CETIRIZINE
Place inTherapy
There is little evidence that supports that second-generation antihistamines are helpful in relieving pruritis due to atopic dermatitis. A dose comparison study showed a significant improvement in revealing symptoms of pruritis and erythema across a number doses which included nonprescription doses. Side effects, such as sedation, may be helpful for some patients.(2, 6-9.) There use can be considered in acute atopic dermatitis patient if other treatment options have been ineffective in treating symptoms of pruritis and erythema. Although it is believed that the sedative properties of cetirizine lends to the effectiveness in treating pruritis secondary to atopic dermatitis, if patient's prefer a less sedating oral antihistmane, and second generation antihistamine such as cetirizine can be considered over second generation oral antihistamines. 2, 5, 7.
References
1. Dimson, S. Nanayakkara C. Do oral antihistamines stop the itch of atopic dermatitis. Arch Dis Child (2003); 88: 831-835.
2. Herman SM, Vender RB. Antihistamine in the treatment of atopic dermatitis. J Cutan Med Surg (2003): 467-473.
3. Frosch PJ, Schwanitz HJ, Macher E. A double blind trial of h1 and h2 receptor antagonists in the treatment of atopic dermatitis. Arch Dermatol Res 1984;276(1):36–40.
4. Toyoda M, Nakamura M, Nakagawa H. Distribution to the skin of epinastine hydrochloride in atopic dermatitis patients. Eur J Dermatol 2007;17(1):33–36.
5. Marks R, Greaves MW. Vascular reactions to histamine and compound 48/80 in human skin: suppression by a histamine H2-receptor blocking agent. Br J Clin Pharmaco 1977;(4): 367-369.
6. Murota H, Kitaba S. Tani M, Wataya-Kaneda M, Azukizawa H, Tanemura A, Umegaki N, Terao M, Kotobuki Y, Katayama I. Impact of sedative and non-sedative antihistamines on the impaired productivity and quality of life in patients with pruritic skin diseases. Allerology International 2010; 59: 345-354.
7. Hannuksela M, Kalimo K, Lammintausta K, Mattila T, Turjanmaa K, Varjonen E, et al. Dose ranging study: cetirizine in the treatment of atopic dermatitis in adults. Ann Allergy 1993; 70(2):127–33.
8. Henz BM, Metzenauer P, O’Keefe E, Zuberbier T. Differential effects of new-generation h1-receptor antagonists in pruritic dermatoses. Allergy 1998;53(2):180–3.
La Rosa M, Ranno C, Musarra I, Guglielmo F, Corrias A, Bellanti JA. Double-blind study of cetirizine in atopic eczema in children. Ann Allergy 1994;73(2):117–22.