Risk of first-generation H1-antihistamines: a GA2LEN position paper
Risk of first-generation H1-antihistamines: a GA2LEN position paper
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.
adverse event, allergic rhinitis, cognitive function, sedation
459-466
Church, M.K.
dad189d5-866e-4ae1-b005-0d87f74282b8
Maurer M, K.
576c639b-82b0-40eb-ac2c-fca9eb05d2e3
Simons, F.E.R.
7af30030-8a44-4f61-93c2-23beecf1420c
Bindslev-Jensen, C.
60da3e9e-2946-4278-8440-a40dd3420eb3
van Cauwenberge, P.
800bb475-4de8-4418-bb96-1ceeac684425
Bousquet, J.
fda25127-be6f-45cd-a455-883cc90d8e0e
Holgate, S.T.
2e7c17a9-6796-436e-8772-1fe6d2ac5edc
Zuberbier, T.
bc707651-5e30-4172-8932-41c003022241
April 2010
Church, M.K.
dad189d5-866e-4ae1-b005-0d87f74282b8
Maurer M, K.
576c639b-82b0-40eb-ac2c-fca9eb05d2e3
Simons, F.E.R.
7af30030-8a44-4f61-93c2-23beecf1420c
Bindslev-Jensen, C.
60da3e9e-2946-4278-8440-a40dd3420eb3
van Cauwenberge, P.
800bb475-4de8-4418-bb96-1ceeac684425
Bousquet, J.
fda25127-be6f-45cd-a455-883cc90d8e0e
Holgate, S.T.
2e7c17a9-6796-436e-8772-1fe6d2ac5edc
Zuberbier, T.
bc707651-5e30-4172-8932-41c003022241
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), .
(doi:10.1111/j.1398-9995.2009.02325.x).
(PMID:20146728)
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.
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e-pub ahead of print date: 8 February 2010
Published date: April 2010
Keywords:
adverse event, allergic rhinitis, cognitive function, sedation
Identifiers
Local EPrints ID: 79613
URI: http://eprints.soton.ac.uk/id/eprint/79613
ISSN: 0105-4538
PURE UUID: 8227a8d8-8f43-4db2-b590-55a0d7693628
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Date deposited: 17 Mar 2010
Last modified: 14 Mar 2024 00:32
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Author:
M.K. Church
Author:
K. Maurer M
Author:
F.E.R. Simons
Author:
C. Bindslev-Jensen
Author:
P. van Cauwenberge
Author:
J. Bousquet
Author:
T. Zuberbier
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