Should First-Generation Antihistamines Be Available By Prescription Only?
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Citing consumer protection and the widespread availability of second-generation antihistamines with superior risk/benefit ratios, a task force convened by the Global Allergy and Asthma European Network (GA2LEN) has recommended that first-generation antihistamines should no longer be available on a nonprescription basis.
The task force was charged with investigating the risk/benefit ratio of first-generation antihistamines in the treatment of allergic and pruritic diseases. Task force members noted that first-generation antihistamines generally are regarded as safe by laypersons and health care professionals because of their long-standing use. As a result, users of first-generation antihistamines either (1) may not be aware of or (2) may underestimate the potential dangers associated with effects such as reduced rapid eye movement sleep, impaired learning, and reduced work efficiency.
The task force concluded that there is no good argument today for first-generation antihistamines to be available as nonprescription medications. Instead, they should be available only for prescribing by medical practitioners.
Allergy. 2010;65:459-66.