# Antihistamines without cardiac side effects
**URL:** https://boards.straightdope.com/t/antihistamines-without-cardiac-side-effects/131247
**Category:** Factual Questions
**Created:** [October 7, 2002, 7:06pm UTC](https://boards.straightdope.com/t/antihistamines-without-cardiac-side-effects/131247 "2002-10-07T19:06:40Z")
**Posts on this page:** 6
**Page:** 1
### Author:  [@YWalker](https://boards.straightdope.com/u/YWalker)
#### Post date: [October 7, 2002, 7:06pm UTC](https://boards.straightdope.com/t/antihistamines-without-cardiac-side-effects/131247/1 "2002-10-07T19:06:40Z")
I have recently started having problems with tachycardia (very fast heart rate.) When this problem initially manifested in November, I asked my physician if the fact that I was taking Actifed for itchy eyes and palate might have something to do with it. He just glared at me, and prescribed Allegra.
As soon as I discontinued Actifed, the tachycardia went away immediately. Things were going fine until May, when the problem began again.
When I looked up prescription information on Allegra, it lists both tachycardia and palpitations under “uncommon adverse reactions.” So, I’m hoping that by dropping Allegra, I may once again be able to get rid of this problem.
So does anyone know of any antihistamines that do not have cardiac side effects? (Claritin also lists tachycardia as a side effect.)
(For the record, I am under a cardiologist’s care. I will be seeing him on Wednesday. Although I expect that he can comment on whether dropping Allegra will be of any use, I don’t necessarily expect him to know of good alternatives for my allergy problems. He has known of my Allegra usage all along, by the way.)
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### Author:  [@Duck\_Duck\_Goose](https://boards.straightdope.com/u/Duck_Duck_Goose)
#### Post date: [October 7, 2002, 8:04pm UTC](https://boards.straightdope.com/t/antihistamines-without-cardiac-side-effects/131247/2 "2002-10-07T20:04:16Z")
Any antihistamine can cause you to feel a trifle nervous, or excitable, but that’s not quite the same thing as real tachycardia, which is the truly racing, hammering heartbeat. The Old Reliables–chloropheniramine (Chlortrimeton), diphenhydramine (Benadryl), and brompheniramine (Dimetapp)–don’t usually cause “racing heartbeat” palpitations, although of course YMMV. Benadryl usually puts most people right to sleep.
But, um, Actifed isn’t just an antihistamine–it’s actually two drugs, triprolidine and pseudoephedrine, and pseudoephedrine at least quite definitely causes palpitations and nervousness all by itself–it’s what’s in Sudafed.
[http://webmd.lycos.com/drug\_article/article/4046.1344?bn=Allerfrim#sideeffects](http://webmd.lycos.com/drug_article/article/4046.1344?bn=Allerfrim#sideeffects)
But WebMD doesn’t list actual “tachycardia” or heart palpitations as side effects for Actifed, and more importantly, it says:
> [@](#):
>
> Before taking this medication, talk your doctor if you have
> · kidney disease;
> · liver disease;
> · diabetes;
> · glaucoma;
> · heart disease or high blood pressure;
> · thyroid disease;
> · emphysema or chronic bronchitis; or
> · difficulty urinating or an enlarged prostate.
> • You may not be able to take triprolidine and pseudoephedrine, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
>
> \< snip \>
>
> Drugs other than those listed here may also interact with triprolidine and pseudoephedrine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.
It’s entirely possible that your cardiac specialist glared at you because he just found out that you were taking OTC allergy pills that could have caused a dangerous interaction.
So maybe you should go back to Square One and think about what other kinds of medication you were taking while you were taking the Actifed for the allergies.
Anyway, Allegra-D (was that the one you were taking?) also has pseudoephedrine in it, which, again, can cause nervousness all by itself.
[http://www.allegra.com/seasonal-allergy-site.jsp](http://www.allegra.com/seasonal-allergy-site.jsp)
> [@](#):
>
> Side effects with Allegra-D were similar to Allegra alone and may include headache, insomnia, and nausea. Due to the decongestant (pseudoephedrine) component in Allegra-D, this product must not be used if you: are taking an MAO inhibitor (a medication for depression) or have stopped taking an MAO inhibitor within 14 days; retain urine; have narrow angle glaucoma; have severe high blood pressure or severe heart disease. You should also tell your doctor if you have high blood pressure, diabetes, heart disease, glaucoma, thyroid disease, impaired kidney function, or symptoms of an enlarged prostate such as difficulty urinating.
And especially you’re taking Allegra and it’s combined with other drugs.
[http://www.accessmednet.com/prescription-drug-information/allegra-online.html#side-effects](http://www.accessmednet.com/prescription-drug-information/allegra-online.html#side-effects)
> [@](#):
>
> Allegra may interact with certain prescription or over the counter medication. Be sure to speak to your doctor about other medications or supplements you may take while you are using Allegra.
>
> Aldomet (methyldopa) - Increased risk of side effects.
>
> Allergy or Cold medication (antihistamines or decongestants) - If you are presently taking any over the counter sinus medication, speak with your doctor or pharmacist regarding possible interactions. These medications should not be combined with Allegra or Allegra-D.
>
> Antacids containing aluminum or magnesium, like Maalox or Mylanta, may make Allegra less effective. Ask your doctor or pharmacist about any prescription or over the counter antacids, to see how long you should wait between using these medications.
>
> Diupress or Hydropres (reserpine) - Increased risk of side effects.
>
> erythromycin - May increase side effect from Allegra.
>
> Ephedra - This herb, a natural stimulant found in some herbal energy and weight loss mixtures, should not be combined with Allegra-D. This combination could overstimulate the nervous system.
>
> Inversine (mecamylamine) - Increased risk of side effects.
>
> Lanoxin (digoxin) - Do not use Allegra if you take this medication.
>
> MAO inhibitors - Allegra should not be mixed with MAO (monoamine oxidase) inhibitors, a class of antidepressants and antisenility drugs, such as Eldepryl (selegiline), Furoxone (furazolidone), Nardil (phenelzine), Marplan (isocarboxazid), or Parnate (tranylcypromine). Do not use Allegra within 2 weeks of using these medications, as there is an increased risk of heart complications.
>
> Nizoral (ketoconazole) - Increased risk of side effects.
>
> Vitamin supplements - Some of these may interact with Allegra, particularly those containing magnesium, speak with your doctor or pharmacist regarding any vitamins you take.
Any of these ring a bell?
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### Author:  [@YWalker](https://boards.straightdope.com/u/YWalker)
#### Post date: [October 7, 2002, 11:11pm UTC](https://boards.straightdope.com/t/antihistamines-without-cardiac-side-effects/131247/3 "2002-10-07T23:11:32Z")
Lots of good info, **DDG**. I’ll definitely be looking into some of those. I remember that I had earlier marked chloropheneramine off my list, because I think I read that it tended to dry out your eyes, and I wear contact lenses. Dry eyes, however, are starting to sound better and better.
Yes, I shouldn’t have been taking Actifed for so long. And, actually, it made no sense for me to be taking it, since most of the time, I didn’t really need the decongestant activity of the pseudoephedrine. But it worked so well…
My family physician did discuss it with me (besides just glaring at me.) His objection was to the pseudoephedrine in there. Knowing that that was the problem, he prescribed Allegra (180 mg), and definitely not Allegra-D for me.
Drug interaction was not a problem. I’m basically a disgustingly healthy person. I didn’t have any of the health conditions listed. I do have mild problems with asthma, but I’m generally only symptomatic after an upper respiratory infection. The only thing I take on a regular basis is a multivitamin and an antioxidant. Taking allergy medication was a real departure for me, because normally I don’t like to be all drugged up. I just couldn’t deal with the itchy eyes and palate all the time.
Hmmm. On re-reading your entire post, I note that Allegra does include a possible interaction with multivitamins containing magnesium. I’ll have to check the label, but I’m nearly certain my multivitamin does. However, since Allegra has the potential to cause tachycardia problems all on its own, I think it’s in my best interest to ditch it. I discontinued taking it as of this morning.
Interestingly, every doctor I’ve talked to regarding this problem is aware that I’m taking Allegra. My family physician prescribed it, and the cardiologist and the two electrophysiologists (a subspecialty in cardiology which handles arrythmias) all know my history of starting on Actifed and switching to Allegra. I’ll be seeing one of the electrophysiologists on Wednesday.
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### Author:  [@Nevermind](https://boards.straightdope.com/u/Nevermind)
#### Post date: [October 7, 2002, 11:56pm UTC](https://boards.straightdope.com/t/antihistamines-without-cardiac-side-effects/131247/4 "2002-10-07T23:56:31Z")
Ask about steroid nasal spray (flonase) to help control your allergy symptoms. It helps eliminate the initial inflammation that can lead to the need for antihistamines and decongestants. Takes about a week to kick in, but seems to work well on a lot of people. Also try getting a hepa filter for at least your bedroom.
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### Author:  [@5-HT](https://boards.straightdope.com/u/5-HT)
#### Post date: [October 8, 2002, 5:25am UTC](https://boards.straightdope.com/t/antihistamines-without-cardiac-side-effects/131247/5 "2002-10-08T05:25:21Z")
Avoiding both racing heartbeat and dry eyes is going to be pretty tricky when it comes to antiallergy drugs. as has been noted, pseudoephidrine(basically low-grade speed) always carries a risk of heart-related reactions, and non-CNS antihistamines like diphenhydramine will definately dry you out. IANAD, but I would recommend something like Tavist(Clemastine). I think you can get it without Pseudoephedrine in it, and it doesn’t dry you out quite as bad. be careful though, it can be quite psychoactive if you go beyond the recommended dosage.
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### Author:  [@YWalker](https://boards.straightdope.com/u/YWalker)
#### Post date: [October 8, 2002, 9:46pm UTC](https://boards.straightdope.com/t/antihistamines-without-cardiac-side-effects/131247/6 "2002-10-08T21:46:07Z")
Thanks for the advice, **Nevermind** and **5-HT**.
The hepa filter is a very good idea. (Getting rid of the dogs in the bedroom would be an even better idea, but they tend to end up vandalizing the house when left to roam the house on their own at night.)
I know that they make both a Tavist and a Tavist-D, so I’m presuming that the regular Tavist is pseudoephedrine-free. I had not heard about the psychoactive effects, though!
I’ll find out tomorrow if my cardiologist thinks that dropping Allegra will help, or if it is implicated in a different type of tachycardia than I’ve been experiencing. If getting rid of it works, maybe I can just trade in my cardiologist for an allergist…