CHLORPHENIRAMINE
Place in Therapy
First-generation antihistamines cause drowsiness, which may help patients with atopic or contact dermatitis by promoting sleep or decreasing sleep disturbances due to pruritis. Several antihistamines continue to provide relief of pruritus by central sedation, and they can also be used therapeutically for concomitant allergic conditions associated with AD. More clinical trials examining the therapeutic efficacy of antihistamines, are needed specifically in comparing 2nd generation antihistamines that are less sedating and possibly more desirable for patients require symptom control during daytime hours. (1-5) The efficacy in relieving symptoms that include pruritis and erythema of chlorpheniramine has been demonstrated in a randomized controlled trial however, not consistently among other primary literature.
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.