Antihistamine
Generic and Trade Names:
| Astemizole | Hismanal | ||
| Azatadine | Optimine | ||
| Cetirizine | Zyrtec | ||
| Chlorpheniramine | Chlor-Trimeton | ||
| Clemastine | Tavist | ||
| Dimenhydrinate | Dramamine | ||
| Diphenhydramine | Benadryl | ||
| Fexofenidine | Allegra | ||
| Hydroxyzine | Atarax | ||
| Loratadine | Claritin | ||
| Promethazine | Phenergan |
Description
Antihistamines form a class of drugs which are used to treat many different conditions, from allergies, to reducing rigidity and tremors, and the management of motion sickness, to name a few. These drugs prevent the release of histamines. The antihistamine drugs include Promethazine hydrochloride [Phenergan], Clemastine fumarate (Tavist), Cyproheptadine HCl (Periactin) and Chlorpheniramine Maleate (Chlor-Trimeton). Cyproheptadine hydrochloride is used to alleviate allergy symptoms such as inflammation of the mucous membrane, mild skin manifestation, and conjunctivitis.
Cyproheptadine hydrochloride and others also have other medical applications such as prevention of reactions to blood or plasma in patients with a known history of such reactions and for treating cold urticaria or cold-induced vascular reaction of the skin characterized by the eruption of pale evanescent and wheals.
There are several major classifications (underlined):
Ethanolamine derivatives (e.g. Diphenhydramine).
Ethylenediamine derivatives (e.g. Pyrilamine).
Peripherally selective piperidine class: Loratadine (Claritin), Fexofenadine, Cetirizine
Phenothiazine (which includes Promethazine) is a major class of antihistamines.
Triprolidine is an alkylamine derivative.
Nutritional Considerations:
There may be a possible increased need for Co-Q-10 when using Promethazine. (Kishi 1980)
Take Loratadine, Astemizole on an empty stomach. (Pronsky 1999)
Increased requirement for riboflavin.(Pinto 1987)
Avoid alcohol. (Pronsky 1999)
Patients should drink plenty of fluids unless otherwise directed (Pronsky).
Increased appetite and weight gain are side effects. (Facts 1999)
Herbal Considerations:
The use of herbs like motherwort and skullcap may potentally increase the sedative effects of antihistamines. (Brinker 1998)
Schisandra may antagonize antihistamines or other hepatically metabolized drugs. (Natural Products Review 1999)
Phenergan may increase Yohimbe toxicity, and these two substances should not be used in combination (DeSmet 1994).
The German Commission E has noted that Henbane leaf interacts with antihistamines. (Blumenthal 1998)
Toxicity of Yohimbe may be increased if given together with Promethazines. (Brinker 1998)
Given the drowsiness often associated with antihistamines, the addition of any herb with sedative action could be potentiate the sedative effects of both. The following list has been compiled by Newall and Brinker:
Herb
Ashwagandha (Withania somnifera)
Balm plant (Melissa officinalis)
Calendula flowers (Calendula officinalis)
Calamus
California poppy plant (Eschscholtzia californica)
Catnip leaves (Nepeta cataria)
Cayenne fruit (Capsicum frutescens)
Celery
Chamomile, German
Couchgrass
Elecampane
Ginsengs
Goldenseal
Hops
Hydrocotyle
Jamaica Dogwood
Kava root (Piper methysticum)
Nettle
Passionflower
Sage
Sassafras bark (Sassafras albidum)
Scullcap,
Shepherd's Purse
Siberian ginseng root (Eleutherococccus senticosus)
Valerian
Wild Carrot
Wild Lettuce
Yerba mansa root/rhizome (Anemopsis californica)
References
Angel, J.E. 1983. Physicians Desk Reference. Medical Economics Company, Inc. Oradell, New Jersey.
Blumenthal, M (Ed.): The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council. Austin, TX. 1998.
Brinker, Francis.N.D. Herb Contraindications and Drug Interactions.1998
DeSmet PAGM, Smeets OSNM. \"Potential risks of health food products containing yohimbe extracts,\" Br. Med. J., 309:958, 1994
Facts and Comparisons, Natural Products Review, Wolters Kluwer Company, 1999.
Kishi T, et al. Inhibition of Myocardial Respiration by Psychotherapeutic Drugs and Prevention by Coenzyme Q. Biomedical and Clinical Aspects of Coenzyme Q, Yamamura Y, Folkers K, and Ito Y, eds, Elsevier/North-Holland Biomedical Press: Amsterdam, 1980, Vol 2, 139-54.
Kastrup, E.K., ed. 1981. Drug Facts and Comparisons, 1982 edition. Facts and Comparisons Division, J.P. Lippincott Co, Philadelphia, St. Louis.
Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996
Osol, Arthur. 1980. Remington's Pharmaceutical Sciences. Mack Publishing Company, Pennsylvania.
Pinto, J.T. & Rivlin, R.S. : Drugs that promote renal excretion of riboflavin. Drug Nutrient Interactions, 1987, 5: 143-151.
Product Information: Periactin(R), cyproheptadine. Merck Sharp & Dohme, West Point, PA, 1991.
Pronsky, ZM, et al: Food-Medication Interactions, Pottstown, PA, 1999.
Silverstone T & Schuyler D: The effect of cyproheptadine on hunger, calorie intake and body weight in man. Psychopharmacologia 1975; 40:335.
Thomas, C. L. 1985. Taber's Cyclopedic Medical Dictionary F.A. Davis Co. Pub., Philadelphia. 2170 pp.
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