial allergic rhinitis, atopic syndrome, chronic urticaria, contact dermatitis and others.

Zyrtec (cetirizine) and Claritin (loratadine) are considered the best antihistamines today. The safe profiles of these drugs are great for all age groups, especially children, as they reduce the risk of future allergic reactions.

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I have finally found the answer to a question that has been bugging me for a long time.

I have long noticed that with exacerbations of seasonal allergies, all these expensive and sophisticated antihistamines of the latest generation, which can be taken only once every 24 or even 48 hours, for some reason help me much worse than budget diazolin. I thought that the matter was in the individual characteristics of the body, but it turned out that several acquaintances had the same situation. It turns out that the drugs of the first generation are better at stopping acute attacks, and the drugs of the latest generation are more suitable for the treatment of chronic allergies? But after all, even during a short-term allergy, you don’t feel like drinking handfuls of pills and pecking at work ... Well, one more confirmation of the common truth that you need to contact a specialist for a competent appointment.

I have been using Claritin all my life as an antihistamine, and I am completely satisfied with it - it relieves symptoms quickly, does not pull me to sleep, I drink calmly and drive. There are now, of course, more fashionable and new means, for example, the zodak, but I am somehow inclined to trust a time-tested tool, and why change something that already helps? In general, of course, first of all, it is necessary to identify the allergen itself, and, based on this, build a treatment regimen, and it is better, of course, after consulting with a specialist ...

Our magazine contains the most complete information on dermatological diseases. We especially pay attention to the symptoms, causes and treatment.

The most effective antihistamines for children and adults - a list of medicines with instructions and prices

A small number of people were lucky enough to never experience allergic reactions in their lives. Most people have to deal with them from time to time. Effective antihistamines will help to cope with allergies for both an adult and a child. Such funds help to eliminate negative reactions on the body to certain stimuli. There is a wide range of anti-allergic drugs on the market. It is desirable for every person to be able to understand them.

What are antihistamines

These are drugs whose work is aimed at suppressing the action of free histamine. This substance is released from the connective tissue cells that enter the immune system when an allergen enters the human body. When histamine interacts with certain receptors, swelling, itching, and rashes begin. All of these are symptoms of an allergy. Drugs with an antihistamine effect block the aforementioned receptors, alleviating the patient's condition.

Indications for use

You must be prescribed antihistamines by a doctor, having made an accurate diagnosis. As a rule, their administration is advisable in the presence of such symptoms and diseases:

• early atopic syndrome in a child;
• seasonal or year-round rhinitis;
• negative reaction to plant pollen, animal hair, household dust, some medications;
• severe bronchitis;
• angioedema;
• anaphylactic shock;
• food allergies;
• enteropathy;
• bronchial asthma;
• atopic dermatitis;
• conjunctivitis caused by exposure to allergens;
• chronic, acute and other forms of urticaria;
• allergic dermatitis.

Antihistamines - list

There are several generations of antiallergic drugs. Their classification:

1. New generation drugs. The most modern medicines. They act very quickly, and the effect of their use lasts for a long time. Block H1 receptors, suppressing allergy symptoms. Antihistamines in this group do not worsen the functioning of the heart, therefore they are considered one of the safest.
2. 3rd generation drugs. Active metabolites with very few contraindications. They provide a fast stable result, they are gentle on the heart.
3. 2nd generation drugs. Not sedative drugs. They have a small list of side effects, give a big load on the heart. Do not affect mental or physical activity. Antiallergic drugs of the second generation are often prescribed for the appearance of a rash, itching.
4. 1st generation drugs. Sedative drugs that last up to several hours. Well eliminate the symptoms of allergies, but have many side effects, contraindications. From their use always tends to sleep. At the present time, such drugs are prescribed very rarely.

New generation antiallergic drugs

It is not possible to list all the drugs in this group. Let's take a look at some of the best ones. This list opens with the following drug:

• name: Fexofenadine (analogues - Allegra (Telfast), Fexofast, Tigofast, Altiva, Fexofen-Sanovel, Kestin, Norastemizol);
• action: blocks H1-histamine receptors, relieves all allergy symptoms;
• pluses: acts quickly and for a long time, is available in tablets and suspensions, is well tolerated by patients, does not have too many side effects, is dispensed without a prescription;
• cons: not suitable for children under six years of age, pregnant women, nursing mothers, incompatible with antibiotics.

Another drug that deserves attention:

• name: Levocetirizine (analogues - Aleron, Zilola, Alerzin, Glenset, Aleron Neo, Rupafin);
• action: antihistamine, blocks H1 receptors, reduces vascular permeability, has antipruritic and antiexudative effects;
• pluses: there are tablets, drops, syrup on sale, the drug acts in just a quarter of an hour, there are not many contraindications, there is compatibility with many drugs;
• cons: a wide range of strong side effects.

• name: Desloratadine (analogues - Lordes, Allergostop, Alersis, Fribris, Edem, Eridez, Alergomax, Erius);
• action: antihistamine, antipruritic, decongestant, relieves rash, runny nose, nasal congestion, reduces bronchial hyperactivity;
• pluses: the new generation allergy medicine is well absorbed and works quickly, relieves allergy symptoms for a day, does not have a negative effect on the central nervous system and reaction rate, does not harm the heart, joint use with other drugs is allowed;
• cons: not suitable for pregnancy and lactation, prohibited for children under 12 years of age.

Antihistamine 3 generations

The following drug is popular and has many good reviews:

• name: Desal (analogues - Ezlor, Nalorius, Elyseus);
• action: antihistamine, relieves swelling and spasms, relieves itching, rash, allergic rhinitis;
• pluses: it is available in tablets and solution, does not give a sedative effect and does not affect the rate of reactions, it works quickly and acts for about a day, it is quickly absorbed;
• cons: bad effect on the heart, many side effects.

Experts respond well to this drug:

• name: Suprastinex;
• action: antihistamine, prevents the appearance of allergic manifestations and facilitates their course, helps with itching, peeling, sneezing, swelling, rhinitis, lacrimation;
• pluses: it is available in drops and tablets, there is no sedative, anticholinergic and antiserotonergic effect, the drug acts in an hour and continues to work for a day;
• cons: there are a number of strict contraindications.

The group of third-generation drugs also includes the following:

• name: Ksizal;
• action: pronounced antihistamine, not only relieves allergy symptoms, but also prevents their occurrence, reduces the permeability of vascular walls, fights sneezing, lacrimation, edema, urticaria, inflammation of the mucous membranes;
• pluses: sold in tablets and drops, does not have a sedative effect, is well absorbed;
• cons: has a wide list of side effects.

2nd generation antiallergenic drugs

A well-known series of drugs, represented by tablets, drops, syrups:

• name: Zodak;
• action: prolonged anti-allergic, helps against itching, skin peeling, relieves swelling;
• pluses: subject to dosages and rules of administration, it does not cause drowsiness, quickly begins to act, is not addictive;
• cons: prohibited for pregnant women and children.

The next second generation drug:

• name: Cetrin;
• action: antihistamine, well helps with edema, hyperemia, itching, peeling, rhinitis, urticaria, reduces capillary permeability, relieves spasms;
• pluses: there are drops and syrup on sale, low cost, lack of anticholinergic and antiserotonin effects, if the dosage is observed, it does not affect concentration, is not addictive, side effects are extremely rare;
• cons: there are a number of strict contraindications, an overdose is very dangerous.

Another very good drug in this category:

• name: Lomilan;
• action: systemic blocker of H1 receptors, relieves all allergy symptoms: itching, peeling, swelling;
• pluses: does not affect the heart and central nervous system, is completely excreted from the body, helps to overcome allergies well and quickly, suitable for continuous use;
• cons: many contraindications and side effects.

Means of the 1st generation

Antihistamines of this group appeared a very long time ago and are now used less often than others, however, they deserve attention. Here is one of the most famous:

• name: Diazolin;
• action: antihistamine, blocker of H1 receptors;
• pluses: gives an anesthetic effect, acts for a long time, helps well with dermatoses with skin itching, rhinitis, cough, food and drug allergies, insect bites, is cheap;
• cons: there is a moderately pronounced sedative effect, many side effects, contraindications.

This one also belongs to the drugs of the 1st generation:

• name: Suprastin;
• action: anti-allergic;
• pluses: available in tablets and ampoules;
• cons: a pronounced sedative effect, the effect does not last long, there are a lot of contraindications, side effects.

The last member of this group:

• name: Fenistil;
• action: histamine blocker, antipruritic;
• pluses: available in the form of a gel, emulsion, drops, tablets, relieves skin irritation well, relieves pain a little, inexpensive;
• cons: the effect after application passes quickly.

Allergy pills for children

Most antihistamines have strict age contraindications. The question would be quite reasonable: how to treat very small allergies, who suffer at least as often as adults? As a rule, children are prescribed drugs in the form of drops, suspensions, and not tablets. Means approved for the treatment of infants and persons under 12 years of age:

• Diphenhydramine;
• Fenistil (drops are suitable for babies older than a month);
• Peritol;
• Diazolin;
• Suprastin (suitable for babies);
• Clarotadine;
• Tavegil;
• Tsetrin (suitable for newborns);
• Zyrtec;
• Claricens;
• Cinnarizine;
• Loratadine;
• Zodak;
• Claritin;
• Erius (allowed from birth);
• Lomilan;
• Fenkarol.

Mechanism of action of antihistamines

Under the action of an allergen, an excess of histamine is produced in the body. When it is associated with certain receptors, negative reactions are caused (edema, rash, itching, runny nose, conjunctivitis, etc.). Antihistamines reduce the release of this substance into the blood. In addition, they block the action of H1-histamine receptors, thereby preventing them from binding and reacting with histamine itself.

Side effects

Each drug has its own list. The specific list of side effects also depends on which generation the remedy belongs to. Here are a few of the most common:

• headache;
• drowsiness;
• confusion;
• decreased muscle tone;
• fast fatiguability;
• constipation;
• concentration disorders;
• blurred vision;
• abdominal pain;
• dizziness;
• dry mouth.

Contraindications

Each antihistamine drug has its own list, specified in the instructions. Almost every one of them is forbidden to be taken by pregnant girls and nursing mothers. In addition, the list of contraindications for therapy may include:

• individual intolerance to the components;
• glaucoma;
• stomach or duodenal ulcer;
• prostate adenoma;
• obstruction of the bladder;
• childhood or old age;
• diseases of the lower respiratory tract.

Best Allergy Remedies

TOP 5 most effective drugs:

1. Erius. A fast-acting medicine that well eliminates a runny nose, itching, rashes. It costs expensive.
2. Eden. Drug with desloratadine. Does not give a hypnotic effect. It copes well with lacrimation, itching, swelling.
3. Zyrtec. A drug based on cetirizine. Fast acting and efficient.
4. Zodak. An excellent allergy medicine that instantly eliminates symptoms.
5. Tsetrin. A drug that rarely gives side effects. Quickly eliminates allergy symptoms.

The price of antihistamines

Name of the drug, form of release, volume

Approximate cost in rubles

Suprastin, tablets, 20 pcs.

Zyrtec, drops, 10 ml

Fenistil, drops, 20 ml

Erius, tablets, 10 pcs.

Zodak, tablets, 30 pcs.

Claritin, tablets, 30 pcs.

Tavegil, tablets, 10 pcs.

Cetrin, tablets, 20 pcs.

Loratadine, tablets, 10 pcs.

Video: Antiallergic drugs for children

Margarita, 28 years old

Since childhood, spring has been a terrible period for me. I just tried not to leave the house, there was not a single photo where I was on the street. When it bothered me, I turned to an allergist. He prescribed me the drug Cetrine. Taking it, I calmly walked, not reacting to flowering plants, other irritants. There were no side effects from the drug.

Christina, 32 years old

I am allergic to household and other types of dust. Houses are perfectly clean, but on the street or at a party only medicines save. At first I took Erius, but the price of this antihistamine bites. I changed it to Desloratadine. Works the same, but much cheaper. This medicine helps me perfectly, one tablet is enough for a day.

The information presented in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment based on the individual characteristics of a particular patient.

Allergy medicines 4 generations

Antihistamines of the 4th generation are the latest tools aimed at enhancing the effectiveness of the fight against allergies. Their distinguishing feature is the duration of the therapeutic effect and a minimum of side effects.

What is histamine?

Histamine is a complex organic substance that is part of many tissues and cells. It is located in special mast cells - histiocytes. This is the so-called passive histamine.

Under special conditions, passive histamine becomes active. Thrown into the blood, it spreads throughout the body and has a negative effect on it. This transition occurs under the influence of:

• traumatic lesions;
• stress
• infectious diseases;
• actions of drugs;
• malignant and benign neoplasms;
• chronic diseases;
• removal of organs or their parts.

Active histamine can enter the body with both food and water. Most often this occurs when eating food of animal origin in a stale form.

How does the body react to the appearance of free histamine?

The transition of histamine from a bound state to a free one creates the effect of a viral effect.

For this reason, flu and allergy symptoms are often similar. In this case, the following processes occur in the body:

1. Spasms of smooth muscles. Most often they occur in the bronchi and intestines.
2. Adrenaline rush. This entails an increase in blood pressure, increased heart rate.
3. Increased production of digestive enzymes and mucus in the bronchi and nasal cavity.
4. Narrowing of large and expansion of small blood vessels. This causes swelling of the mucous membrane, redness of the skin, the appearance of a rash, a sharp decrease in pressure.
5. The development of anaphylactic shock, which is accompanied by convulsions, loss of consciousness, vomiting, a sharp drop in pressure.

Antihistamines and their action

The most effective way to combat histamine are special drugs that reduce the level of this substance in a free active state.

Since the first allergy medications were developed, four generations of antihistamines have been released. In connection with the development of chemistry, biology and pharmacology, these drugs have improved, their effect has increased, and contraindications and undesirable effects have decreased.

Representatives of antihistamines of all generations

In order to evaluate the latest generation drugs, the list should start with older drugs.

1. First generation: Diphenhydramine, Diazolin, Mebhydrolin, Promethazine, Chloropyramine, Tavegil, Diphenhydramine, Suprastin, Peritol, Pipolfen, Phencarol. All these drugs have a strong sedative and even hypnotic effect. Their main mechanism of action is the blocking of H1 receptors. The duration of their action is in the range of 4 to 5 hours. The antiallergic effect of these drugs can be called good. However, they have too much effect on the entire body. Side effects of such drugs are: dilated pupils, dry mouth, vagueness of the visual picture, constant drowsiness, weakness.
2. Second generation: Doxylamine, Hifenadine, Clemastine, Cyproheptadine, Claritin, Zodak, Fenistil, Gistalong, Semprex. At this stage in the development of pharmaceuticals, drugs appeared that did not have a sedative effect. In addition, they no longer contain the same side effects. They do not have an inhibitory effect on the psyche, and also do not cause drowsiness. They are taken not only for allergic manifestations from the respiratory system, but also for skin reactions, for example, urticaria. The disadvantage of these agents was the cardiotoxic effect of their ingredients.
3. Third generation: Akrivastine, Astemizol, Dimetinden. These drugs have improved antihistamine capabilities and a small set of contraindications and side effects. In the aggregate of all properties, they are no less effective than 4th generation drugs.
4. Fourth generation: Cetirizine, Desloratadine, Fenspiride, Fexofenadine, Loratadine, Azelastine, Xyzal, Ebastin. Antihistamines of the 4th generation are able to block H1- and H2-histamine receptors. This reduces the body's reactions with the mediator histamine. As a result, the allergic reaction weakens or does not appear at all. The likelihood of bronchospasm is also reduced.

The best of the latest generation

The best 4th generation antihistamines are characterized by a long therapeutic effect and a small number of side effects. They do not suppress the psyche and do not destroy the heart.

1. Fexofenadine is very popular. It is characterized by the versatility of exposure, so it can be used for all types of allergies. However, it is prohibited for children under 6 years of age.
2. Cetirizine is more suitable for the treatment of allergies that manifest on the skin. It is especially recommended for hives. The action of Cetirizine appears 2 hours after ingestion, but the therapeutic effect lasts all day. So with moderate allergy attacks, it can be taken 1 time per day. The drug is often recommended for the treatment of childhood allergies. Long-term use of cetirizine in children suffering from early atopic syndrome significantly reduces the further negative development of diseases of allergic genesis.
3. Loratadine has a particularly significant therapeutic effect. This fourth-generation drug can rightfully top the list of leaders.
4. Xyzal well blocks the release of inflammatory mediators, which allows you to get rid of allergic reactions for a long time. It is better to use it for bronchial asthma and seasonal allergies to pollen.
5. Desloratadine can be classified as one of the most popular antihistamines for all age groups. At the same time, it is rightfully considered one of the safest, with almost no contraindications and undesirable effects. However, it is characterized by at least a small, but still sedative effect. However, this effect is so small that it practically does not affect the rate of human reaction and the activity of the heart.
6. Desloratadine is most commonly prescribed for patients with pollen allergies. It can be used both seasonally, that is, during the period of maximum risk, and in other periods. With success, this drug can be used in the treatment of conjunctivitis and allergic rhinitis.
7. Levocetirizine, also known as Suprastinex and Caesera, is considered an excellent remedy for pollen allergies. In addition, these drugs can be used for conjunctivitis and allergic rhinitis.

Thus, fourth-generation antihistamines can be used while driving and performing other work that requires a good response. They usually do not interact with other medications, including antibiotics. This allows them to be taken in the treatment of inflammatory diseases.

Because these drugs do not interfere with behavior, thought processes, or adverse effects on the heart, they are generally well tolerated by patients.

In addition, they usually do not interact synergistically with other drugs.

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