I have a food allergy that makes my guts ache for hours. My wife has a bee sting allergy that causes major local swelling. In both cases, swallowing a couple of diphenhydramine (Benedryl) tabs greatly reduces the problems.
Diphenhydramine is famous for causing drowsiness, and probably abets senile dementia. Are second generation “non-drowsy” antihistamines as effective for stings and food allergies as Benedryl?
IANAD, but for me the answer is yes. Your doctor can tell you if it is recommended for you.
I’m on Zyrtec for my allergies, I take two a day with no sleepiness. I carry it for bee stings with my Epi-Pen. We haven’t had Benedryl in the house for years.
All antihistamines are famously good at reducing the pain and irritation from insect stings and bites. It’s not gonna make a wasp string just go away, but they definitely help. They’re not gonna help fast enough with a legitimately dangerous insect allergy though.
In terms of which non drowsy one to use I’d suggest just going by whichever one helps you best with other symptoms; I know, in may case, cetirizine works better for me than anything else.
I have a friend with a pineapple allergy and one night we were out to dinner and she accidentally ate some pineapple (cleverly hidden in cheesecake). We happened to be with our friend who is all sorts of nursing levels (MSN, CPN, FNP…a level that can write prescriptions) and she was pretty adamant that the Zyrtec I had at my house was not sufficient for our friend to be able to keep breathing, so someone had to rush out to get Benadryl. She did make it through the episode with Benadryl and no Epi-Pen.
Maybe it was extra caution on her part, but I would definitely ask your doctor.
FWIW I take a daily Zyrtec. I got stung by a bee a few weeks ago, on the top of my foot. It got caught in the tongue of my shoe. I don’t have a huge reaction to bee stings normally (definitely not life threatening). I was able to keep doing what I was doing with little pain and no swelling. I had some pain from the bee sting for a few days and there was a bit of localized swelling, but I think doubling up on my Zyrtec for a while helped. YMMV.
While maybe better than nothing, I find those 2nd gen non-drowsy antihistamines to be largely ineffective for treatment of an acute food allergy episode.
As an aside, I dont know about food allergies or insect stings, but antihistamines worked well on the itch from poison oak.
Britain’s National Health Service seems to think so:
If the issue is “gut aches for hours” and not “risk of dropping dead”, I’d think your wife could test zyrtec, or whatever, herself. People react differently to drugs anyway, and what works for one person may not work for another.
Claritin helps me with bug bites, and is about the only OTC antihistamine that doesn’t put me to sleep (Benedryl and Zyrtec can be counted on to knock me right out, Allegra is variable enough that I can’t trust it if I’m going to need to do things like drive any time in about the next 8-12 hours). Problem is it doesn’t always work any more, and I don’t have a practical alternate on the antihistamine front.
I can’t say anything useful about Claritin and food allergies, since I’m lucky enough to not have food allergies.
If I take any of the first-generation antihistamines, I am very solidly guaranteed to be nonfunctional for art least twenty-four hours after that, possibly up to twice that long.
Diphenhydramine had, for some time, been the dominant OTC drug of this type, sold in the exact same dose either as an anti-allergy medicine, or as sleeping pills. Same drug, same dose. Doxylamine seems to have fairly recently taken over a large share of this role, and seems to be typically sold in a larger does as a sleep aid, than as an anti-allergy medicine. I note that the current bottle of sleeping pills in our medicine cabinet is a 25-milligram dose for that application, while the current Nyquil clone is a 12½mg dose of the same drug, for use as an antihistamine.
Not too many years ago, both the sleeping pills and the Nyquil clone were 25mg of diphenhydramine.
Even the newer second-generation “non-drowsy” antihistamines, such as Claritin, make me a bit groggy, though not as much so as the first-generation antihistamines do. I cannot take any antihistamines if I want or need to be alert and functional for the next day or so.
No. Second generations do have fewer side effects and are effective for mild symptoms. But any allergic reaction in an emergency department will be treated with Benadryl, maybe with added prednisone or epinephrine and sometimes “stomach medicine” antihistamines.
This is because research and experience shows Benadryl is more effective at treating allergy (independent of other effects) and most ER staff believe this too. This doesn’t mean second generation treatments are not effective. They are. But Benadryl more so.
That was my impression, but was interested in additional info. I’m unfamiliar with “stomach medicine” antihistamines.
(My memory is that your “Dr_” user name does not indicate an MD degree – which doesn’t invalidate your response. Which was appreciated.)
Proton pump inhibitors (such as omeprazole, etc.) are a different type of antihistamine from Benadryl or second generations.
Sorry, I meant Ranitidine.
Don’t you have to be on a daily dose of Claritin or Zyrtec for it be effective for allergies, or any of the like?
In an emergency allergic bee sting, Go with the epi pen. A benadryl and go to the ER.
Mild reaction to sting you can use diphenhydramine cream.
Food allergies? Avoidance.
If it’s say, nuts and you accidentally ingest. Epi pen. Go to ER.
Personally I wouldn’t wait on a benadryl to work.
Anaphylaxis is scary.
YMMV
Can you link me to that research? I’ve been taught that second generation antihistamines have the same rapidity of action with longer half life and less side effects, and are a perfectly acceptable alternative. The major guideline agrees they can be substituted. (Page 34)
The World Allergy Guideline says the same thing:
The use of H1-antihistamines has a limited role in treatment of anaphylaxis,94 but can be helpful in relieving cutaneous symptoms. Second generation antihistamines may overcome unwanted side effects such as sedation which may be counterproductive in anaphylaxis
But diphenhydramine can be given IV in the ED unlike any second generation one.
To me the big deal however is if there is a history of actual anaphylaxis use the damn EpiPen! And yes then to the ED.
And, please people tell the people you’re with if you have epi-pen. Insulin pen. Glucose rescue kit and that the time to use it would be such and such. (Whichever would apply to you).
Bystanders, employees in a store and maybe an untaught family member are often reticent to make the call and use the rescue you may desperately need.
Wear you medical alert ID.
The role of antihistamines in anaphylaxis is pretty small. Early epinephrine is indicated, and making sure repeat doses are available for possible biphasic reactions. I didn’t mention albuterol or glucagon. This wasn’t really meant to be a discussion of severe allergies.
During my residency, one of our teachers wrote the Canadian Pharmacists Guide Therapeutic Choices. She did research on antihistamines and that book had info showing Benadryl was better at that time. But it is true the sedation is not always helpful, there are benefits to longer half-lives and that all can be effective for mild cutaneous allergy symptoms.
That said, you are also right about intravenous forms of Benadryl and ranitidine being used, even if epinephrine is what makes by far the biggest difference for severe symptoms.
I was on an island, about an hour away from an emergency department, and a woman has a scary reaction to a yellow jacket string. There was not an epi-pen on the island. Having heard that antihistamines can be valuable in that situation, i suggested she take one, and after some rummaging, we found Benadryl on the island and she took it, and someone took her off island to the nearest hospital ED.
When she returned, she told me the ED physician thought the Benadryl saved her life.
So i kinda think antihistamines can play an important role in treating allergies.
They can. But it’s relative. Epi is stronger, quicker and more efficacious.