New insights into the second generation antihistamines

Garry Michael Walsh, L. Annunziato, K. Knol, J. M. Nicolas, M. Taglialatela, M. D. Tharp, J. P. Tillement, H. Timmerman, N. Frossard, S. Levander

Research output: Contribution to journalArticle

85 Citations (Scopus)

Abstract

Second generation antihistamines are recognised as being highly effective treatments for allergy-based disease and are among the most frequently prescribed and safest drugs in the world. However, consideration of the therapeutic index or the benefit/risk ratio of the H-1 receptor antagonists is of paramount importance when prescribing this class of compounds as they are used to treat non-life threatening conditions. Then are many second generation antihistamines available and at first examination these appear to be comparable in terms of safety and efficacy. However, the newer antihistamines in fact represent a hererogeneous group of compounds, having markedly differing chemical structures, adverse effects, half-life, tissue distribution and metabolism, spectrum of antihistaminic properties, and varying degrees of anti-inflammatory effects. With regard to the latter, there is growing awareness that some of these compounds might represent useful adjunct medications in asthma therapy. In terms of safety issues, the current second generation grouping includes compounds with proven cardiotoxic effects and others with the potential for adverse drug interactions, Moreover, some of the second generation H1 antagonists have given cause for concern regarding their potential to cause a degree of somnolence in some individuals. It can be argued, therefore, that the present second generation grouping is too large and indistinct since this was based primarily on the concept of separating the first generation sedating compounds from nonsedating H1 antagonists. Although it is too early to talk about a third generation grouping of antihistamines, future membership of such a classification could be based on a low volume of distribution coupled with a lack of sedating effects, drug interactions and cardiotoxicity.

Original languageEnglish
Pages (from-to)207-236
Number of pages29
JournalDrugs
Volume61
Issue number2
DOIs
Publication statusPublished - 2001

Keywords

  • SEASONAL ALLERGIC RHINITIS
  • CHRONIC IDIOPATHIC URTICARIA
  • PLATELET-ACTIVATING-FACTOR
  • NASAL EPITHELIAL-CELLS
  • LATE-PHASE REACTIONS
  • HISTAMINE H-1-RECEPTOR ANTAGONISTS
  • CELLULAR INFLAMMATORY RESPONSES
  • PSYCHOMETRIC TEST-PERFORMANCE
  • PLACEBO-CONTROLLED TRIAL
  • POLLEN-INDUCED ASTHMA

Cite this

Walsh, G. M., Annunziato, L., Knol, K., Nicolas, J. M., Taglialatela, M., Tharp, M. D., ... Levander, S. (2001). New insights into the second generation antihistamines. Drugs, 61(2), 207-236. https://doi.org/10.2165/00003495-200161020-00006

New insights into the second generation antihistamines. / Walsh, Garry Michael; Annunziato, L.; Knol, K.; Nicolas, J. M.; Taglialatela, M.; Tharp, M. D.; Tillement, J. P.; Timmerman, H.; Frossard, N.; Levander, S.

In: Drugs, Vol. 61, No. 2, 2001, p. 207-236.

Research output: Contribution to journalArticle

Walsh, GM, Annunziato, L, Knol, K, Nicolas, JM, Taglialatela, M, Tharp, MD, Tillement, JP, Timmerman, H, Frossard, N & Levander, S 2001, 'New insights into the second generation antihistamines', Drugs, vol. 61, no. 2, pp. 207-236. https://doi.org/10.2165/00003495-200161020-00006
Walsh GM, Annunziato L, Knol K, Nicolas JM, Taglialatela M, Tharp MD et al. New insights into the second generation antihistamines. Drugs. 2001;61(2):207-236. https://doi.org/10.2165/00003495-200161020-00006
Walsh, Garry Michael ; Annunziato, L. ; Knol, K. ; Nicolas, J. M. ; Taglialatela, M. ; Tharp, M. D. ; Tillement, J. P. ; Timmerman, H. ; Frossard, N. ; Levander, S. / New insights into the second generation antihistamines. In: Drugs. 2001 ; Vol. 61, No. 2. pp. 207-236.
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AU - Tharp, M. D.

AU - Tillement, J. P.

AU - Timmerman, H.

AU - Frossard, N.

AU - Levander, S.

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