Table 1.
Requirements of the ideal oral H1 antihistamine
| Pharmacological properties | Efficacy | Side effects |
|---|---|---|
| Potent and selective activity at H1 receptors Other antiallergic activity |
Effective in both intermittent and persistent allergic rhinitis | No sedation or cognitive or psychomotor impairment |
| No clinically relevant pharmacokinetic interactions with food, medication, or intestinal proteins | Effective against all nasal symptoms, including obstruction | No anticholinergic activity No weight gain |
| No interaction with cytochrome P450 | Improves ocular symptoms | No cardiac safety concerns |
| No interaction with other diseases (thereby avoiding toxic reactions) | Studies should be conducted in young children and elderly patients to assess efficacy | Potential use in pregnancy and breastfeeding Studies should be conducted in young children and elderly patients to assess safety Prospective postmarketing safety analyses should be performed |
| Pharmacodynamics | ||
| Rapid onset of action | ||
| Long duration of action permitting once-daily dosing | ||
| No potential for tolerance development (tachyphylaxis) | ||
Note: Reproduced from Bousquet J, Khaltaev N, Cruz AA, et al; World Health Organization; GA(2)LEN; AllerGen. Allergic rhinitis and its impact on asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy. 2008;63(suppl 86):8–160.6 With permission from John Wiley and Sons. Copyright ©2008.