From the Guidelines
For children, liquid antihistamines like Children's Zyrtec (cetirizine) or Children's Claritin (loratadine) are recommended, as they are non-drowsy and only need to be given once daily. These medications work by blocking histamine receptors, reducing allergy symptoms like runny nose, sneezing, and itching. Second-generation antihistamines (Zyrtec, Claritin) typically cause less drowsiness than first-generation ones (Benadryl) 1.
When choosing an antihistamine for a child, it's essential to consider the potential for sedation and anticholinergic effects, which are more common with first-generation antihistamines like diphenhydramine 1. The American Academy of Allergy, Asthma, and Immunology recommends second-generation antihistamines as the preferred treatment for allergic rhinitis in children due to their improved safety profile and reduced risk of adverse effects 1.
Some key points to consider when administering liquid antihistamines to children include:
- Always check the product label or consult with a healthcare provider for the correct dose, as it depends on the child's age and weight.
- For children under 2 years, always consult a doctor before giving any antihistamine.
- Use the measuring device provided with the medication rather than household spoons to ensure accurate dosing.
- If symptoms persist beyond a few days or worsen, seek medical advice.
It's also important to note that the FDA has recommended avoiding the use of OTC cough and cold medications, including antihistamines, in children under 6 years of age due to concerns about safety and efficacy 1. Therefore, it's crucial to consult with a healthcare provider before giving any medication to a child.
From the FDA Drug Label
Active ingredient per 10 mL (1 Unit Dose) Diphenhydramine HCl 25 mg Purpose Antihistamine
The recommended antihistamine for a child, preferably in liquid form, is diphenhydramine. Key points to consider:
- Diphenhydramine is available in a liquid form with a concentration of 25 mg per 10 mL.
- It is used as an antihistamine for relieving allergy symptoms. 2 2
From the Research
Antihistamine Options for Children
When it comes to choosing an antihistamine for a child, preferably in liquid form, there are several options to consider. The choice of antihistamine depends on various factors, including the child's age, weight, and medical history.
Liquid Formulations
- Diphenhydramine is available in liquid form and has been studied in children 3, 4.
- Loratadine and cetirizine are also available in liquid form, but there is limited information on their use in children in the provided studies.
Safety and Efficacy
- Diphenhydramine has been associated with adverse events, including tachycardia, hallucinations, and somnolence, particularly in children under 4 years of age 3.
- Cetirizine has been shown to be effective in suppressing skin reactivity to histamine in adults, with a longer duration of action compared to desloratadine 5.
- Loratadine has been found to have a favorable safety profile, with no significant adverse cardiovascular effects 6.
Age-Specific Considerations
- Children under 5 years of age may require a different dosing regimen due to faster clearance of antihistamines 7, 4.
- Children over 5 years of age may be able to tolerate adult dosing regimens, but this should be determined on a case-by-case basis.
Recommendations
Based on the available evidence, cetirizine may be a suitable option for children due to its efficacy and safety profile. However, it is essential to consult with a healthcare professional to determine the best course of treatment for a child's specific needs. Diphenhydramine should be used with caution, particularly in young children, due to the risk of adverse events. Loratadine may also be considered, but more research is needed to fully understand its effects in children.