Pharmacology of non sedating antihistamines

Avoiding trigger factors is the first step in the management of allergic rhinitis but some triggers can be difficult to avoid.

Oral antihistamines can be used for allergic conjunctivitis or, if the symptoms are only related to the eye, topical antihistamines with or without mast cell stabilisers are recommended.Cetirizine is eliminated in the urine, while fexofenadine is excreted in the faeces.Dose reduction should be considered in patients with severe liver or kidney dysfunction.They are particularly useful for nasal itchiness, sneezing and rhinorrhoea, but are less effective for nasal obstruction.Oral antihistamines also have the benefit of treating associated conjunctival symptoms.

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