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. Author manuscript; available in PMC: 2020 Jun 10.
Published in final edited form as: Int Forum Allergy Rhinol. 2018 Feb;8(2):108–352. doi: 10.1002/alr.22073

TABLE IX.B.1.b.

Evidence for the role of oral H2 antihistamines in the management of allergic rhinitis

Study Year LOE Study design Study groups Clinical endpoint Conclusion
Taylor-Clark et al.1194 2005 1b RCT Histamine challenge with premedication:

  1. PO cetirizine;

  2. PO ranitidine;

  3. PO cetirizine + ranitidine;

  4. Placebo

 Nasal airway resistance Cetirizine alone and ranitidine alone improve nasal resistance. Cetirizine plus ranitidine improves nasal resistance more than either alone.
Juliusson & Bende1196 1996 1b RCT Allergy challenge with premedication:

  1. PO terfenadine;

  2. PO cimetidine;

  3. PO terfenadine + cimetidine;

  4. Placebo

 Laser Doppler flowmeter, allergic symptoms No difference in symptoms or flowmetry with cimetidine. No additive effect of cimetidine with terfenadine.
Wang et al.1195 1996 1b RCT Allergy challenge with premedication:

  1. PO cetirizine;

  2. PO cetirizine + cimetidine

 Symptoms (itching, sneezing, rhinorrhea, congestion), sneeze count, nasal airway resistance Combination of cetirizine + cimetidine showed improved nasal airway resistance and nasal airflow over cetirizine alone.
Wood-Baker et al.1193 1996 1b RCT Allergy challenge with premedication:

  1. PO cetirizine;

  2. PO ranitidine

 Nasal lavage fluid protein concentration, nasal airway resistance Ranitidine improved nasal resistance more than cetirizine. Cetirizine decreased total protein and albumin more than ranitidine.
Carpenter et al.1198 1983 1b RCT During allergy season medicated with:

  1. PO chlorpheniramine;

  2. PO chlorpheniramine + cimetidine

 Symptoms (rhinorrhea, sneezing, nasal congestion, nasal pruritus, eye discomfort), medication usage beyond study therapy Reduced symptoms and medication scores in cimetidine plus chlorpheniramine group.
Brooks et al.1197 1982 1b RCT Allergy challenge with premedication:

  1. PO cimetidine;

  2. Placebo

 Subjective symptoms (congestion, itch, drainage, sneeze), nasal resistance, nasal secretion weight No difference in subjective scores. Increased secretion and sneeze count, no difference in nasal resistance.

H2 = histamine receptor H2; LOE = level of evidence; PO = per os (medication taken orally); RCT = randomized controlled trial.