Risk of first-generation H1-antihistamines: a GA2LEN position paper
Church, M.K., Maurer M, K., Simons, F.E.R., Bindslev-Jensen, C., van Cauwenberge, P., Bousquet, J., Holgate, S.T. and Zuberbier, T. (2010) Risk of first-generation H1-antihistamines: a GA2LEN position paper. Allergy, 65, (4), 459-466. (doi:10.1111/j.1398-9995.2009.02325.x). (PMID:20146728).
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Description/Abstract
Background: First-generation H1-antihistamines obtained without prescription are the most frequent form of self-medication for allergic diseases, coughs and colds and insomnia even though they have potentially dangerous unwanted effects which are not recognized by the general public.
Aims: To increase consumer protection by bringing to the attention of regulatory authorities, physicians and the general public the potential dangers of the indiscriminate use first-generation H1-antihistamines purchased over-the counter in the absence of appropriate medical supervision.
Methods: A GA2LEN (Global Allergy and Asthma European Network) task force assessed the unwanted side-effects and potential dangers of first-generation H1-antihistamines by reviewing the literature (Medline and Embase) and performing a media audit of US coverage from 1996 to 2008 of accidents and fatal adverse events in which these drugs were implicated.
Results: First-generation H1-antihistamines, all of which are sedating, are generally regarded as safe by laypersons and healthcare professionals because of their long-standing use. However, they reduce rapid eye movement (REM)-sleep, impair learning and reduce work efficiency. They are implicated in civil aviation, motor vehicle and boating accidents, deaths as a result of accidental or intentional overdosing in infants and young children and suicide in teenagers and adults. Some exhibit cardiotoxicity in overdose.
Conclusions: This review raises the issue of better consumer protection by recommending that older first-generation H1-antihistamines should no longer be available over-the-counter as prescription- free drugs for self-medication of allergic and other diseases now that newer second- generation nonsedating H1-antihistamines with superior risk/benefit ratios are widely available at competitive prices.
| Item Type: | Article |
|---|---|
| ISSNs: | 0105-4538 (print) 1398-9995 (electronic) |
| Keywords: | adverse event, allergic rhinitis, cognitive function, sedation |
| Subjects: | Q Science > QR Microbiology > QR180 Immunology R Medicine > RM Therapeutics. Pharmacology R Medicine > RS Pharmacy and materia medica |
| Divisions: | University Structure - Pre August 2011 > School of Medicine |
| Item ID: | 79613 |
| Date Deposited: | 17 Mar 2010 |
| Last Modified: | 18 Jun 2012 11:28 |
| Contributors: | Church, M.K. (Author) Maurer M, K. (Author) Simons, F.E.R. (Author) Bindslev-Jensen, C. (Author) van Cauwenberge, P. (Author) Bousquet, J. (Author) Holgate, S.T. (Author) Zuberbier, T. (Author) |
| Date: | April 2010 |
| Status: | Published |
| URI: | http://eprints.soton.ac.uk/id/eprint/79613 |
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