Antihistamine selection in patients with allergic rhinitis.
Seven hundred eighty-two patients diagnosed as having either seasonal allergic rhinitis or perennial allergic rhinitis in a solo allergy practice were given five different antihistamine products representing each of the five classes of antihistamines. The following products were evaluated for 2 weeks each: tripelennamine, diphenhydramine, chlorpheniramine, hydroxyzine, and trimeprazine. Symptoms and side effects were graded 0 to 4. The more troublesome side effects, graded 3 or 4, were tabulated. The antihistamine products in order of increasing frequency of significant side effects were: trimeprazine, chlorpheniramine, hydroxyzine, diphenhydramine, and tripelennamine. The order of antihistamine preference by the patients was chlorpheniramine (27%), diphenhydramine (22%), tripelennamine (20%), hydroxyzine (16%), and trimeprazine (14%). Only seven of 758 patients (less than 1%) were unable to find an acceptable antihistamine class. Patients remained on their antihistamine class of first choice 78% of the time after 1 year, 71% after 3 years and 51% after 5 years. The antihistamine pack provides a rational approach to antihistamine selection in patients with allergic rhinitis.
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D002744:Chlorpheniramine / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004155:Diphenhydramine / Q000627:therapeutic use; D006634:Histamine H1 Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D006919:Hydroxyzine / Q000627:therapeutic use; D010358:Patient Participation; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy*; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy*; D012894:Sleep Stages; D014291:Trimeprazine / Q000627:therapeutic use; D014309:Tripelennamine / Q000627:therapeutic use
D006634:Histamine H1 Antagonists; D006919:Hydroxyzine; D014309:Tripelennamine; D002744:Chlorpheniramine; D014291:Trimeprazine; D004155:Diphenhydramine