These drugs are used in urticaria and acute allergic (type I immediate hypersensitivity) reactions. The newer long acting and non-sedating antihistamines are useful for treatment during the day and can be combined with one of the sedating type at night if pruritus is preventing sleep.

Non-sedating antihistamines only cross the blood-brain barrier to a slight extent. They may cause arrhythmias, particularly terfenadine.

• Acrivastine (Semprex, GSK) 8 mg three times daily

• Cetirizine (Zirtek, UCB Pharma) 10 mg once daily

• Fexofenadine (Telfast, Hoechst) 120 or 180 mg once daily

• Loratadine (Clarityn, Schering-Plough) 10 mg once daily.

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