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Antihistamine use in children
  1. Roisin Fitzsimons1,2,
  2. Lauri-Ann van der Poel1,
  3. William Thornhill3,
  4. George du Toit1,2,
  5. Neil Shah4,5,
  6. Helen A Brough1,2
  1. 1Children's Allergy Service, Guy's and St. Thomas’ NHS Foundation Trust, London, UK
  2. 2Department of Asthma, Allergy and Respiratory Science, King's College London, London, UK
  3. 3Evelina Children's Pharmacy, Guy's and St. Thomas’ NHS Foundation Trust, London, UK
  4. 4Department of Gastroenterology, Great Ormond Street Hospital, London, UK
  5. 5TARGID, Catholic University of Leuven, Leuven, The Netherlands
  1. Correspondence to Dr Helen A Brough, Children's Allergy Service, Guy's and St Thomas’ NHS Foundation Trust, 2nd Floor, Stairwell B, South Wing, Westminster Bridge Road, London SE1 7EH, UK; helen.brough{at}


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.

  • Allergy
  • Paediatric Practice
  • Therapeutics
  • Dermatology
  • Respiratory

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