I had a young couple come to the pharmacy the other day. The man looked miserable - with itchy, puffy, watery eyes, stuffy nose and a horrible cough. His girlfriend came to the pharmacy and said, “My boyfriend is sick and has been a baby about it and snoring at night! What can I give him?”

All of his symptoms were caused by histamines (which are released when we have a cold or allergies). Histamine can also cause hives (itchy, red, raised bumpy rash). So, we treat them by taking an ANTIhistamine. The antihistamine neutralizes some or all of the histamines so that our symptoms are lessened. Antihistamines come in many forms -oral, topical, nasal spray and eye drops.

These oral antihistamines can help with cold/allergy symptoms and hives…

The following are available OTC:

1. Benadryl (diphenhydramine) -Best for rashes and to take at bedtime if the patient can’t sleep due to cold/allergy symptoms (it will help symptoms and cause drowsiness).

2. Dimetapp allergy (brompheniramine)

3. Chlor-Trimeton (chlorpheniramine)

4. Tavist (clemastine) The above antihistamines work well but can cause a lot of sedation for most people (although some young kids may become hyperactive). It has been estimated that up to 90% of the Benadryl sold is used as a sleeping aid.

Helpful hint: Diphenhydramine (the active ingredient in Benadryl) is used in most OTC sleeping pills and can be used to treat motion sickness.

5. Claritin and Alavert (loratadine)

6. Zyrtec (cetirizine) The two above do not usually cause drowsiness. They are available in generics, combo products with pseudophedrine (decongestants) and come in formulations for kids 2 years old to adult.

The following antihistamines are available with a prescription…

7. Xyzal (levocetirizine) -Great for rashes and itchy skin due to allergies. It often causes drowsiness.

8. Allegra (fexofenadine) -Option for those that an OTC antihistamines does not work or causes too much drowsiness. It is available in a generic!

9. Clarinex (desloratadine) -It does not come in a generic and hasn’t really been proven to help more than the generic OTC Claritin.

If you have questions about how to treat other symptoms from allergies/cold, come check out this other article.

Although all the drugs are antihistamines they work differently for each person. You may need to try out a few to see which one works for you.

Oral antihistamines are also used to treat acid reflux, motion sickness and dizziness…but that is a story for a different time.

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