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Pediatric Allergic Rhinitis:
Antihistamine Selection

Introduction
As the most common of mediated inflammation of the are not serious and do not endan- Allergic Rhinitis
and Children
19 years.5,8 As with adults, the im-pact of AR in children extends be-yond the immediate symptomsand has a profound effect on chil-dren’s QoL, the extent of which Allergy/Asthma Associates, Mission Viejo, California.
the severity of disease.9 Trouble-some, repeated nose blowing, fa- This paper was supported by an educational grant from Aventis Pharmaceuticals.
Reprint requests and correspondence to: William E. Berger, MD, Allergy/Asthma Associates,
27800 Medical Center Road, 244 Mission Viejo, CA 92691.
2005 Westminster Publications, Inc., 708 Glen Cove Avenue, Glen Head, NY 11545, U.S.A.
Older-Generation
Antihistamines
A n t i h i s t a m i n e s a n d A l l e r g i c R h i n i t i s cost, availability, and advertisingplay a significant role in deter- mining which antihistamine achild receives.
MAXIMUM RECOMMENDED DAILY DOSES FOR AVAILABLE
SECOND-GENERATION ANTIHISTAMINES FOR CHILDREN WITH SAR
Newer-Generation
Antihistamines
Loratadine rapidly disintegrating tablets avoiding the adverse events (AEs)obser ved with older agents. Al-though these agents are credited Cetirizine (Zyrtec®) tablets (5 mg, 10 mg) Cetirizine (Zyrtec®) syrup (5 mL [2.5mg]) gous. Therefore, each agentshould be judged separately interms of relative efficacy and 60 mg (30 mg BID) (children 6–11 yrof age) safety. To date, three oral newer-generation antihistamines areavailable for use in children in the gra® [Aventis Pharm.], indicatedfor use in children aged 6 yearsand older), loratadine (Claritin®[Schering-Plough], 2 years orolder) and cetirizine (Zyrtec® Clinical Efficacy and
Safety of Newer-
Generation
Antihistamines in
Children
rated ‘good’ or ‘excellent’ in 82% A n t i h i s t a m i n e s a n d A l l e r g i c R h i n i t i s A n t i h i s t a m i n e s a n d A l l e r g i c R h i n i t i s Conclusions
with trials of these antihistamines.
a fast onset of action is desirable.
gic rhinitis. J Allergy Clin Immunol. rhinitis. In: ML B, ed. Epidemiology of Clinical Allergy. Monographs in Allergy. A n t i h i s t a m i n e s a n d A l l e r g i c R h i n i t i s and its impact on asthma. J Allergy Clin PB, et al., eds. The Pharmacological Ba- sis of Therapeutics. 9th ed. New York: rhinitis. In: Allergy: Principles and Prac- 18. Jumbelic MI, Hanzlick R, Cohle S.
placebo-controlled study. Clin Pediatr. Pediatr Emerg Care. 2000;16:97-96.
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gic rhinitis. Pediatr Clin North Am. 21. Le Blaye I, Donatini B, Hall M, et al.
blind, placebo controlled study. J Al- of present clinical experience. Drug lergy Clin Immunol. 2003;111:1244- J Allergy Clin Immunol. 2001;108(1 22. Lutsky BN, Klose P, Melon J, Krupp P.
sonal allergic rhinitis. Clin Ther. tionnaires. J Allergy Clin Immunol. placebo-controlled comparative study.
Pediatrics. 2004;113:e116-e121.
and other side effects. Clin Exp Allergy. learning. Ann Allergy. 1993;71:121- years. Clin Ther. 2000;22(5):613-621.
the United States in 1990. Ann Allergy. study. Pediatr Asthma Allergy Immunol. gic rhinitis. J Allergy Clin Immunol. children. In: Simons FER, ed: Hista- 25. Masi M, Candiani R, van de Venne H.
of fexofenadine in children. J Allergy 14. Settipane RA. Complications of aller- Clin Immunol. 1996;98(6 Pt 1):1062- gic rhinitis. Allergy Asthma Proc. 15. Casale TB, Blaiss MS, Gelfand E, et al.
tirizine for seasonal allergic rhinitis in children aged 2–6 years. Pediatr Allergy for seasonal allergic rhinitis. Ann Al- lergic rhinitis. J Allergy Clin Immunol. lergy Asthma Immunol. 2001;87:22-26.
histamine for the 21st century. Clin dence of its antiallergic activity. Clin Exp Allergy. 1997;27(10):1160-1166.
jects with seasonal allergic rhinitis: ef- pairment ratios. Hum Psychopharmacol Asthma Proc. 2003;24(2):95-105.
38. Wober W, Diez Crespo CD, Bahre M.
sure unit. J Allergy Clin Immunol. 46. Horak F, Stuber P, Zieglmayer R, Kav- tice. BMJ. 2000;320:1184-1186.
years of age. Ar zneimittelforschung. 39. Azelastine Product Infor mation.
symptoms of seasonal allergic rhinitis.
47. Day JH, Briscoe MP, Welsh A. Onset of 40. Salib RJ, Howarth PH. Safety and tol- erability profiles of intranasal antihist- treatment of allergic rhinitis. J Am Os- in the treatment of allergic rhinitis.
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Asthma Immunol. 1997;79:533-540.

Source: http://m.www.inovapeds.org/library/readings/AR/Clinical%20Pediatrics-Antihistamines.pdf

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