Taking Different Types Of Antihistamine Together

[flop]

Hi I was just wondering if anyone took more than one antihistamine medication at the same time? I take acrivastine (UK only, non-drowsy) three times a day all year round for my rhinits. Most of the time it works well and I don't get any side-effects from it.

At the moment the pollen counts are officially "very high" (off the top of the scale) and despite the acrivastine, singulair, cromoglycate eye drops and cromoglycate nasal spray my symptoms are becoming unbareable.

Worst issues are intense itching of the soft palate / roof of my mouth (I am scratching at it in my sleep), sore itchy throat, itchy ears and congested nose. I have unofficially "self-diagnosed" oral allergy syndrome (I get swollen lips and tongue after eating several different sorts of fresh fruit - apparently a cross reaction to pollens and I can eat them ok in the winter months - weired). The only relief is from holding ice lollies (popsicles) against the roof of my mouth - this temporarily relieves the itching for 10 mins. Having minor asthma symptoms (usually really well controlled unless I get a lower respiratory infection and then need to use home nebuliser).

The last two summers I have had to go onto oral steroids which have taken until Christmas to get back off again - I really don't want to have to go down that route again.

It is really getting me down and stopping me from sleeping (I know several people have commented in PMs that I am on here most of the night). Got to sleep at 5:30am last night and delayed alarm until 8am which put me in a mad rush to get ready to go to work.

Is it ok to mix two different types of antihistamine? Like perhaps take a sedating one in the evenings or just take two different ones together? I've asked 2 different doctors and one said it was fine, the other said it should never be done?

I've never had any allergy testing or seen a specialist but my GP says it is unneccessary.

Thanks,

Flop

[MightyMouse]

Every day I take:

Singulair 10mg

Zyrtec 10mg

Benedryl 50mg

Nasonex spray

and during my worst times, add Advair 100/150 inhaled powder

[flop]

Thanks Nina,

I'm assuming the combination of Zyrtec and Benedryl hasn't caused any problems?

I've just got my GP to prescribe Singulair (I used to take it for asthma back in 1998)

Nasonex was brilliant but I'm not allowed to use nasal steroid sprays since my major nose bleeds (ended up having 6 blood transfusions) and recent nasal surgery.

I've not heard of Advair inhaled powder - can you supply any more info on that please?

Flop

[MightyMouse]

Nope, no problems with both the benedryl and zyrtec; in fact, my allergist is the one who put me on it. Also, when I'm really having problems with hives and generally allergic, I was instructed to add Zantac (rantidine) to hit the other histamine channel.

Advair is a combination of two drugs in one inhaler. This is the company website:

http://www.advair.com/asthma_inhaler.html

then go to the bottom for "complete prescribing info"

The two components are:

fluticasone propionate and salmeterol inhalation powder

Nina

[mkoven]

Under an allergist's supervision, I take zyrtec, allegra, and singulair, all every day. I can add benadryl as needed for breakthrough symptoms. My eyes are still itchy and I may need drops. It's really hard to override allergic reactions when my body's hellbent on itching! When it's really bad, I wear one of those blue masks over my nose and mouth. I run filters at home, keep inside.

And I'm sympathetic about oral allergy stuff... I've just had to say goodbye to cherries. Sigh.

[flop]

Thanks for the information - it looks like several of you are mixing antihistamines without any problems. I'll ask my cardiologist tomorrow about adding in a second antihistamine and an H2 antagonist (like nizatidine or ranitidine).

Nina - the Advair made perfect sense when you listed the "ingredients". I'm actually taking a different version of the same thing, "Seretide" is an inhaler with the same steroid and long-acting b2 agonist as you listed. It shows how the generic names are the same worldwide but the brand names can be totally alien the other side of the atlantic.

For the moment I'm just taking the odd extra dose of acrivastine (it is working, well making things bearable, but only lasts about 5 hours instead of the 10 it usually lasts). Infact I'm off to fetch the packet right now...

Thanks,

Flop atchoooo!

[Sunfish]

in short, i've combined various antihistamines over the years (under the direction of doctors) & never had a problem. hope you figure out something to bring about better relief soon!

melissa

[flop]

Thanks Melissa,

the itching is driving me crazy. I know others have much more troublesome symptoms than itching but it really does seem to interfere with every aspect of your life. Currently wishing for sleep...I normally need a lot of sleep at the best of times so running on 2-4 hours per night and trying to work too really is a recipe for disaster.

Fingers crossed for the cardiologist's opinion tomorrow (later today actually since it is 1am here).

Flop

[flop]

Well I didn't get a chance to ask the cardiologist about the allergies, just had the tilt and a chat about the results.

My GP said no-way could I mix anti-histamines. I tried out a few over the counter ones myself (chlorpheniramine/piriton, cetirizine/zirtek, loratadine/clarityn) none of them seemed to help much when taken in combination with my acrivastine and singulair.

I asked the pharmacist about a h2 blocker like ranitidine, she said it couldn't be mixed with antihistamines which I know to be rubbish so I will have to ask my doctor next time I see one about trying that.

I just really want to find a solution other than prednisolone - I think I have already rotted my bones enough with steroids.

an itchy, tired Flop!

[mkoven]

Any idea why they were so absolute? It was an allergist who told me I could combine antihistamines and told me how high I could go--and not a local one. I went up to chicago and saw a big-wig. She's used to treating people who regularly go into anaphylaxis and is trying to get them off prednisone-- my regimen came from her.

Different people react differently to antihistamines, but it seems strange to just say no.... at my worst I was taking 360 allegra, 20 zyrtec, 10 singulair, and 50 benadryl with no problem. And I'd do it again, rather than go back on prednisone, which was much worse for my pots.

[flop]

I don't know why my GP and pharmacist were so adamant. I know that higher doses of some antihistamines are ok. Years ago I lived with a friend who had severe angioedema reactions and I did some research for her and found trials that used 960mg of fexofenadine (allegra, called Telfast in the UK) daily for months on end - they concluded that the huge doses gave no additional benefit but no extra side-effects either.

I used to take 120mg fexofenadine, after 2 summers use it was increased to 180mg which worked for another 2 years but just didn't last the full 24 hours. When it was working all of my allergy symptoms would dissapear but after about 18 hours they came back, and really badly. I could never decide whether to be itchy at night or during the day! Ideally if I could take 120mg twice a day it might work out to settle my symptoms.

Luckily it has been raining really heavily for the last 2 days here which has lowered the pollen count and given me some relief (other areas of the UK have been flooded from all the rain).

Flop

[juliegee]

Hi Flop-

Mixing antihistamines is a necessity for many. My allergist (previously from Mayo) insists that the combo of H-1 and H-2 blockers can best stabilize mast cells. I take ranitidine, singulair, zyrtec, and benadryl daily. This controls not only my hives, but also helps to stabilize my BP and HR- definately improves my POTS. This combo also controls my daily nausea and headaches. Definately seek the advice of an allergist! Like you, everything is worse for me when the pollen count is high (despite the fact that I'm officially alllergic to nothing:-) And, I do take low doses of all of my meds. It is the COMBO that really helps.

All the best-

Julie

[flop]

Thanks,

I spoke to my cardiologist about allergy meds today. Unfortunately I can't see an allergist / immunologist as my GP won't refer me and thinks that hayfever is a trivial problem! My cardiologist admitted that he knows nothing about antihistamines or H2 blockers for allergy but suggested that I just buy some Ranitidine / Zantac over the counter and try it myself. I tried explaining to him about histamine release causing vasodilatation and lowering my BP but he didn't seem too interested in my theory.

At the moment I am making do with the extra doses of acrivastine (plus singulair, nasal sprays and eye drops).

I'll let you know how I get on with the Ranitidine.

Flop

[lthomas521]

Hi Flop:

Actually, among the drugs you listed, only acrivastine is truly an antihistamine. Technically, an antihistamine is a drug that blocks the H1 type of histamine receptor, which is responsible for the symptoms of allergic rhinitis. (H2 receptors are responsible for triggering the release of stomach acid.) Cromoglycate, which is called cromolyn in the United States, is a mast cell stabilizer: it prevents the histamine from being released from mast cells, rather than blocking the effect of the histamine at the target cells. Singulair is a leukotriene receptor blocker. So all three drugs work in completely different ways. Therefore, you are not combining different kinds of antihistamines at present. I don?t know whether it would do you any good to do so.

If I were you, I?d see a specialist. Maybe if you could find out what you are allergic to, you might be able to use some nonmedical approaches to avoiding the allergens. You might not be a good candidate for allergy shots, because of the POTS.

[flop]

Hi LThomas,

sorry if I didn't make my initial post clear. I know that I am currently taking only one antihistamine (the acrivastine), what I was trying to ask was about others experience of taking more than one antihistamine in combination. I was specifically wondering about adding an older type sedating antihistamine at night to the one I am already taking.

Since the original post I have experimented with adding (one at a time) the 3 antihistamines that I named in one of my later posts.

My GP said no-way could I mix anti-histamines. I tried out a few over the counter ones myself (chlorpheniramine/piriton, cetirizine/zirtek, loratadine/clarityn) none of them seemed to help much when taken in combination with my acrivastine and singulair.

I wish that I could see a specialist but in the UK you have to have a referal from your GP and he thinks that a referal isn't needed. Unfortunately I wouldn't be allowed to have allergy shots as I have asthma (the UK guidelines forbid giving to asthmatics because of the increased risk of anaphylaxis).

Flop

[lthomas521]

Allergies must be aggressively managed in people with POTS. It says so somewhere on the POTSPlace Web site. That in itself should be a reason for a referral.

Can you explain to the GP that you won't be able to solve the POTS-related disability problem unless you solve the histamine problem? If the GP still resists, can you get a different GP?

[Lukkychrm42]

I take 10 mg loratadine every day morning and evening, and then zicam allergy spray, and benadryl as needed. Plus decongestant nasal spray when absolutely necessary.

I was on prescription shots and pills until age 18, and seem to be doing better, but still get seasonal issues.

I don't know why your meds don't seem to be working in combination, but if your gp doesn't seem concerned about this, than can you try to go to someone else?

[juliegee]

Oh Flop,

I feel for you. How frustrating to not be able to get a referral! Can you switch GP's to one more open to your plight and possible solutions?

How's the ranitidine going? Like you, I just buy it over the counter- since it's been available that way my insurance co. will no longer pay for it. My allergist says that it is a type of antihistamine, an H-2 blocker, that controls stomach acid. I was actually taking it for GERD before I found out that it was also helping to stabilize my mast cells. I take 300mg daily, 150mg in the AM and 150mg in the PM. This dosage pattern seems to best help with the GERD and hives.

Tell us if it's making a difference for you.

Julie

[flop]

Hi Julie,

I only started the Ranitidine yesterday so I think I need to give it a while to see how I get on with it. No side-effects so far so that is at least one positive. It has also been pouring with rain here which always lowers the airborne pollen count which helps a bit. Still got really itchy palate and throat, slightly swollen so it feels like having a chronic sore throat when I swallow. I almost wish that I could squirt my nasal cromoglycate into my mouth. In the past I have tried taking my steroid asthma inhaler without using a spacer to deliberately increase the amount of steroid landing in my mouth - no help, I think it gets swallowed before it has a chance to have any effect.

Flop

[anna]

Hi Flop,

Not sure if this is true but when I asked our local Boot's pharmasist whether my daughter could take her Cinnarizine Stugeron (that she takes for vertigo) with some hayfever meds Cetirizine as she was suffering from high pollen count, anyway Pham told me that they would infact cancel each other out!! could that happen. So she said not much point bothering but no harm if we wanted to try.

Anna

[flop]

Hi Anna,

I looked up Cinnarizine - it is an antihistamine but only used for the treatment of nausea. I can't see any way that it would "cancel out" Cetirizine but perhaps the pharmacist meant that there would be no additional benefit of taking the two together?

Pharmacists here in the UK seem to be insistant that you can only take one type of antihistamine. In fact one told me off yesterday for taking Ranitidine with Acrivastine. I'm having to buy the ranitidine over the counter telling the pharmacist that I need it for indigestion, then an taking double the recommended dose. When it is prescribed by doctors the dose is 150mg twice daily (which I'm taking) but when you buy it you are only supposed to take 75mg as needed, maximum 2 tablets daily. It is working out at ?1 a day!

Flop