For seniors, the best antihistamines are second-generation options like loratadine (Claritin), fexofenadine (Allegra), or cetirizine (Zyrtec), as they are less sedating and safer, with fexofenadine being the least likely to cause drowsiness. Older, first-generation antihistamines like Benadryl (diphenhydramine) should be avoided due to risks like falls, confusion, and dry mouth, and steroid nasal sprays or antihistamine nasal sprays are also excellent, safer choices.
Non-drowsy oral antihistamines, such as Claritin (loratadine), are also safe options. Nasalcrom (cromolyn) nasal spray and antihistamine eye drops, such as Zaditor (ketotifen) are also safe for older adults.
In studies, nosebleed was common in people taking cetirizine oral solution. This side effect is usually mild. Nosebleeds may also be caused by your allergy symptoms. Certain factors can increase the risk of nosebleeds with cetirizine oral solution.
Some elderly people may have higher risk of side effects because of poor kidney function. The drowsiness and fatigue which may occur in a small percentage of patients may be more of a problem for the elderly because of the increased risk of bone fracture if they fall.
Over-the-counter antihistamines like Zyrtec, Claritin, or Benadryl can help alleviate allergic reactions causing clogged ears. Decongestants such as Sudafed may also be effective. For persistent issues, a doctor may recommend steroid nasal sprays or prescription medication to reduce inflammation and congestion.
Dos for Getting Water Out of Your Ears
Theoretically, antihistamines may reduce the congestion of mucous membranes and decrease obstruction of tubes lined by mucous membrane, such as the Eustachian tube. An open Eustachian tube would allow the middle ear pressure to equalize to ambient air pressure. It may also allow drainage of fluid from the middle ear.
The 2023 American Geriatrics Society (AGS) Beers Criteria for Potentially Inappropriate Medication Use in Older Adults recommends that individuals 65 years or older avoid use of first-generation antihistamines, including oral diphenhydramine.
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Seniors: Seniors are more likely to experience side effects of this medication because of the pseudoephedrine. Discuss with your doctor or pharmacist the risks and benefits of this medication for you.
Self-care at home
Stop taking cetirizine and call your doctor if your hives do not improve during the first 3 days of your treatment or if your hives last longer than 6 weeks. If you do not know the cause of your hives, call your doctor.
A nosebleed can be caused by a range of factors, including: fragile blood vessels that bleed easily, perhaps in warm dry air or after exercise. an infection of the nose lining, sinuses or adenoids. an allergy that causes hay fever or coughing.
Non-drowsy options like loratadine and cetirizine are among the safest choices for long-term allergy relief. Both medications work by blocking the effects of histamine, and people generally tolerate them well.
Diphenhydramine (Benadryl).
The antihistamine diphenhydramine commonly causes sleepiness, but it can also usher in a slew of other symptoms in older adults, like anxiety, confusion, blurred vision, constipation and difficulty urinating.
The older, so-called first generation H1-antihistamines, such as Chlorpheniramine, Diphenydramine, Doxepin, Hydroxyzine after oral or parenteral administration are metabolized in the liver and excreted in large part with the urines. Pharmacological action occurs after 30-60 minutes and persists for about 4-6 hours.
The study found that people had a higher risk for dementia if they took:
Alcohol is the drug of choice for older adults. One of the most damaging drugs to the human body, alcohols effects on physical health and cognitive functioning can be devastating to a body already facing changes in mobility and cognition as a part of the aging process.
For elderly patients with primary hypertension, the first antihypertensive drug should be a thiazide diuretic (preferably chlorthalidone) or a calcium channel blocker [35]. The first and if needed second antihypertensive drug should be a thiazide diuretic plus a calcium channel blocker.
Older adults should ideally use second-generation antihistamines (like cetirizine, loratadine, or fexofenadine) as they are less likely to cause drowsiness and cognitive impairment compared to first-generation antihistamines.
Be aware, too, that first-generation antihistamines typically are not recommended for adults 65 and older. That's because they have something called anticholinergic properties. Research suggests those properties might raise the risk of dementia.
Acrivastine is not recommended for people over 65 years old because very little research on the medicine has been done in this age group. Talk to your pharmacist or doctor if you're over 65 and want to take acrivastine.
Management and Treatment
Additionally, if you've developed vertigo or dizziness as a result of your inner ear infection, your provider may recommend antihistamines such as diphenhydramine, fexofenadine or loratadine.
A myringotomy is a procedure to create a hole in the ear drum to allow fluid that is trapped in the middle ear to drain out. The fluid may be blood, pus and/or water. In many cases, a small tube is inserted into the hole in the ear drum to help maintain drainage.
Which one should you take? For true cold symptoms, a decongestant will provide more relief than an antihistamine. If you notice your “cold” symptoms occur at the same time each year (spring for examine), or are consistent year-round, you may actually have allergies that could benefit from antihistamine medication.