First-generation H1-antihistamines should no longer be available over-the-counter for self-medication

From the GA2LEN position paper:

First-generation H1-antihistamines obtained without prescription are the most frequent form of self-medication for allergic diseases, coughs and colds and insomnia even though they have potentially dangerous unwanted effects which are not recognized by the general public.

A GA2LEN (Global Allergy and Asthma European Network) task force assessed the unwanted side-effects and potential dangers of first-generation H1-antihistamines.

First-generation H1-antihistamines, all of which are sedating, are generally regarded as safe by laypersons and healthcare professionals because of their long-standing use. However, they reduce rapid eye movement (REM)-sleep, impair learning and reduce work efficiency.

They are implicated in:

- civil aviation, motor vehicle and boating accidents
- deaths as a result of accidental or intentional overdosing in infants and young children and suicide in teenagers and adults
- cardiotoxicity in overdose

Older first-generation H1-antihistamines should no longer be available over-the-counter as prescription- free drugs for self-medication of allergic and other diseases now that newer second- generation nonsedating H1-antihistamines with superior risk/benefit ratios are widely available at competitive prices.

Church MK, Maurer M, Simons FER, Bindslev-Jensen C, van Cauwenberge P, Bousquet J, Holgate ST, Zuberbier T. Risk of first-generation H1-antihistamines: a GA2LEN position paper. Allergy 2010; DOI: 10.1111/j.1398-9995.2009.02325.x.
Patient response to different antihistamines will vary



  1. Anonymous4/09/2010

    "Silly" in terms of? Can you expand a little?


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