Brand Names for Second-Generation Antihistamines
The commonly known brand names for these second-generation antihistamines are clearly documented in the clinical guidelines 1:
Non-Sedating Antihistamines (at recommended doses)
- Fexofenadine: Allegra
- Loratadine: Claritin
- Desloratadine: Clarinex
Antihistamines That May Cause Mild Sedation (at recommended doses)
- Cetirizine: Zyrtec (13.7% sedation vs 6.3% placebo) 1
- Intranasal Azelastine: Astelin nasal (11.5% somnolence) 1, 2
Additional Related Brand
- Levocetirizine: Xyzal (the active enantiomer of cetirizine) 1
Important Clinical Distinctions
The sedation profiles differ significantly within the second-generation class 1:
- Fexofenadine demonstrates no sedative properties even at doses exceeding FDA-approved levels 1
- Loratadine and desloratadine remain non-sedating at recommended doses but may cause sedation when doses exceed recommendations 1
- Cetirizine at the standard 10 mg dose causes mild drowsiness (13.7%) compared to placebo (6.3%), though some studies show this occurs without performance impairment while others demonstrate measurable impairment 1
- Intranasal azelastine causes somnolence in 11.5% of patients, along with bitter taste complaints in 19.7% 1
Practical Prescribing Considerations
When selecting among these agents, prioritize fexofenadine (Allegra), loratadine (Claritin), or desloratadine (Clarinex) for patients who drive, operate machinery, or require optimal cognitive performance 1. Reserve cetirizine (Zyrtec) or intranasal azelastine (Astelin) for situations where their specific benefits outweigh sedation concerns, and counsel patients about this risk even when they don't subjectively perceive drowsiness 1.