TY - JOUR T1 - Antihistamine use in children JF - Archives of disease in childhood - Education & practice edition JO - Arch Dis Child Educ Pract Ed DO - 10.1136/archdischild-2013-304446 SP - edpract-2013-304446 AU - Roisin Fitzsimons AU - Lauri-Ann van der Poel AU - William Thornhill AU - George du Toit AU - Neil Shah AU - Helen A Brough Y1 - 2014/08/21 UR - http://ep.bmj.com/content/early/2014/08/21/archdischild-2013-304446.abstract N2 - This review provides an overview of the use of antihistamines in children. We discuss types of histamine receptors and their mechanism of action, absorption, onset and duration of action of first-generation and second-generation H(1)-antihistamines, as well as elimination of H(1)-antihistamines which has important implications for dosing in children. The rationale for the use of H(1)-antihistamines is explored for the relief of histamine-mediated symptoms in a variety of allergic conditions including: non-anaphylactic allergic reactions, atopic eczema (AE), allergic rhinitis (AR) and conjunctivitis, chronic spontaneous urticaria (CSU) and whether they have a role in the management of intermittent and chronic cough, anaphylaxis, food protein-induced gastrointestinal allergy and asthma prevention. Second-generation H(1)-antihistamines are preferable to first-generation H(1)-antihistamines in the management of non-anaphylactic allergic reactions, AR, AE and CSU due to: their better safety profile, including minimal cognitive and antimuscarinic side effects and a longer duration of action. We offer some guidance as to the choices of H(1)-antihistamines available currently and their use in specific clinical settings. H(1)-antihistamine class, availability, licensing, age and dosing administration, recommended indications in allergic conditions and modalities of delivery for the 12 more commonly used H(1)-antihistamines in children are also tabulated. ER -