Prescribing Notes
- Encourage self-care and advise patients that antihistamines can be purchased over the counter (OTC).
- Refer to SPPG hayfever supplement on the management of hay fever in primary care for further information.
- Non-sedating oral antihistamines are a first line option for mild or intermittent symptoms of allergic rhinitis. Antihistamines relieve rhinorrhoea, sneezing, nasal irritation and ocular symptoms but have little effect on nasal congestion. For moderate-to-severe or persistent symptoms refer to 3.4.1.1.
- Oral antihistamines are of some value in the management of urticaria. They are sometimes used at above licensed doses (off-label) under specialist advice.
Cautions
Older Patients – antihistamines
- Older sedating antihistamines, e.g. chlorphenamine, promethazine, are more liable to cause drowsiness, urinary retention or blurred vision. Consideration should be given to the anticholinergic burden, particularly in elderly patients.