Is your tried-and-true allergy medication still recommended?

The next time you are exposed to an allergen and feel the sniffles or an itchy throat coming on, you may want to rethink your go-to allergy medication.

A new recommendation led by The World Allergy Organization encourages the abandonment of diphenhydramine, a popular over-the-counter and sometimes prescription-based antihistamine. The medication is most commonly used for allergy relief, but in some cases, people use it as a temporary sleep aid or to treat motion sickness and some Parkinson’s disease symptoms.

“This recommendation stems from clinical evidence that diphenhydramine often leads to adverse effects and because there are now safer alternatives available,” explains Rachel Crawford, a pharmacist at Advocate Health Care and Aurora Health Care. “Diphenhydramine is considered a first-generation antihistamine, which works by crossing the blood-brain barrier and binding to histamine receptors in the brain. This is what leads to the concerning drowsiness and sedation symptoms.”

Other adverse effects of diphenhydramine include:

• Dizziness
• Dry mouth or eyes
• Constipation
• Urinary retention

Fortunately, there are other ways to safely and effectively treat your bothersome allergy symptoms.

“It’s recommended to take second-generation antihistamines instead because they are more selective for the histamine receptor, which decreases the adverse effects,” Crawford says. “While they have a similar onset to diphenhydramine, they last longer and therefore require reduced dosing frequency.”

Crawford says safe seasonal allergy, rhinitis and pruritus medication alternatives include cetirizine, loratadine, fexofenadine and intranasal corticosteroids, like fluticasone and mometasone. “Certain eye drops also function well to treat dry, itchy or red eyes,” she adds.

You can also modify your lifestyle to prevent allergen exposure. Crawford suggests avoiding the outdoors during times of high pollen levels, keeping windows closed, using air filters and changing your clothes after spending time outdoors.

As always, there are exceptions to this recommendation. In some cases, you may still be prescribed diphenhydramine.

“Most experts agree that diphenhydramine treatment should only be used when recommended by a health care provider, rather than patients buying it over the counter,” explains Crawford. “This will ensure patients avoid unwanted adverse effects and that they are using the safest and most effective medication.”

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