how to choose an antihistamine

Patients will be asking how to choose an antihistamine...especially with all the new ads for OTC Zyrtec.

Efficacy. First-generation antihistamines (diphenhydramine, etc) usually work as well as second generation antihistamines for allergic rhinitis. But drowsiness and dry mouth often limit their use.

Sedation. The first-generations are more sedating than the second generation antihistamines. But cetirizine (Zyrtec, etc) and levocetirizine (Xyzal) are still mildly sedating.

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