Second Generation Antihistamines

Remibrutinib reduced the need for rescue medication and improved symptoms among patients with chronic spontaneous urticaria, according to a study presented at the European Academy of Allergy and Clinical Immunology Hybrid Congress.

The last Pharmacology Consult column, “Antihistamines for the common cold: Where’s the evidence?” (September 2019), reviewed recently published data suggesting that antihistamine product use may be increasing for the treatment of common cold symptoms. Because recent recommendations and regulations have decreased the use of cough/cold products in the pediatric population, pediatric health care providers may be turning to antihistamine-based products instead. Commonly used first-generation antihistamines have strong anticholinergic properties, and recently published data from the adult population have suggested that long-term use of these drugs may increase the risk for developing dementia. As summaries of these publications find their way to the lay media, it is understandable that parents may wonder about the long-term safety of using antihistamines in children. Although the diagnosis of dementia is certainly not associated with the pediatric population, parents may still express concern about the adverse effects and long-term safetyof antihistamines.

Recommendations for the treatment of common viral upper respiratory tract infections (URTIs) in children have undergone significant changes over the past 10 years. In 2008, the FDA and the AAP recommended avoiding over-the-counter products for the treatment of URTI symptoms, including cough/cold (C/C), in young children. These products should be avoided in children aged younger than 4 years, and the AAP cautions about their use in children aged 4 to 6 years and only when the child is receiving care from a provider.