Ditch antihistamines for hayfever: experts
Hayfever sufferers should avoid antihistamine tablets and are better off using a steroid nasal spray, US experts advise.
A systematic research review, published in the journal Annals of Internal Medicine, found taking oral antihistamines to treat seasonal allergic rhinitis seem to add no extra benefit but may cause drowsiness.
The Joint Task Force on Practice Parameters, made up of US allergy specialists, recommends for the initial treatment of allergic rhinitis in persons aged 12 years or older that patients use a single intranasal corticosteroid rather than a spray in combination with a oral antihistamine.
“Overall, we judged the evidence as not proving a benefit of adding an oral antihistamine to an intranasal corticosteroid and recognised that oral antihistamines, mainly first-generation, may cause sedation and other adverse effects,” they concluded.
For a serious hayfever sufferer, the Taskforce strongly recommends using a combo of corticosteroid and antihistamine sprays.
The review guidelines are in line with treatment recommendations from the Australasian Society of Clinical Immunology and Allergy (ASCIA).
The key recommendations are as follows:
- For initial treatment of people 12 years old or older, treat with an intranasal corticosteroid alone, rather than in combination with an oral antihistamine. The Joint Task Force did not find evidence proving a benefit of adding an oral antihistamine and recognized that they may cause sedation and other adverse effects.
- For initial treatment of people 15 years old or older, treat with an intranasal corticosteroid over a leukotriene receptor antagonist.
- For treatment of moderate to severe seasonal allergies in people 12 years old or older, clinicians may recommend the combination of an intranasal corticosteroid and an intranasal antihistamine for initial treatment. The evidence showed that the addition of an intranasal antihistamine to an intranasal corticosteroid in patients with moderate-to-severe seasonal allergic rhinitis provides additional benefit, in contrast to combination therapy with an intranasal corticosteroid and an oral antihistamine.
You access the guideline update here.