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--- antihystamines [2025.07.29 16:23] – Steve Isenberg
+++ antihystamines [2025.07.29 16:42] (current) – Steve Isenberg
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 | Loratadine | Claritin | 2nd Gen | Very low | 24 hrs | No known link | Allergies |
 | Diphenhydramine | Benadryl | 1st Gen | High | 4–6 hrs | Yes (with long-term use) | Allergies, sleep aid |
-⸻
 ==== ✅ Safest to Use (Short and Long Term) ====
 The second-generation antihistamines — ‘‘cetirizine’’, ‘‘fexofenadine’’, and ‘‘loratadine’’ — are generally safer for most people, especially for long-term use:
-  •	They don’t cross the blood-brain barrier as easily, so they cause less drowsiness
+  * They don’t cross the blood-brain barrier as easily, so they cause less drowsiness
-  •	No solid evidence links them to dementia
+  * No solid evidence links them to dementia
-  •	Often recommended by allergists for chronic allergy relief
+  * Often recommended by allergists for chronic allergy relief
 ⸻
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 ‘‘Diphenhydramine’’ is a first-generation antihistamine. It’s effective, but:
-	•	Strongly sedating
+  * Strongly sedating
-	•	Shorter-acting, often requiring multiple doses per day
+  * Shorter-acting, often requiring multiple doses per day
-	•	Linked in studies to increased risk of dementia when used regularly or long-term
+  * Linked in studies to increased risk of dementia when used regularly or long-term
-(due to its strong anticholinergic effects)
+  * (due to its strong anticholinergic effects)
-	•	Sometimes misused as a sleep aid, especially in older adults — this is not recommended
+  * Sometimes misused as a sleep aid, especially in older adults — this is not recommended
 The Beers Criteria, a guide used in geriatrics, advises against using diphenhydramine in older adults unless absolutely necessary.
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 ==== Summary ====
-	•	Best for daily allergies: ‘‘Fexofenadine’’ (least sedating), ‘‘loratadine’’, or ‘‘cetirizine’’
+  * Best for daily allergies: ‘‘Fexofenadine’’ (least sedating), ‘‘loratadine’’, or ‘‘cetirizine’’
-	•	Avoid long-term use of Benadryl, especially in older adults or for sleep
+  * Avoid long-term use of Benadryl, especially in older adults or for sleep
-	•	If you’re older (65+) or have concerns about cognition, stick with second-generation options
+  * If you’re older (65+) or have concerns about cognition, stick with second-generation options
+===== Is Sudafed an Antihistamine? =====
+No — Sudafed is not an antihistamine. It is a decongestant, though it’s often used alongside antihistamines to treat cold or allergy symptoms.
 ⸻
-If you’d like help choosing the best one based on your symptoms (e.g., itchy eyes, runny nose, hives), I can help with that too.
+==== 🧪 What Is Sudafed? ====
+Sudafed is the brand name for:
+  * ‘‘Pseudoephedrine’’ – the original version, available behind the pharmacy counter
+  * ‘‘Phenylephrine’’ – an over-the-counter version that is less effective
+It’s classified as a nasal decongestant.
 ⸻
-Let me know if you’d like this saved as a .txt file for upload to your DokuWiki installation.
+==== 💊 How It Works ====
+Decongestants like Sudafed:
+  * Constrict blood vessels in the nasal passages
+  * Reduce swelling and improve airflow
+  * Do not block histamine
+Antihistamines:
+  * Block histamine, the chemical responsible for sneezing, itching, and watery eyes
+^ Symptom ^ Use Antihistamine? ^ Use Decongestant (Sudafed)? ^
+| Sneezing | ✅ Yes | ❌ No |
+| Itchy eyes or nose | ✅ Yes | ❌ No |
+| Runny nose | ✅ Yes | ❌ Not directly |
+| Nasal congestion | ❌ Not effective | ✅ Yes |
+⸻
+==== ⚠️ Warnings About Sudafed ====
+  * Can raise blood pressure – not ideal for people with hypertension or heart disease
+  * May cause jitters, restlessness, or insomnia
+  * Pseudoephedrine is regulated — you must request it from the pharmacy counter and show ID
+  * Phenylephrine, found in many OTC products, has been shown to be ineffective when taken orally (per FDA findings)
+⸻
+==== 🔄 Combination Medications ====
+Some allergy medications combine antihistamines with Sudafed, such as:
+  * Claritin-D (loratadine + pseudoephedrine)
+  * Zyrtec-D (cetirizine + pseudoephedrine)
+These treat both:
+  * Histamine symptoms – sneezing, itching, watery eyes
+  * Nasal congestion
+⸻
+==== ✅ Bottom Line ====
+  * Sudafed is a decongestant, not an antihistamine
+  * Best for nasal congestion, not for sneezing or itchy eyes
+  * Can be used alongside antihistamines for broader relief
+  * Use with caution if you have heart conditions, high blood pressure, or insomnia