Allergy Relief – Which is the best antihistamine for you?

Histamine is a chemical released from the body when it encounters something that it perceives as a threat, such as an infection. However, in people with allergies, histamine is released even then the threat is not a true danger such as pollen, dust, or animal hair. When this happens, histamine causes symptoms such as itchy and watery eyes, runny or blocked nose, sneezing, and rashes. If you suffer from allergies and want to avoid these symptoms, antihistamines can help. As the name suggests, these medications work by blocking histamine’s effect and offering allergy relief. You may take antihistamines either before encountering the allergen or to combat the symptoms you may already be experiencing. They are the first-line treatment for hay fever, pet allergies, or insect bites.

What types of antihistamines are there?

With many forms, active ingredients, and brands available, navigating the antihistamine market can be tricky. Let’s break it down.

1^st and 2^nd Generation

Antihistamines fall into two categories: the older first generation, and new second generation. First generation antihistamines are more likely to cause drowsiness and fatigue, while second generation antihistamines which are less likely to do so.

First-Generation Antihistamines	Second-Generation Antihistamines
Chlorpheniramine (e.g., Piriton)	Loratadine (e.g., Claritin)
Promethazine (e.g., Phenergan)	Cetirizine (e.g., Piriteze)
	Fexofenadine (e.g., Allevia)

No antihistamine can be entirely non-drowsy, but second generation antihistamines are the best choice for people working safety-critical jobs. Yet, for many, the sedative effect of first generation antihistamines is actually desirable. These medications are often marketed as sleeping aids because of this side effect.

	First-Generation	Second-Generation
Time to Start Working	30 minutes to 1 hour	30 minutes to 1 hour
Duration of effect	4 to 6 hours	up to 24 hours
Drowsiness	High potential for sedation	Low to none
Common Side Effects	Dry mouth, blurry vision, constipation, urinary retention	Headache, cough, sore throat

Forms of antihistamines

Antihistamines come in various forms to suit different needs, such as tablets/capsules, liquids, nasal sprays, eye drops, and creams. Knowing which form is best for your symptoms is key. While tablets or liquids are often the easiest and most affordable options, other methods may be more effective for direct relief.

• Nasal sprays (e.g., Flixonase) are best for a stuffy or blocked noses
• Eye drops (e.g., Opticrom) help with red and watery eyes.
• Creams (e.g., Anthisan) are effective for insect bites.

These forms can be used in combination for more targeted relief, but be cautious; you should never use two oral antihistamines (tablets/capsules or liquids), or two nasal sprays at the same time. In order to work out which ones work for you, always try a new medication at different times.

What should you use?

Managing allergy symptoms isn’t about simply choosing the ‘best’ or ‘strongest’ option on the market, but instead about understanding your symptoms and finding the right approach. For general allergy relief, a second generation tablet such as loratadine or cetirizine is often preferred due to their low risk of side effects and long lasting effect. However, if this isn’t effective, you might consider a more targeted approach.

Bottom line

Antihistamines are effective tools for managing allergy symptoms, but choosing the right one depends on your symptoms, their severity, and your lifestyle. Whether you choose a second generation tablet for general relief or more targeted approach, always consult a pharmacist or patient information leaflet before taking antihistamines. If in doubt, don’t hesitate to ask for guidance on the best option for you.