Drugs, driving and traffic safety in allergic rhinitis

Abstract

Antihistamines are used as a treatment for allergies but cause sedation as a side effect. This sedation can be so severe that it interferes with patients daily functioning such as driving a vehicle. This chapter gives an overview of the effects of numerous antihistamines on driving performance as assessed in a standard highway driving test. When investigating the effects of an acute administration of the therapeutic dose, many antihistamines cause driving impairment comparable or larger than the effect of 0,5 mg/ml alcohol (i.e. hydroxizine, emedastine, diphenhydramine, clemastine, triprolidine, mizolastine, mequitazine, dexchlorpheniramine CR). However this does not mean that the other antihistamines are free of sedating effects. Driving impairment has been demonstrated for most antihistamines after increased or repeated doses. Also women often appeared to be more sensitive for the sedating effects of antihistamines. So far, only a few antihistamines appear to be free of impairing effects on driving (i.e. desloratadine, levocetirizine, fexofenadine and rupatadine), however, not all have them have been tested after higher or repeated dosing. This review of more than 15 driving studies indicates that most antihistamines have the potential to impair performance. Therefore patients should be correctly advised and informed about the possible risks when choosing a treatment. © 2009 Birkhéuser Verlag/Switzerland.