Summary of preferred antihistamines for allergy and urticaria
| Antihistamine (standard single adult dose, mg) | Available in liquid form? | Prescription required? | Approval for children? | Evidence for safety during pregnancy/breastfeeding | |
|---|---|---|---|---|---|
| HC (age) | FDA* (age) | ||||
| Bilastine (20) | No | Yes | N/A | N/A | Lack of data |
| Cetirizine (10)† | Yes | No‡ | Yes (2 yr) | Yes (6 mo) | Yes |
| Desloratadine (5)† | Yes | No | Yes (2 yr) | Yes (6 mo) | Yes |
| Fexofenadine(180)† | No | No | N/A | N/A | Yes |
| Loratadine (10)† | Yes | No‡ | Yes (2 yr) | Yes (1 yr) | Yes |
| Rupatadine (10) | Yes | Yes | Yes (2 yr) | N/A | Lack of data |
Note: FDA = Food and Drug Administration, HC = Health Canada, N/A = not applicable.
↵* FDA and/or supporting randomized controlled trial evidence for efficacy and safety.
↵† Most affordable (see Appendix 1, available at www.cmaj.ca/lookup/doi/10.1503/cmaj.201959/tab-related-content).
↵‡ Prescription not required, but can be prescribed and covered by some provincial plans as an affordable route of accessing this medication. However, prescriptions often have barriers to access (e.g., Exceptional Access Program forms with very low approval rates).