2nd generation antihistamines list. The most effective antihistamines: a review of the most effective anti-allergy drugs

Currently, in the specialized literature, opinions differ regarding which antiallergic drugs should be classified as second and third generation. In this regard, the list of 2nd generation antihistamines will have its own characteristics depending on what point of view modern pharmacists adhere to.

By what criteria are antihistamines classified into the second group?

According to the first point of view, second-generation drugs are all those antiallergic drugs that do not have a sedative effect because they do not penetrate the brain through the blood-brain barrier.

The second and most common point of view is that only those that, although they do not have an effect on nervous system, but can cause changes in the heart muscle. Medicines that do not affect the heart and nervous system are classified as the third generation of antihistamines.

According to the third point of view, only one drug that has antihistamine properties belongs to the second generation - ketotifen, because it has a membrane-stabilizing effect. And all those drugs that stabilize the mast cell membrane, but do not cause a sedative effect, constitute the third generation of antihistamines.

Why did antihistamines get this name?

Histamine is the most important substance, which is predominantly found in mast cells connective tissue and blood basophils. Released from these cells under the influence of various factors, it binds to the H 1 and H 2 receptors:

• H1 receptors, when interacting with histamine, cause bronchospasm, contraction of smooth muscles, dilate capillaries and increase their permeability.
• H 2 receptors stimulate an increase in acidity in the stomach and affect heart rate.

Indirectly, histamine can cause severe itching, stimulating the release of catecholamines from adrenal cells, increasing the secretion of the salivary and lacrimal glands, and also accelerating intestinal motility.

Antihistamines connect to H1 and H2 receptors and block the action of histamine.

List of drugs of the second group

According to the most common classification of antihistamines, the second generation includes:

• dimethindene,
• loratadine,
• ebastine,
• cyproheptadine,
• azelastine,
• acrivastine.

All these drugs do not penetrate the brain and therefore do not cause sedation. However possible development cardiotoxic effect limits the use of this group of drugs in older people and those who suffer from heart disease.

Increases myocardial damage during treatment with second-generation antihistamines when taken simultaneously with them antifungal agents and some antibiotics, such as clarithromycin, erythromycin, itraconazole and ketoconazole. You should also avoid drinking grapefruit juice and antidepressants.

Dimetindene (fenistil)

Available in the form of drops, gel and capsules for oral administration. It is one of the few drugs that can be used in children of the first year of life, with the exception of the neonatal period.

Fenistil is well absorbed orally and has a pronounced antiallergic effect, lasting after 1 dose for about 6–11 hours.

The drug is effective for skin itching, eczema, drug and food allergies, insect bites, itchy dermatoses and exudative-catarrhal diathesis in children. Its other purpose is to relieve mild household and sunburns.

Features of application. It is one of the few second-generation drugs that does cross the blood-brain barrier, so it may slow down your reaction time while driving. In this connection, it should be prescribed with extreme caution to drivers, and especially not during work that requires a quick reaction.

When applying the gel to the skin, it is necessary to protect this area from exposure to direct sunlight.

Dimetindene is contraindicated during the first trimester of pregnancy and in the neonatal period. It is used with caution in the second and third trimesters of pregnancy, with prostate adenoma, and angle-closure glaucoma.

Loratadine (claritin, lomilan, lotharen)

Like other drugs in this group, it effectively treats all kinds of allergic diseases, especially allergic rhinitis, conjunctivitis, nasopharyngitis, angioedema, urticaria, endogenous itching. The drug is available in the form of tablets and syrup for oral administration, and is also part of multicomponent antiallergic gels and ointments for local treatment.

Effective for pseudoallergic reactions, hay fever, urticaria, itchy dermatoses. As aid prescribed for bronchial asthma.

Features of application. May cause sedation in the elderly, not recommended during pregnancy and breastfeeding. Many drugs reduce the effectiveness of loratadine or increase its side effects, so be sure to consult your doctor before starting to take it.

Ebastine (kestin)

Also belongs to the group of second generation antihistamines. Its distinctive feature is the absence of interaction with ethanol, so it is not contraindicated when using medications containing alcohol. Simultaneous use with ketoconazole enhances toxic effect on the heart, which can lead to fatal consequences.

Ebastine is prescribed for allergic rhinitis, urticaria and other diseases accompanied by excessive release of histamine.

Cyproheptadine (peritol)

This drug for the treatment of allergic reactions can be prescribed to children from 6 months. Like other drugs in this group, cyproheptadine has a strong and long-lasting effect, eliminating allergy symptoms. Distinctive feature peritol - relief of migraine headaches, calming effect, reduction of excess secretion of somatotropin in acromegaly. Cyproheptadine is prescribed for toxicoderma, neurodermatitis, complex therapy chronic pancreatitis, serum sickness.

Azelastine (allergodil)

This drug copes well with such types of allergies as allergic rhinitis and conjunctivitis. Available as a nasal spray and eye drops. In pediatrics it is prescribed to children from 4 years of age ( eye drops) and from 6 years (spray). The duration of treatment with azelastine, on the recommendation of a doctor, can last up to 6 months.

From the nasal mucosa, the drug is well absorbed into the general bloodstream and has a systemic effect on the body.

Acrivastine (Semprex)

The drug poorly penetrates the blood-brain barrier and therefore does not have sedative effect, however, vehicle drivers and those whose work requires quick and precise actions should refrain from taking it.

Acrivastine differs from other representatives of this group in that it begins to act within the first 30 minutes, and the maximum effect on the skin is observed within 1.5 hours after administration.

Drugs of the second group, about which there is controversy in scientific circles

Mebhydrolin (diazolin)

Most experts classify Diazolin as a first-generation antihistamine, while others, due to its minimally expressed sedative effect, classify this remedy to the second. Be that as it may, diazolin is widely used not only in adults, but also in pediatric practice, considered one of the most inexpensive and accessible medicines.

Desloratadine (Eden, Erius)

It is most often classified as a third generation antihistamine because it is an active metabolite of loratadine.

Cetirizine (Zodak, Cetrin, Parlazine)

Most researchers classify this medicine as a second generation of antihistamines, although some confidently classify it as a third because it is an active metabolite of hydroxyzine.

Zodak is well tolerated and rarely causes side effects. Available in the form of drops, tablets and syrup for oral administration. With a single dose of the drug, it has therapeutic effect throughout the day, so it can be taken only once a day.

Cetirizine relieves allergy symptoms, does not cause sedation, and prevents the development of smooth muscle spasm and swelling of surrounding tissues. Effective when hay fever, allergic conjunctivitis, urticaria, eczema, relieves itching well.

Features of application. If the drug is prescribed in large doses, then you should refrain from driving vehicles, as well as work that requires quick reactions. When used together with alcohol, cetirizine can enhance its negative effects.

The duration of treatment with this drug can be from 1 to 6 weeks.

Fexofenadine (Telfast)

Most researchers also consider it to be a third generation of antihistamines, because it is an active metabolite of terfenadine. It can be used by those whose activities involve driving, as well as those suffering from heart disease.

Antihistamines (or in simple words Allergy medications) belong to a group of medications whose action is based on blocking histamine, which is the main mediator of inflammation and a provocateur of allergic reactions. As you know, an allergic reaction is the body’s immune response to the effects of foreign proteins - allergens. Antihistamines are designed to relieve such symptoms and prevent their occurrence in the future.

IN modern world antiallergic drugs have become widespread; representatives of this group can be found in the medicine cabinet of any family. Every year the pharmaceutical industry expands its range and produces more and more new drugs, the action of which is aimed at combating allergies.

1st generation antihistamines are gradually becoming a thing of the past; they are being replaced by new drugs that are distinguished by their ease of use and safety. It can be difficult for the average consumer to understand such a variety of medicines, so in this article we will present the best antihistamines different generations and tell you about their advantages and disadvantages.

The main job of allergy medications is to inhibit the production of histamine, which is produced by cells of the immune system. Histamine in the body accumulates in mast cells, basophils and platelets. A large number of these cells are concentrated in skin, mucous membranes of the respiratory system, near blood vessels and nerve fibers. Under the influence of an allergen, histamine is released, which penetrates into the extracellular space and circulatory system, causes allergic reactions from the most important systems of the body (nervous, respiratory, integumentary).

All antihistamines inhibit the release of histamine and prevent it from attaching to the endings of nerve receptors. Medicines in this group have antipruritic, antispastic and decongestant effects, effectively eliminating allergy symptoms.

To date, several generations of antihistamines have been developed, differing from each other in their mechanism of action and duration of therapeutic effect. Let us dwell in more detail on the most popular representatives of each generation of antiallergic drugs.

1st generation antihistamines - list

The first drugs with antihistamine action were developed back in 1937 and since then have been widely used in therapeutic practice. Drugs enter into a reversible relationship with H1 receptors, additionally involving cholinergic muscarinic receptors.

Medicines in this group provide rapid and pronounced healing effect, have an antiemetic and anti-sickness effect, but it does not last long (from 4 to 8 hours). This explains the need frequent use high doses of the drug. 1st generation antihistamines can effectively cope with allergy symptoms, but they positive traits are largely offset by significant disadvantages:

• A distinctive characteristic of all drugs in this group is the sedative effect. 1st generation drugs are able to penetrate the blood-brain barrier to the brain, causing drowsiness, muscle weakness, inhibiting the activity of the nervous system.
• The effects of drugs quickly become addictive, which significantly reduces their effectiveness.
• First generation drugs have quite a lot side effects. Taking pills can cause tachycardia, blurred vision, dry mouth, constipation, urinary retention and increase the negative effects of alcohol on the body.
• Due to the sedative effect, medications should not be taken by persons managing vehicles, as well as those whose professional activity requires high concentration and quick reaction.

First generation antihistamines include:

1. Diphenhydramine (from 20 to 110 rubles)
2. Diazolin (from 18 to 60 rub.)
3. Suprastin (from 80 to 150 rub.)
4. Tavegil (from 100 to 130 rubles)
5. Fenkarol (from 95 to 200 rubles)

Diphenhydramine

The medicine has quite high antihistamine activity, has an antitussive and antiemetic effect. Effective for hay fever, vasomotor rhinitis, hives, seasickness, allergic reactions caused by taking medications.

Diphenhydramine has a local anesthetic effect, so it can replace Lidocaine or Novocaine in case of intolerance.

The disadvantages of the drug include a pronounced sedative effect, short duration of therapeutic effect and the ability to cause quite serious adverse reactions(tachycardia, disturbances in the functioning of the vestibular apparatus).

Diazolin

Indications for use are the same as for Diphenhydramine, but the sedative effect of the drug is much less pronounced.

However, when taking the medication, patients may experience drowsiness and slowed psychomotor reactions. Diazolin can cause side effects: dizziness, irritation of the gastrointestinal mucosa, fluid retention in the body.

Suprastin

It can be used to treat symptoms of urticaria, atopic dermatitis, allergic conjunctivitis, rhinitis, and pruritus. The drug can help with severe complications by preventing.

Has high antihistamine activity, has fast action, which allows the drug to be used to relieve acute allergic conditions. The disadvantages include the short duration of the therapeutic effect, lethargy, drowsiness, and dizziness.

Tavegil

The drug has a longer lasting effect antihistamine effect(up to 8 hours) and has a less pronounced sedative effect. However, taking the drug may cause dizziness and confusion. Tavegil in the form of injections is recommended for use in cases of serious complications such as Quincke's edema and anaphylactic shock.

Fenkarol

It is taken in cases where it is necessary to replace an antihistamine that has lost its effectiveness due to addiction. This drug is less toxic, does not have a depressing effect on the nervous system, but retains weak sedative properties.

Currently, doctors are trying not to prescribe 1st generation antihistamines due to the abundance of side effects, preferring more modern medicines 2-3 generations.

2nd generation antihistamines - list

Unlike 1st generation drugs, more modern antihistamines do not have a sedative effect, are not able to penetrate the blood-brain barrier and have a depressant effect on the nervous system. 2nd generation drugs do not reduce physical and mental activity, provide quick therapeutic effect, which lasts for a long time (up to 24 hours), which allows you to take only one dose of the medicine per day.

Other advantages include the absence of addiction, due to which medications can be used for a long time. The therapeutic effect of taking medications lasts for 7 days after discontinuation of the drug.

The main disadvantage of this group is the cardiotoxic effect that develops as a result of blocking potassium channels heart muscle. Therefore, 2nd generation drugs are not prescribed to patients with heart disease. vascular problems and elderly patients. In other patients, medication should be accompanied by monitoring of cardiac activity.

Here is a list of 2nd generation antihistamines that are in greatest demand and their prices:

• Allergodil (Azelastine) – from 250 to 400 rubles.
• Claritin (Loratadine) – price from 40 to 200 rubles.
• Semprex (Activastin) – from 100 to 160 rubles.
• Kestin (Ebastin) – from price 120 to 240 rubles.
• Fenistil (Dimetinden) – from 140 to 350 rubles.

Claritin (Loratadine)

This is one of the most popular second generation drugs. It has high antihistamine activity and no sedative effect. The medicine does not enhance the effects of alcohol and combines well with other medications.

The only drug in the group that does not have an adverse effect on the heart. It does not cause addiction, lethargy or drowsiness, which makes it possible to prescribe Loratadine (Claritin) to drivers. Available in the form of tablets and syrup for children.

Kestin

The drug is used to treat allergic rhinitis, conjunctivitis, and urticaria. The advantages of the drug include the absence of sedative effects, the rapid onset of the therapeutic effect and its duration, which lasts for 48 hours. The downsides are adverse reactions (insomnia, dry mouth, abdominal pain, weakness, headache).

Fenistil(drops, gel) – differs from 1st generation drugs in high antihistamine activity, duration therapeutic effects and less pronounced sedative effect.

Semprex– has a minimal sedative effect with pronounced antihistamine activity. Therapeutic effect it occurs quickly, but it is shorter-term compared to other drugs in this group.

3rd generation - list of the best drugs

3rd generation antihistamines act as active metabolites of second generation drugs, but unlike them they do not have a cardiotoxic effect and do not affect the functioning of the heart muscle. They have virtually no sedative effect, which allows the use of medications in persons whose activities are related to increased concentration attention.

Due to the absence of side effects and negative influence on the nervous system, these drugs are recommended for long-term treatment, for example, for seasonal exacerbations of long-term allergies. Drugs in this group are used in various age categories, convenient forms are produced for children (drops, syrup, suspension) to facilitate administration.

New generation antihistamines are distinguished by their speed and duration of action. The therapeutic effect occurs within 15 minutes after administration and lasts up to 48 hours.

Medicines allow you to cope with the symptoms of chronic allergies, year-round and seasonal rhinitis, conjunctivitis, bronchial asthma, urticaria, and dermatitis. They are used to relieve acute allergic reactions and are prescribed as part of complex treatment bronchial asthma, dermatological diseases, in particular psoriasis.

The most popular representatives of this group are the following drugs:

• Zyrtec (price from 150 to 250 rubles)
• Zodak (price from 110 to 130 rubles)
• Cetrin (from 150 to 200 rub.)
• Cetirizine (from 50 to 80 rub.)

Cetrin (Cetirizine)

This drug is rightfully considered the “gold standard” in the treatment of allergic manifestations. It is successfully used in adults and children to eliminate severe forms allergies and bronchial asthma.

Cetrin is used for the treatment and prevention of conjunctivitis, allergic rhinitis, skin itching, urticaria, angioedema. After a single dose, relief occurs within 15-20 minutes and continues throughout the day. With a course of use, addiction to the drug does not occur, and after cessation of therapy, the therapeutic effect persists for 3 days.

Zyrtec (Zodak)

The drug can not only alleviate the course of allergic reactions, but also prevent their occurrence. By reducing capillary permeability, it effectively eliminates swelling and relieves skin symptoms, relieves itching, allergic rhinitis, inflammation of the conjunctiva.

Taking Zyrtec (Zodak) allows you to stop attacks of bronchial asthma and prevent the development of serious complications (Quincke's edema, anaphylactic shock). At the same time, failure to comply with the dosage can lead to migraines, dizziness, and drowsiness.

4th generation antihistamines are the latest drugs that can have an immediate effect with no side effects. These are modern and safe means, the effect of which lasts for a long time, without in any way affecting the state of the cardiovascular and nervous system.

Despite the minimum side effects and contraindications, before you start taking it, you should consult your doctor, since medications latest generation have certain restrictions for use in children and are not recommended for use in pregnant and lactating women.

Add to list the latest drugs includes:

• Telfast (Fexofenadine) – price from 180 to 360 rubles.
• Erius (Desloratadine) – from 350 to 450 rubles.
• Xyzal (Levocetirizine) – from 140 to 240 rubles.

Telfast

It is highly effective against hay fever, urticaria, and prevents acute reactions (Quincke's edema). Due to the lack of sedative effect, it does not affect the speed of reactions and does not cause drowsiness. If the recommended dosage is followed, it has virtually no side effects; when taken in high doses, dizziness, headache, and nausea may occur. High efficiency and duration of action (more than 24 hours) allow you to take only 1 tablet of the drug per day.

Erius

The medicine is produced in the form of film-coated tablets and syrup intended for children over 12 months. The maximum therapeutic effect is achieved 30 minutes after taking the drug and continues for 24 hours.

Therefore, it is recommended to take only 1 Erius tablet per day. The dosage of syrup is determined by the doctor and depends on the age and weight of the child. The drug has virtually no contraindications (except during pregnancy and lactation) and does not affect concentration and the condition of vital systems of the body.

Xizal

The effect of using the medicine occurs within 10-15 minutes after administration and continues long time, therefore it is enough to take only 1 dose of medication per day.

The drug effectively eliminates swelling of the mucous membrane, itchy skin and rashes, prevents the development of acute allergic reactions. You can be treated with Xyzal for a long time (up to 18 months), it is not addictive and has virtually no side effects.

4th generation antihistamines have proven their effectiveness and safety in practice; they are becoming increasingly popular and are available to a wide range of consumers.

However, you should not self-medicate; before purchasing the medicine, you should consult a doctor who will select best option taking into account the severity of the disease and possible contraindications.

Children are much more susceptible to allergic diseases than adults. Antihistamines for children should be effective, have a milder effect and a minimum of contraindications. Must pick them up qualified specialist- an allergist, since many medications can cause unwanted side reactions.

A child’s body, with an immature immune system, may react acutely to taking the drug, so the child should be monitored by a doctor during the treatment period. For children, medications are produced in convenient dosage forms (in the form of syrup, drops, suspension), which facilitates dosage and does not cause disgust in the child when taken.

Suprastin, Fenistil will help to quickly relieve acute symptoms; for longer treatment, modern drugs Zyrtec or Ketotifen are usually used, which are approved for use from 6 one month old. Of the latest generation of drugs, the most popular is Erius, which in syrup form can be prescribed to children from 12 months. Medicines such as Claritin and Diazolin can be used from 2 years of age, but the latest generation drugs (Telfast and Xyzal) can only be used from 6 years of age.

The most common drug for treatment infants is Suprastin, the doctor prescribes it in the minimum dosage that can have a therapeutic effect and provide a slight sedative and hypnotic effect. Suprastin is completely safe not only for babies, but also for nursing mothers.

Of the more modern drugs, Zyrtec and Claritin are most often used to eliminate allergic manifestations in children. These medications last longer, so you can take one dose of the medication throughout the day.

Allergy medications during pregnancy

Antihistamines during pregnancy should not be taken in the first trimester. Subsequently, they are prescribed only according to indications and taken under the supervision of a doctor, since no medication is completely safe.

Medicines of the latest, 4th generation are absolutely contraindicated in any trimester of pregnancy and during breastfeeding. Among the most safe medicines for allergies during pregnancy include Claritin, Suprastin, Zyrtec.

It is a rare child who does not experience allergies to various pathogens; some already from birth react painfully to certain products, others - for cosmetics or flowering plants, but thanks to new generation medications - antihistamines for children, serious complications can be avoided. If you take timely measures to eliminate childhood allergies, then acute processes will not turn into a state of chronic illnesses.

What are antihistamines

A group of modern medications that suppress the action of histamine (a neurotransmitter) are called antihistamines. When the body is exposed to an allergen, a mediator or an organic compound, histamine begins to be released from connective tissue cells that are part of the immune system. When a neurotransmitter interacts with specific receptors? Swelling, itching, rash and other manifestations of allergies often occur. Antihistamines are responsible for blocking these receptors. Today there are four generations of these drugs.

Antiallergic drugs do not completely cure the disease. They do not particularly affect the cause of allergies, but only help to cope with unpleasant symptoms. Such medications can be prescribed to patients of any age, even one-year-olds and infants. Antihistamines are prodrugs. This means that when they enter the body, they begin to be converted into active metabolites. Important property these funds are considered complete absence cardiotoxic effect.

Indications for use

When teething, before vaccination to neutralize possible allergic reaction special antiallergic medications can be used medications. Besides, indications for the use of such drugs are:

• hay fever (hay fever);
• Quincke's edema;
• year-round, seasonal allergic reactions (conjunctivitis, rhinitis);
• skin itching in infectious chronic diseases;
• previously observed complex manifestations of allergies or symptoms of anaphylactic shock;
• atopic dermatitis, eczema, dermatosis, urticaria and other skin rashes;
• individual predisposition to allergies;
• deterioration of the child's condition chronic illnesses respiratory tract(laryngitis, laryngeal stenosis, allergic cough);
• high level of eosinophils in the blood;
• insect bites;
• swelling of the nasal mucosa, oral cavity;
• acute manifestations of allergies to drugs.

Classification

Antiallergic medications depending on the characteristics chemical composition can be divided into groups:

• piperidine derivatives;
• alkylamines;
• alphacarboline derivatives;
• ethylenediamines;
• phenothiazine derivatives;
• piperazine derivatives;
• ethanolamines;
• quinuclidine derivatives.

Modern medicine offers great amount classifications of antiallergic drugs, but none of them is generally accepted. More wide application V clinical practice received a classification of medications according to the time of their creation or according to generations, of which there are currently 4: 1 - sedatives, 2nd generation - non-sedative, 3rd and 4th - metabolites.

Generations of antihistamines

The very first antiallergic drugs appeared back in the 30s of the 20th century - these were 1st generation drugs. Science is constantly moving forward, so over time, similar means second, 3rd and 4th generations. With the advent of each new drug, the strength and number of side effects decrease, and the duration of exposure increases. Below is a table of 4 generations of antiallergic drugs:

Antiallergic drugs for children

The choice of antihistamines should be made by a doctor. Self-medication will only aggravate the emerging allergic reaction and cause undesirable consequences. Parents often use creams to provide first aid. They can be smeared when a reaction to the vaccine occurs. Other forms: drops, tablets, syrup, suspension should be used after consulting a specialist. The pediatrician will select the dosage taking into account the severity of the allergy and the age of the baby.

Up to a year

Usually, Pediatricians prescribe new generation medications for infants, since the second and first are capable of causing side effects: headache, drowsiness, suppression of activity, respiratory depression. Doctors often do not recommend taking antihistamines for children, but sometimes in acute situations they are simply necessary. The most the best means for young patients are:

• Suprastin solution. Used to treat runny nose, urticaria, acute allergic dermatitis. It relieves itching well and speeds up the process of getting rid of skin rashes. Approved for the treatment of infants (from the age of 30 days). The pediatric dose is one fourth of an ampoule 2 times a day. Rarely, the medicine can cause nausea, bowel dysfunction, and dyspepsia. Suprastin is dangerous when taking more than one ampoule.
• Fenistil drops. A popular allergy remedy for children is used to treat rubella and chickenpox. In addition, it is often drunk for contact dermatitis, sunburn, insect bites. Antihistamine drops for children, Fenistil can cause drowsiness at the very beginning of treatment, but after a few days this effect disappears. The medicine has side effects: dizziness, muscle spasms, swelling of the oral mucosa. Children under one year of age are prescribed 10 drops per day once, but not more than 30.

From 2 to 5 years

As the child grows up, the range of medications expands, although many well-known drugs are still contraindicated, for example, Suprastin and Claritin tablets, Azelastine drops. The most popular medications used from 2 to 5 years are:

• Cetrin drops. Used when food allergies, for the treatment of conjunctivitis and rhinitis. The advantage of using the medicine is its long-lasting effect. The drops need to be taken only once a day. Side effects: anticholinergic effects, drowsiness, headache.
• Erius. This allergy syrup for children is one of the most popular. It belongs to the 3rd generation drugs. Helps dock allergic symptoms and ease general state patient. Not addictive. Erius syrup is useful for rhinitis, hay fever, allergic conjunctivitis, and urticaria. Side effects: nausea, headache, diathesis, diarrhea.

From 6 years and older

As a rule, starting from the age of 6, a specialist can prescribe 2nd generation antihistamines for children. A child at this age is already able to take the tablet form, so allergists often prescribe Suprastin in tablets. For allergic rhinitis and conjunctivitis, Allergodil drops are used. Besides, Patients over 6 years of age can take:

• Tavegil. Recommended for hay fever, dermatitis, allergic insect bites. Among antiallergic drugs, Tavegil is considered the safest. Therapy for children from 6 to 12 years of age involves next appointment means - half a capsule in the morning and evening. The tablets should be taken regularly before meals, preferably at the same time. They should be taken with caution by patients with glaucoma, because... Tavegil causes deterioration in the clarity of perception of visual images.
• Zyrtec. These non-hormonal tablets have anti-inflammatory and anti-exudative effects. The advantage of using the medicine is its use within combination treatment bronchial asthma. Children over 6 years old can take half a tablet 2 times a day. Side effects: itching, rash, malaise, asthenia.

Which antihistamines are best for a child?

Unstable children's immunity often contributes to the occurrence of allergic reactions. Modern antihistamines for children help cope with negative symptoms. Many pharmaceutical companies They produce antiallergic medications in children's dosages in the form of syrup, drops, and suspension. This makes it easier to take and does not cause the baby to have an aversion to treatment. Often to eliminate local inflammation Your doctor may prescribe an antihistamine in the form of a gel or cream. They are used externally for allergic skin reactions to insect bites.

Usually, antihistamines for newborns are allowed to be given in the form of syrup or oral drops, and they should not use old generation (1st) products due to sedation and high toxicity. The dosage of medications also depends on the severity of symptoms and the patient’s body weight. For children over one year of age, 3rd generation antiallergic drugs are recommended. For older children, tablets are more suitable. It is also possible to use anti-allergenic local funds: nasal sprays, eye drops, gels, creams, ointments.

Pills

The most common form of antiallergenic drugs is tablets. A child can take them only from the age of 3, but often at this age the child is not yet able to swallow the medicine. Therefore, you can give crushed tablets, diluting them with water. Popular tablet drugs are:

• Loratadine. Second generation medicine. Helps quickly eliminate unpleasant symptoms for allergic rhinitis, reactions to pollen and flowering plants. Used in the treatment of urticaria and bronchial asthma. Children over two years of age are recommended to take a single dose of 5 mg. Teenagers – 10 mg. Side effects: fever, blurred vision, chills.
• Diazolin. Helps with allergic seasonal runny nose and cough. It can be prescribed during chickenpox, urticaria, and conjunctivitis caused by pollen. The maximum daily dose of Diazolin for patients aged 2 to 5 years is 150 mg. It is not recommended to take pills if you have heart problems.

Drops

This form is convenient for use in small children; it is easily dosed using a special bottle. As a rule, doctors try to prescribe antihistamines in drops for newborns. The most by known means are considered:

• Zodak. The product has an antiexudative, antipruritic, antiallergic effect, prevents further development diseases. The effect of the medicine begins within 20 minutes after administration and lasts throughout the day. Dosage for children over one year of age: 2 times a day, 5 drops. Rarely, when using drops, nausea and dry mouth occur. Patients with liver diseases should drink them with caution.
• Fenkarol. The drug relieves spasms, reduces suffocation, and quickly extinguishes the negative manifestations of allergies. It is recommended to give 5 drops 2 times a day to patients under three years of age. Fenkarol is prescribed for chronic and acute hay fever, urticaria, dermatosis (psoriasis, eczema). Side effects: headache, nausea, dry mouth.

Syrups

Most antihistamines for children come in tablets, but some have alternative views in the form of syrups. Most of them have age restrictions of up to two years. The most popular antihistamine syrups are:

• Claritin. Has a long-lasting antiallergic effect. The product is suitable for eliminating acute symptoms, preventing severe relapses. After oral administration, the medicine will begin to act within 30 minutes. Claritin is prescribed for seasonal or year-round rhinitis, allergic conjunctivitis. Rarely, drowsiness and headache may occur while taking the medicine.
• Gismanal. The drug is prescribed for allergic skin reactions, for the treatment and prevention of angioedema. Doses of the drug: patients over 6 years old - 5 mg once a day, younger than this age - 2 mg per 10 kg. Rarely, the medication may cause nausea, headache and dry mouth.

Ointments

Antiallergic children's ointments are large group medicines intended for local use. Antihistamine ointments are applied to the affected area of ​​skin manifestations of allergies. The most famous are:

• Bepanten. An ointment that stimulates tissue regeneration. Used to care for babies skin irritations, diaper dermatitis, to relieve dry skin. Rarely Bepanten at long-term treatment causes itching and hives.
• Gistan. Non-hormonal antihistamine cream. It contains components such as string extract, violets, and calendula. This topical medication is used for allergic skin reactions and as a topical anti-inflammatory agent for atopic dermatitis. Contraindications: the ointment should not be used by children under one year of age.

Overdose of antihistamines in children

Abuse, improper use or long-term therapy with antiallergic drugs can lead to their overdose, which often manifests itself in the form of increased side effects. They only wear temporary nature and disappear after the patient stops taking the medicine or is prescribed permissible dose. Usually, Children with an overdose may experience:

• severe drowsiness;
• excessive stimulation of the central nervous system;
• dizziness;
• hallucinations;
• tachycardia;
• excited state;
• fever;
• convulsions;
• renal dysfunction;
• dry mucous membranes;
• pupil dilation.

Price of antihistamines for children

Any antiallergic medications and their analogues can be purchased at a pharmacy without a prescription or ordered online. Their cost depends on the manufacturer, dosage, release form, pricing policy pharmacy and sales region. Approximate prices for antiallergic medications in Moscow are presented in the table:

Allergic reactions are a common occurrence, especially in children; antihistamines for children help combat this problem. Timely intake of these medications will help eliminate allergy symptoms and avoid serious illnesses (bronchial, edema, atypical, etc.). In some cases, prophylactic medication is indicated. For example, to avoid seasonal allergies, you need to start taking the medicine about a week before trees and plants bloom. Then the allergy will not manifest itself in any way.

How does an allergy occur?

To understand how antihistamines work, you need to know how exactly an allergic reaction occurs. The human immune system produces histamine, a special substance that normally does not manifest itself in any way. Under the influence of certain factors, histamine is activated, and its amount increases noticeably. This substance acts on special receptors that cause various reactions– tearfulness, runny nose, swelling of the mucous membranes, difficulty breathing, skin reactions. In this case, the causative agent of the allergy is not dangerous to the body, but the immune system trying to fight him. In addition to the usual manifestations of allergies, histamine can cause the following conditions in babies:

• Gastrointestinal disorders - vomiting, nausea, indigestion, colic;
• pathological changes in internal organs with smooth muscles;
• disturbances in the functioning of the heart and changes in vascular tone - decreased arterial blood pressure, etc.;
• non-standard skin reaction, manifested in the form of blisters, swelling of the skin, itching, peeling, etc.

It is important to know that antihistamines do not cure allergies or stop exposure to the allergen, they only fight the symptoms. Allergies cannot be cured at all, as this disease is caused by humans.

Features of antihistamines for children and when to take them

Due to instability, children are more likely to suffer from allergic reactions than adults, but their body can react very sharply and unpredictably to the medicine. For this reason, children can be given drugs with minimum quantity side effects, soft action and enough high efficiency. Many companies produce anti-allergy medications in pediatric dosages in drops, syrup or suspension. This makes it easier to take the drug and does not cause an aversion to treatment in the child. Also, in most cases, you can use antihistamines in gel form. They are used externally from birth if there is an allergic skin reaction (for example, to an insect bite).

Antihistamines of the 4th generation are distinguished by their effectiveness and prolonged action, but they should not be given to children under 6 years of age, as intoxication and disruption of the functioning of internal organs are possible.

Many of the best new generation drugs fight not only allergies, but also have additional pharmacological properties, therefore their application varies. Most old and time-tested drugs have a sedative effect, which is important if a sick baby is anxious and cannot fall asleep for a long time. Also, many antiallergic drugs enhance the effect of concomitant medications, so they are often taken together with antipyretic drugs for colds, runny nose, and chickenpox in children. Also, antihistamines are often used before vaccination to reduce stress on the body and avoid an allergic reaction to the vaccine.

Important: You need to choose a drug for your baby together with your doctor. If this is not possible, and the child needs to be treated for allergies as soon as possible, then it is important to take into account the symptoms, the cause of the allergy and the age of the child, as advised by Dr. Komarovsky.

First generation antihistamines

These remedies, despite their “advanced” age, are considered the best in cases where allergies are accompanied by a cold, the child is ill chicken pox. Experiences severe anxiety and overexcitement due to illness. The best drugs in this category include:

• Diphenhydramine. In the form of an injection, it is allowed for children from 7 months (0.5 ml per day), from 1 year to 3 years - 1 ml per day. Diphenhydramine tablets are safe for children up to 12 months at a dosage of 2 mg per day, up to 5 years - 5 mg per day, up to 12 years - 20 mg per day. This medicine has a strong sedative and analgesic effect, it fights well against skin manifestations of allergies, but it is better not to use it for swelling of the mucous membranes of the nasopharynx and bronchospasm.
• Psilo-balm. Ointment for external use based on Diphenhydramine, which can be used for allergies in babies up to one year old. A small amount of ointment is applied to the affected area and rubbed thoroughly.
• Diazolin. A drug with analgesic and sedative effects that can be given to children from two years of age. Effective for laryngospasms and severe swelling. Daily dose for children 2 years old is 50-100 mg, for children from 5 to 10 years old - 100-200 mg.
• Tavegil (Clemastine). Effective for allergies that have skin manifestations. In tablet form, it is allowed for children from 6 years of age. From 6 to 12 years of age, the daily dose should be 0.5 - 1 tablet, which is taken either before bed or during breakfast. From 1 year you can also use Tavegil syrup, which is taken 2 times a day - in the morning and before bed in the dosage specified in the instructions.
• Fenkarol. The drug is used for laryngospasms, allergies, and all skin manifestations allergies. The product is powerful, but toxic, so it should not be given to children under 3 years of age. The exception is Fenkarol in powder 5 mg, which can be taken 2-3 times a day.

First-generation antihistamines, when taken for a long time, need to be replaced every 2 weeks, as they are addictive, as a result of which their effectiveness decreases. The price of such drugs is usually very low.

Second generation antihistamines

This generation of drugs does not cause drowsiness in adults, but children may experience a pronounced sedative effect. Therefore, if the allergy is not too severe, it is best to give the drug to the baby before bedtime. List the best drugs, suitable for children, is given below.

• Zodak. Effective medicine, which has proven itself in the treatment of seasonal allergies, urticaria, rhinitis, allergic. Available in tablets, drops and syrup. Children over 1 year old are given 5 drops twice a day, and children over 6 years old – 0.5 tablets. The syrup can be taken by children over 2 years old, 1 spoon once a day. This dose can be divided into two and taken in the morning and before bed.
• Cetrin. This drug is similar in its action to Zodak, it must be taken in the same way.
• Fenistil. The product, which is suitable for infants from 1 month, is available in drops. Effective in combating seasonal allergies, urticaria, it can be given to a child before vaccination. Fenistil can also be taken by mothers of infants during lactation. The drug practically does not cause drowsiness or addiction. Fenistil, produced in the form of a gel, can also be used externally for children from 1 month.

Important! Allergy treatment for newborns should be selected together with a doctor, since even the most harmless drugs may be dangerous for a child of this age.

Third generation antihistamines

These are metabolite drugs that do not have a sedative effect. They are not addictive and last much longer than their predecessors (up to 3 days).

Telfast (Fexofast). This is one of the few 3rd generation antihistamines that does not cause side effects in children. It can be taken by children from 5 years old (up to 60 mg). Children over 12 years old can take 120-180 mg. Telfast is usually taken once at skin allergies and very quickly eliminates allergy symptoms. This strong drug, which Dr. Komarovsky advises to use only in extreme cases. In some cases, it is prescribed before vaccination.

Fourth generation antihistamines

The latest generation of drugs are characterized by almost instantaneous action and versatility. In addition, they can be taken every few days for a long time. The list of the best of them, judging by the reviews, is given below:

• Erius. In the form of syrup, you can give children from one year old 2.5 ml per day, from 6 to 12 years old - 5 ml per day. Erius tablets can be taken from 12 years of age, preferably only once.
• Xizal (Glenset). basis this drug is levocetrizine. It can be prescribed to children over 6 years old, 5 mg once.

The disadvantage of the newest drugs is that they are all released at adult dosage, so there is a high chance that the child will experience side effects.

Which antihistamines are suitable for children of different ages?

Absolutely not safe drugs for newborns and during breastfeeding, but in critical cases it is recommended to take the following medications:

• Fenkarol;
• Fenistil;
• Tavegil;
• Donormil;
• Clemastine;
• Diphenhydramine;
• Bravegil.

Nursing mothers can take Zyrtec once, as it is very effective and has a long-lasting effect.

For children from three to five years old, the following drugs are good:

• Erus;
• Claritin;
• Cetrin;
• Diazolin;

All these drugs can be taken 1 tablet per day. Their price is quite high, so it makes sense to pay attention to cheaper analogues:

• Zodal;
• Litesin;
• Zetrinal;
• Cetrinax.

After 6 years, children are often prescribed new drugs:

• Clemastine;
• Zyrtec;
• Terfenadine.

If the child's condition worsens or new symptoms appear after taking the drug, you must immediately stop taking the medication. In case of severe swelling, you should immediately call an ambulance.

Allergic reactions are divided into immediate, developing immediately after exposure to the antigen, and delayed, appearing after several days or even weeks. For immediate allergies, antihistamines are most effective. The principle of their action is based on blocking free histamine, which is released in the body in response to a physical or chemical irritant. Having a structure similar to a biogenic amine, the active substance blocks histamine receptors, preventing the amine itself from performing the functions of a mediator of allergic reactions.

There are three generations of antihistamines. Designed in different time, they differ in their selectivity of action. Each of the subsequent pharmaceutical lines is more selective, that is, the active substance of the drug binds predominantly to one type of receptor. This increases the safety of the drug and reduces the risk of side effects.

The first generation was created in 1936, its representatives are Diphenhydramine, Diazolin, Tavegil, Suprastin, Fenkarol. They demonstrate good results as histamine blockers: eliminate allergic manifestations in the form of rash, swelling, itching. However, all these drugs have a short-term effect (3 - 4 hours), and when long-term use reduce their activity and also give quite a lot of side effects:

• due to low selectivity they have unwanted effect on cellular structures many organs, and therefore are contraindicated in peptic ulcer, renal, hepatic and cardiovascular pathologies, glaucoma, epilepsy;
• being anticholinergics, they can cause dysfunction of the central nervous system, headache, dizziness, drop in blood pressure;
• reduce muscle tone;
• have a hypnotic effect;
• cause an increase in body weight.

Important information!

Due to the pronounced sedative effect of first-generation antihistamines, if they are used, drive or perform other work that requires increased attention or a rapid reaction, it is possible only 12 hours after taking the medicine.

Second generation drugs - Hexal, Clarisens, Kestin, Claritin, Clarotadine, Lomilan, Zirtec, Rupafin and others - appeared in the 80s of the last century. They act more selectively, affecting mainly histamine receptors, and therefore have fewer side effects.

Another advantage is the lack of addiction and the duration of action is up to 24 hours. This allows you to take the medicine once a day and not increase the dose during long-term use. However, due to the cardiotoxic effect, when taking most of these drugs, constant monitoring of cardiac activity is required, and in patients with serious cardiovascular pathologies, 2nd generation antihistamines are contraindicated.

IN last years To treat all types of allergies, drugs are successfully used whose active ingredients belong to the category of prodrugs, that is, they are converted into pharmacologically active compounds in the body as a result of metabolic processes. The effectiveness of these products is several times higher than that of their predecessors. They also have high selectivity, and therefore do not produce either sedative or cardiotoxic effects, and, therefore, are the safest.

The list of new generation antihistamines is still relatively small, but they all have a common advantage: they can be taken for diseases of the heart, gastrointestinal tract, kidney and liver pathologies, as well as for people whose work requires a high concentration of attention. Some of the drugs in this group are not contraindicated during pregnancy and childhood.

Comparative characteristics of 3rd generation drugs

Indications for the use of this category of drugs are:

• food allergies;
• seasonal and chronic allergic conjunctivitis and rhinitis;
• hives;
• exudative diathesis;
• contact and atopic dermatitis.

Drugs with the same active ingredient can be produced under different names trademarks(these are so-called synonymous drugs).

Allegra

It is also produced under the names Fexadin, Fexofenadine, Telfast, Fexofast, Tigofast. The active ingredient is fexofenadine hydrochloride. Release form: film-coated tablets of 120 and 180 mg.

The initial effect is produced an hour after administration, the maximum concentration in the blood is reached after 3 hours, the half-life is about 12 hours, the duration of action is a day. A single dose is 180 mg, the course of treatment is determined individually. Because the clinical researches the effect of fexofenadine on the fetus and children's body have not been carried out, during pregnancy, children under 12 years of age and breastfeeding women, it is prescribed only in cases of special need.

The cost of a drug depends on the content of the main substance and the manufacturer. For example, 10 tablets of 120 mg of Fexadine Ranbaxy (India) cost 220 rubles, the same package of Allegra from Sanofi-Aventis (France) costs 550 rubles, and 10 tablets of 180 mg of Telfast Sanofi-Aventis cost 530 rubles.

Cetirizine

Other trade names: Cetrin, Cetrinal, Parlazin, Zodak, Amertil, Allertek, Zirtec. A substance that is active against histamine is cetirizine dihydrochloride. Available in tablets containing active substance 10 mg, as well as in the form of drops, solutions and syrup.

The initial effect is observed 1 - 1.5 hours after administration, the total duration of action is up to 24 hours, metabolites are excreted within 10-15 hours in the urine. Single (and daily) dose of 10 mg. Medicine is not addictive and can be used for long-term therapy. It is not recommended for children under 1 year of age and pregnant women to take it.

Approximate cost of cetirizine and its analogues:

• Cetirizine, manufacturer Vertex, Russia (10 tablets) – 66 rubles;
• Tsetrin, manufacturer Dr. Reddy, India (20 tables) – 160 rubles;
• Zodak, manufacturer Zentiva, Czech Republic (10 tablets) – 140 rubles;
• Zirtek, manufacturer USB Farshim, Belgium (drops in 10 ml bottles) – 320 rubles.

Xizal

Synonyms: Suprastinex, Levocetirizine, Glencet, Zilola, Alerzin. Active ingredient: Levocetirizine dihydrochloride. The medicine is available in 5 mg tablets and drops, dosage form for children - syrup.

The affinity for histamine receptors of this drug is several times higher than that of other representatives of this series, so its effect lasts for 2 days. Metabolic products are excreted by the kidneys, the half-life is 8 – 10 hours. The daily dose for adults and children over 6 years of age is 5 mg. Congenital disorders of carbohydrate metabolism are contraindications to the use of levocetirizine.

Estimated cost of drugs:

• Xyzal, manufacturer YUSB Farshim, Belgium (drops in 10 ml bottles) – 440 rubles;
• Levocetirizine, manufacturer Teva, France (10 tablets) – 270 rubles;
• Alerzin, manufacturer Eric, Hungary (14 tables) –300 rubles;
• Suprastinex, manufacturer Eric, Hungary (7 tables) – 150 rubles.

Desloratadine

Other trade names: Erius, Dezal, Allergostop, Fribris, Alersis, Lordestin. The bioactive substance is desloratadine. Release forms: film-coated tablets of 5 mg, solution containing active substance 5 mg/ml and syrup.

The maximum concentration in the blood is observed after 3–4 hours, the half-life is 20–30 hours, the total duration of action is 24 hours. A single dose for adults and children over 12 years of age is 5 mg; the dosage for children from 2 to 12 years of age is determined individually. For pregnant and lactating women, the drug is prescribed for life-threatening conditions.

Cost of desloratadine and its synonyms:

• Desloratadine, manufacturer Vertex, Russia (10 tablets) – 145 rubles;
• Lordestin, Bayer, USA, manufacturer Gedeon Richter, Hungary (10 tablets) – 340 rubles;
• Erius, manufacturer Bayer, USA (7 tablets) – 90 rubles.

All antiallergic drugs are prescribed by a doctor, taking into account the specifics of their action, the causes of allergies, the age and characteristics of the patient’s body. When taking antihistamines, you should strictly adhere to the rules specified in the instructions.