Antihistamines

[jskinner]

I know this has been discussed before but I can't seem to find it. I have trouble with antihistamines making me kind of jumpy and irritable the next day. What are the different types of antihistamines and are there any that won't give me this side effect?

thanks, james
(still fighting my nasal congestion/sinus issues)

[curtcurt46]

Have you tried Astelin Nose Spray. It's a nasal antihistamine and I have had good luck with it and no side effects that I can tell.

[bookwrm63]

I see it's by prescription only. If you go to the website http://www.astelin.com, there is a $10.00 off coupon. I'll have to ask my doctor about it. Anthing to help my congestion issues without rebound would be great!

[Yoga]

James,

Astelin Spray, as Curt said is excellent.

What antihistimine caused you a problem?

Actifed made me very jittery.

Claritin works well for me without side effects.

[jules]

I think you need to watch and see if the med is more than just an antihistimine but if it also has decongestants in it.

For example Actifed was mentioned. That contains a decongestant too (the old sudafed which has made a lot of people jittery over the years and can also be used to make meth).

Claritan (no D) is just an antihistimine.

[Snoredog]

Claritin/Loratadine 10mg (without the D) also works for me, but I buy the generic OTC stuff called ALLERCLEAR from Costco and save some money.

I can get a bottle of 300 tabs from Costco for like $12-$14 bucks (10 month's supply) compared to a month's supply of the higher priced Claritin.

[drbandage]

I know this has been discussed before but I can't seem to find it. I have trouble with antihistamines making me kind of jumpy and irritable the next day. What are the different types of antihistamines and are there any that won't give me this side effect?

thanks, james
(still fighting my nasal congestion/sinus issues)

Hi James -
The following information is liberally borrowed and lightly edited from the website of the American Academy of Otolaryngology. There is a part in there that gets to the issue of "jittery". Hope this helps.

Antihistamines, Decongestants, and "Cold Remedies"

Drugs in these categories are useful for relief of symptoms from allergies, upper respiratory infections. These drugs do not cure the allergies, infections, etc.; they only relieve the symptoms, thereby making the patient more comfortable.

Antihistamines
Histamine is an important body chemical that is responsible for the congestion, sneezing, and runny nose that a patient suffers with an allergic attack or an infection. Antihistamine drugs block the action of histamine, therefore reducing the allergy symptoms. For the best result, antihistamines should be taken before allergic symptoms get well established.
The most annoying side effect that antihistamines produce is drowsiness. Though desirable at bedtime, it is a nuisance to many people who need to use antihistamines in the daytime. To some people, it is even hazardous. These drugs are not recommended for daytime use for people who may be driving an automobile or operating equipment that could be dangerous. Newer non-sedating antihistamines, available by prescription only, do not have this effect. The first few doses cause the most sleepiness; subsequent doses are usually less troublesome.

Typical antihistamines include Allegra®, Benadryl®, Chlor-Trimetron,®, Claritin®, Clarinex®, Teldrin®, Zyrtec,® etc.

Decongestants
Congestion in the nose, sinuses, and chest is due to swollen, expanded, or dilated blood vessels in the membranes of the nose and air passages. These membranes have an abundant supply of blood vessels with a great capacity for expansion (swelling and congestion). Histamine stimulates these blood vessels to expand as described previously.
Decongestants, on the other hand, cause constriction or tightening of the blood vessels in those membranes, which then forces much of the blood out of the membranes so that they shrink, and the air passages open up again.
Decongestants are chemically related to adrenalin, the natural decongestant, which is also a type of stimulant. Therefore, the side effect of decongestants is a jittery or nervous feeling. They can cause difficulty in going to sleep, and they can elevate blood pressure and pulse rate. Decongestants should not be used by a patient who has an irregular heart rhythm (pulse), high blood pressure, heart disease, or glaucoma. Some patients taking decongestants experience difficulty with urination. Furthermore, decongestants are often used as ingredients in diet pills. To avoid excessively stimulating effects, patients taking diet pills should not take decongestants.

Typical decongestants are phenylephrine (Neo-Synephrine®*), and pseudoephedrine (Sudafed®, etc.)

Combination Remedies
Theoretically, if the side effects could be properly balanced, the sleepiness sometimes caused by antihistamines could be cancelled by the stimulation of decongestants.
Numerous combinations of antihistamines with decongestants are available: Actifed,®* Allegra-D,® Chlor-Trimeton D,®* Claritin D,® Contac,®* Co-Pyronil 2,®* Deconamine,® Demazin,®* Dimetapp,®* Drixoral,®* Isoclor,®* Nolamine,® Novafed A,® Ornade,® Sudafed Plus,® Tavist D,®* Triaminic,®* and Trinalin,® to name just a few.

A patient may find one preparation quite helpful for several months or years but may need to switch to another one when the first loses its effectiveness. Since no one reacts exactly the same as another to the side effects of these drugs, a patient may wish to try his own ideas on adjusting the dosages. One might take the antihistamine only at night and take the decongestant alone in the daytime. Or take them together, increasing the dosage of antihistamine at night (while decreasing the decongestant dose) and then doing the opposite for daytime use.

For Example: Antihistamine (Chlor-Trimeton,®* 4mg)—one tablet three times daily and two tablets at bedtime.
Plus
Decongestant (Sudafed,®* 30mg)—two tablets three times daily and one tablet at bedtime.



Medicine with Symptoms Relieved and Possible Side Effects
Antihistamines
Sneezing
Runny Nose
Stuffy Nose
Itchy Eyes
Congestion

Drowsiness
Dry Mouth & Nose

Decongestants
Stuffy Nose
Congestion

Stimulation
Insomnia
Rapid Heart Beat

Combinations of above, All of above, or Any of above


"Cold" Remedies
Decongestants and/or antihistamines are the principal ingredients in "cold" remedies, but drying agents, aspirin (or aspirin substitutes) and cough suppressants may also be added. The patient should choose the remedy with ingredients best suited to combat his own symptoms. If the label does not clearly state the ingredients and their functions, the consumer should ask the pharmacist to explain

Nose Sprays
The types of nose sprays that can be purchased without a prescription usually contain decongestants for direct application to nasal membranes. They can give prompt relief from congestion by constricting blood vessels. However, direct application creates a stronger stimulation than decongestants taken by mouth. It also impairs the circulation in the nose, which after a few hours, stimulates the vessels to expand to improve the blood flow again. This results in a "bounce-back" effect. The congestion recurs. If the patient uses the spray again, it starts the cycle again. Spray–decongestion– rebound–and more congestion.

In infants, this rebound rhinitis can develop in two days, whereas in adults, it often takes several more days to become established. Adults often require more than a simple "cold turkey" withdrawal. They need decongestants by mouth, sometimes corticosteroids, and possibly (in patients who continuously have used the sprays for months and years) a surgical procedure to the inside of the nose. For this reason, the labels on these types of nose sprays contain the warning "Do not use this product for more than three days." Nose sprays should be reserved for emergency and short term use.

(The above description and advice does not apply to the type of prescription anti-allergy nose sprays that may be ordered by your physician.)

drBandage

[jskinner]

I see it's by prescription only. If you go to the website http://www.astelin.com, there is a $10.00 off coupon. I'll have to ask my doctor about it. Anthing to help my congestion issues without rebound would be great!

Can you really take Astelin without getting rebound when you stop it?
-james

[bookwrm63]

Can you really take Astelin without getting rebound when you stop it?
-james

I'm not sure, that's why I said I would need to ask my doctor. When I went today, he actually gave me Nasonex to use instead and Mucinex D for the congestion. Turns out I have sinus and double ear infection..Ouch!

[Guest]

(in patients who continuously have used the sprays for months and years) a surgical procedure to the inside of the nose. For this reason, the labels on these types of nose sprays contain the warning "Do not use this product for more than three days." Nose sprays should be reserved for emergency and short term use.

I find that rebound happens for me with as little was one use. I try to avoid them if at all possible. What is the damage that happens if one of these nose sprays is used to long? What is the surgical produced that is done to correct it?

-jams

[bookwrm63]

Beats me, James but any surgical procedure needed is just not worth it. My doctor told me that the Nasonex can be used indefinitely without the worry of rebound. He also said it may take up to 2 weeks to start feeling 100% effective but it's worth a shot to me. I did already take the Mucinex D and am already feeling clearer and my ear pain has subsided quite a bit. I hope this works for me...good luck!

[jskinner]

My doctor told me that the Nasonex can be used indefinitely without the worry of rebound. He also said it may take up to 2 weeks to start feeling 100% effective but it's worth a shot to me.

Yes corticosteroid sprays take a couple of week to really kick in. I was on Nasonex and am currently on Flonase. They used to work well for me but since starting on CPAP have become less and less effective.

[roster]

[quote="jskinner"]

Can you really take Astelin without getting rebound when you stop it?
-james

[drbandage]

(in patients who continuously have used the sprays for months and years) a surgical procedure to the inside of the nose. For this reason, the labels on these types of nose sprays contain the warning "Do not use this product for more than three days." Nose sprays should be reserved for emergency and short term use.

I find that rebound happens for me with as little was one use. I try to avoid them if at all possible. What is the damage that happens if one of these nose sprays is used to long? What is the surgical produced that is done to correct it?

-jams

In patients who suffer from perennial allergic rhinitis for many years, a severe drug-resistant hypertrophy and increase in glandular structures of the inferior turbinates may develop, which leads to constant nasal obstruction and watery nasal drip. Surgical reduction of the turbinates can reduce nasal obstruction and secretions. However, unless nasal surgery is both properly indicated and performed with skill, outcomes may be poor.
drB
P.S. I have a doctor friend who is just learning and would probably do it on the cheap . . . ''

[kteague]

On the subject of turbinates, when my daughter had severe allergies and snored horribly as a child and kept ear infections and strep throat, at age 9 she had her tonsils and adenoids out, and another procedure. The surgeon said he did not want to put a child through removing the turbinates, but he said he "burned" them in a few spots to reduce swelling. His explanation was that scar tissue does not swell and the scarring would bind the turbinates and limit their swelling. Don't know if that's an option still used today, but it sounded reasonable then (over 25 years ago). Not so sure now.
Kathy