From the Guidelines
For individuals allergic to Benadryl (diphenhydramine), the most suitable alternative allergy medication is likely a second-generation antihistamine such as Cetirizine (Zyrtec) or Fexofenadine (Allegra), due to their efficacy and low sedation profiles, as indicated in the study published in the Journal of Allergy and Clinical Immunology 1.
Key Considerations
- Non-sedating antihistamines like Claritin (loratadine), Zyrtec (cetirizine), Allegra (fexofenadine), and Xyzal (levocetirizine) are good options for individuals allergic to Benadryl, with typical doses being 10mg for loratadine and cetirizine, 180mg for fexofenadine, and 5mg for levocetirizine, as outlined in the study 1.
- These medications work by blocking histamine receptors without crossing the blood-brain barrier significantly, resulting in fewer sedative effects than Benadryl, which is a key consideration for maintaining quality of life.
- Nasal corticosteroids such as Flonase (fluticasone) or Nasacort (triamcinolone) can be used for nasal symptoms, typically 1-2 sprays per nostril daily, as an adjunct to antihistamine therapy.
- For eye symptoms, antihistamine eye drops like Pataday (olopatadine) or Zaditor (ketotifen) may provide relief, as suggested by the variety of options listed in the study 1.
- It is crucial to consult with an allergist before trying other antihistamines if you have a true allergy to diphenhydramine, due to potential cross-reactivity, emphasizing the importance of personalized medical advice.
- Always reading medication labels carefully is advised, as some combination products may contain diphenhydramine even if not prominently advertised, to avoid unintended exposure.
From the FDA Drug Label
PRINCIPAL DISPLAY PANEL-500'S COUNT Rising® 16571-402-50 Original Prescription Strength Cetirizine Hydrochloride Tablets USP 10 mg 6 yrs & older Antihistamine ALLERGY Indoor & Outdoor Allergies 24 Hour Relief of: •Sneezing •Runny Nose •Itchy, Watery Eyes •Itchy Throat or Nose 500 Tablets T10 - M.L. G/1430
The medication cetirizine can be used as an allergy medication for persons allergic to Benadryl, as it is an antihistamine that provides 24 Hour Relief of allergy symptoms.
- Key benefits: relief of sneezing, runny nose, itchy, watery eyes, and itchy throat or nose. 2
From the Research
Allergy Medication Alternatives to Benadryl
For individuals allergic to Benadryl (diphenhydramine), there are several alternative allergy medications available. These alternatives are often preferred due to their safer profile and reduced side effects compared to first-generation antihistamines like Benadryl 3, 4, 5.
Second-Generation Antihistamines
- Cetirizine: Known for its fast onset of action and is considered a good option for acute allergic reactions 4.
- Fexofenadine: Does not impair psychomotor or cognitive skills and shows no dose-related increase in sedation, although it has a slower onset of action compared to diphenhydramine 4.
- Desloratadine and Loratadine: Nonsedating options, though less efficacious than cetirizine or fexofenadine 4.
Treatment Recommendations
For mild intermittent or mild persistent allergic rhinitis, second-generation H1 antihistamines (such as cetirizine, fexofenadine, desloratadine, loratadine) or intranasal antihistamines (like azelastine, olopatadine) are recommended as first-line treatment 6. For persistent moderate to severe allergic rhinitis, intranasal corticosteroids (e.g., fluticasone, triamcinolone, budesonide, mometasone) are suggested, either alone or in combination with an intranasal antihistamine 6.
Role of Pharmacists
Community pharmacists play a crucial role in managing allergic rhinitis by providing patient-specific pharmacotherapy based on the type, duration, and severity of symptoms, comorbidities, prior treatment, and patient preference 7. They can guide patients in selecting the most appropriate medication from the available options, including second-generation oral antihistamines and intranasal corticosteroids.