New DrugsLoratadine versus cetirizine: Assessment of somnolence and motivation during the workday
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Unintentional cetirizine overdose causing anticholinergic syndrome
2022, American Journal of Emergency MedicineCitation Excerpt :One study examined the difference in first versus second generation antihistamines using positron emission tomography (PET) scanning, demonstrating that at recommended medication dosing first generation antihistamines occupied >70% of central histamine (H1) receptors, while second generation antihistamines only occupied 20–30% of receptors. [4] However, recent studies have demonstrated not only that drowsiness and fatigue occur more frequently with cetirizine than with placebo, but also that cetirizine is more sedating than levocetirizine (a third generation antihistamine). [5-11] While effects can be dose related, a large ingestion is not necessary to experience adverse effect(s).
Pharmacology of Antihistamines
2011, World Allergy Organization JournalCitation Excerpt :For example, positron emission tomography scanning of the human brain has shown that single oral doses of 10 and 20 mg of cetirizine caused 12.5 and 25.2% occupancy of the H1-receptors in prefrontal and cingulate cortices, respectively55. These results would explain the repeated clinical findings that the incidence of drowsiness or fatigue is greater with cetirizine than with placebo56–59. Recent publications have suggested that, at manufacturer's recommended doses, levocetirizine is less sedating than cetirizine60 and desloratadine causes negligible somnolence49, 61.
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2018, Journal of Allergy and Clinical Immunology: In PracticeManagement of Pediatric Urticaria with Review of the Literature on Chronic Spontaneous Urticaria in Children
2018, Journal of Allergy and Clinical Immunology: In PracticeCitation Excerpt :However, the efficacy of these dose escalations was not established in children although they are suggested to be applicable in children on the basis of extrapolated data from rhinitis studies.81 Studies suggest that in teenagers and adults, cetirizine use may promote somnolence and decrease motivation to perform activities during the workday compared with loratadine even at recommended doses.82,83 Hence, we suggest using other second-generation antihistamines at higher than normal doses (eg, desloratadine or bilastine in children 12 years and older).
A strong quintet. 2nd generation antihistamines: Many similarities, but also relevant differences
2023, Deutsche Apotheker ZeitungAn international Delphi study on the burden of allergic rhinoconjunctivitis and urticaria and the role of bilastine among current treatment options
2023, Expert Review of Clinical Immunology