6 modern antihistamines for children from one year old

Review of the best according to the editorial board. On the selection criteria. This material is subjective and does not constitute advertising and does not serve as a purchase guide. Before buying, you need to consult with a specialist.

Doctors, and even more so, parents, should always have special attention to medicines that are prescribed to young children. Kids cannot complain about the occurrence of side effects, and if their parents do not see them with their own eyes, it is possible to use the wrong prescription, or in general, by 'self-medication', to significantly worsen the condition of the baby.

During the first year of life, a small person learns a new world, and, among other things, encounters a huge number of different allergens. These are complementary foods that are introduced after several months of life, these are various household allergens, for example house dust, detergents, fabrics, and even insect bites in summer. Therefore, many parents are rightly concerned about the question: what antiallergic and antihistamines can be safely given to young children?

There are relatively few such medicines. In addition to the fact that in general, there are fewer drugs in pediatrics than for adults, there are elementary physical restrictions on the use of this or that drug, and even commercial ones. Let us explain these types of restrictions.

About different restrictions in pediatrics

Physical limitations include the impossibility of taking certain medications by babies in the form of pills, since they simply cannot swallow them and may choke. In this case, manufacturers sometimes produce special forms of medicines for children, usually in liquid form, in the form of drops or in the form of syrup. So, in drops, the popular drug Fenistil is produced, which also still exists in local form in the form of a gel. In the form of drops for babies, one of the cetirizine preparations is produced, for example Zodak, which are also actively used by pediatric allergists-immunologists and pediatricians in their clinical practice.

Sometimes a situation arises that one dosage form of the same medicine is indicated for use in babies, and the other is not. An example is the old, well-known drug Diphenhydramine, or diphenhydramine, which can be used in ampoules for intramuscular and intravenous administration in children of the first year of life, and in tablets, its initial intake is allowed later, and not only because they are difficult to swallow.

It would seem that you can find a simple way out: crush a pill, dilute it in water and give the baby a drink. However, everything is not so simple here. Since the manufacturer announced in advance that the tablets are not intended for babies, therefore, the dosage in tablets may only be suitable for adults, and for children it may be too large. Therefore, the tablet will have to be divided into several parts, which can cause error and overdose. For the same Diphenhydramine we read: 'When taken orally, single doses for children under the age of 1 year – 2-5 mg; from 2 to 5 years – 5-15 mg '. All this is good, but one small and fragile tablet of Diphenhydramine contains 0.05 g, that is, 50 mg. It turns out that a one-year-old baby must manage to separate no more than 1/10 of a tablet, otherwise an overdose is possible. On the other hand, the taste of Diphenhydramine is unpleasant, bitter-pungent, and the child will simply refuse to drink what his parents did to him.

Therefore, one should abandon such irresponsible experiments that can negatively affect the health of the child, and strictly follow the instructions, using special, children's dosages.

What does commercial restriction mean? This is a fairly common situation when a drug sells very well in adults, and the strategy of its promotion on the market simply does not imply expansion towards this niche. The company is not going to conduct additional expensive clinical trials of the drug's effect on children and pregnant women. Why waste money when the product is already selling well? In this case, the instructions usually indicate that 'the medicine is contraindicated in children (for example, under 12 years of age), pregnant and lactating women. Sometimes it is further attributed that 'no relevant studies have been carried out', or 'little data has been accumulated' Again, in this case, one should strictly follow the official instructions and not risk it.

About indications for use

When are antihistamines most often used in children? In the case of well-known allergic symptoms, such as urticaria, itchy dermatoses, profuse, watery rhinorrhea, nasal congestion like allergic rhinitis, conjunctivitis, bronchospasm, wheezing and nocturnal cough. However, the rule remains that antihistamines should be prescribed either by a local pediatrician or a pediatric allergist, since many diseases can hide behind the mask of a common allergy, and they need to be treated with other methods and drugs.

It should be remembered that without exception, all antihistamines are pathogenetic therapy, that is, a method of treatment that breaks a certain pathological process, and as a result, either reduces the severity of a symptom or completely eliminates it. But the fact that the baby has become more comfortable to exist, since the itching has disappeared, does not mean that he has recovered. For example, exposure to an allergen such as dried fish food, which includes small copepods, daphnia, is very harmful to health, is a strong allergen, and can result in the development of bronchial asthma.

But if a child is given modern antihistamines constantly, for a long time, and simply (and successfully!) To deal with complaints, then he may not have such symptoms as a barking cough, bronchospasm, itching, urticaria. This can lull the vigilance of the parents, but all the same, since the elimination of the allergen has not been made, the risk of developing bronchial asthma is very high. That is why only a doctor should prescribe antihistamines, and they should be used in extremely short courses, with rare exceptions, for example, in the presence of a diagnosis of atopic dermatitis, and other serious disorders.

If, nevertheless, we are talking about a rather long-term use of antihistamines, from 1 week or longer, then of course, the advantages should be given to second-generation drugs. Firstly, it is the convenience of a single dose, and secondly, the absence of a sedative effect. However, all 2nd generation drugs have the potential to cause side effects, affect the cardiovascular system, and therefore, in any case, the course should be as short as possible.

But if we are talking about an acute allergic attack, for example, the same urticaria, Quincke's edema, then babies from a year and older need to take first generation drugs. And if an ambulance doctor comes, they can be injected intramuscularly. This is the same Diphenhydramine, and Suprastin, they well stop the manifestation of any allergic reaction, except for the most severe, namely anaphylactic shock, when corticosteroid hormones are already required, and this therapy is quite enough.

Before listing a relatively small range of medicinal antihistamines for children over one year old, it should be said that this drug review will not include drugs from the group of corticosteroid hormones. That is, it will only talk about histamine receptor blockers, which are safer.

Drug therapy

Before starting the review of medicines, we recall that first the international non-proprietary name, that is, the INN, is given. Then – the first drug in brackets is usually the most expensive, the original one, which was first introduced on the market, and which is equal in quality to all other commercial copies, or generics. They are also listed in brackets after the first original drug. The following is the range of pharmacy prices, with the originator brand being the most expensive. We will not save on children.

This list is not an advertisement or anti-advertising of any drug or manufacturer, and is dictated exclusively by existing clinical and national guidelines for the use of antihistamines in pediatrics. The price range for specific dosages is indicated for January 2020, and is relevant for pharmacies of all forms of ownership in the territory of the Russian Federation.

Antihistamines for children from one year old

Nomination	a place	Name of product	price
Modern means of the second, or 'third' generation	1	Ketotifen (Zaditen, Ketotifen Sopharma)	55 RUB
	2	Cetirizine (Zyrtec Zodak-drops, Parlazin)	112 RUB
	3	Desloratadin (Erius, Blogir-3, Lordestin)	RUB 565
	4	Fenistil (dimetindene)	357 r
First generation antihistamines	1	Clemastine (Tavegil)	139 RUB
	2	Diphenhydramine	RUB 11

Modern means of the second, or 'third' generation

In order not to return to this topic anymore, let's say a few words about antihistamines of the 'third', and even more so, the hypothetical 'fourth' generation. In fact, while there are only 2 generations in the world, and the third generation will be officially created only when the first antihistamine appears, free of harmful effects on the cardiovascular system and the liver.

Of course, if you use the second generation means reasonably, according to indications, in therapeutic dosages, and in the shortest possible courses, knowing in advance about the risks associated with one or another pathology of the liver or cardiovascular system in a particular patient and monitoring, then this treatment can be considered quite safe: he who is forewarned is armed. But if you read on the Internet about drugs from the group of third, or even more so, fourth generation antihistamines, then do not flatter yourself: no such drugs have been created yet. If you look at a couple of dozen similar sites, you will see that these drugs remain on professional medical resources as a second generation agent, and moving them to a higher rank is nothing more than simple advertising gimmicks.

And now we turn directly to these drugs, and the first of them is membrane stabilizing, called Ketotifen. The original remedy is Zaditen, but at present it is very difficult to find it on the territory of the Russian Federation.

Ketotifen (Zaditen, Ketotifen Sopharma)

Popularity rating: 4.9

But there is a fairly high-quality generic, which are produced in Bulgaria by Sopharma. This is a syrup that is inexpensive, from 70 to 160 rubles, for a 100 ml bottle. It is shown for admission to babies, starting from the age of six months. It is well tolerated, and Ketotifen itself stands slightly apart from other antiallergic agents of the second generation, due to the pronounced membrane stabilizing effect, this is its second action, in addition to the antihistamine. It also works by suppressing the excessive activity of eosinophils and preventing their migration to the site of inflammation. Ketotifen, in addition to bronchial asthma and bronchospasm, is good in situations with acute and chronic urticaria, atopic dermatitis. It must be used with meals, at a dosage of 0.0125 mg of Ketotifen per 1 kg of the baby's body weight twice a day. The required dose can be easily measured using a special dispenser.

Advantages and disadvantages

The advantage of Ketotifen can be considered an effective prevention of bronchial narrowing, and this is important in the treatment of bronchial asthma. It reduces the need for children in the dosage of glucocorticosteroids and bronchodilators – bronchodilators. The disadvantage of ketotifen can be considered a rather long development of the effect. The maximum benefit from taking ketotifen occurs only after a month, so this remedy is an exception to the rule, and it is taken for a rather long time. Of course, the drug also has side effects. This can be mild sedation, drowsiness, increased appetite, or dry mouth. Also, the drug is contraindicated in babies who are under 6 months old, pregnant and lactating women.

There is one more important note. If treatment with Ketotifen is started while taking medications for asthma, then they cannot be abruptly canceled, especially when it comes to glucocorticosteroid hormones. There is a risk of adrenal insufficiency. An overdose of Ketotifen is also possible, which in young children can occur in the form of a convulsive syndrome, a decrease in blood pressure and drowsiness. Therefore, in no case should the indicated dose be exceeded.

Cetirizine (Zyrtec Zodak-drops, Parlazin)

Popularity rating: 4.8

The next high-quality drug is Zyrtec, but its analogue is produced in drops by the Hungarian company Egis, and it is called Parlazin, and the drug is also produced in drops called Zodak-drops. It reliably protects against both early and late or delayed allergic reactions. In the bronchi, the production of secretion decreases, so breathing is easier, and the risk of infection decreases. It acts on histamine receptors, and in addition to antipruritic it is believed that it has a pronounced anti-exudative effect. Parlazin is indicated in the case of allergic conjunctivitis and rhinitis, with hay fever, with Quincke's edema, urticaria and various forms of itching dermatoses. It should be used for babies over the age of 1 year, five drops, or 2.5 mg 2 times a day, and children over the age of 2 years – 10 drops once. Partialzin costs in the range from 230 to 300 rubles. for one bottle of 20 ml.

Advantages and disadvantages

No addiction develops to this medication, which means that the dose does not need to be increased if a long-term administration is required. Still, after a long experience of use, it turned out that the drug still slightly causes drowsiness in children, it should also not be prescribed to pregnant and lactating women. But this is most likely a commercial contraindication due to lack of research and good sales. However, if children have chronic renal failure, then the medicine must be used with extreme caution. There may be side effects from taking Zirtek and Parlazin. This is dry mouth, as already mentioned above, some drowsiness, less often headache and dizziness appear, and in case of an overdose, there may be an increase in side effects, urinary retention, constipation and increased irritability appear.

Desloratadin (Erius, Blogir-3, Lordestin)

Popularity rating: 4.7

Erius is undoubtedly one of the best reference drugs that is produced, including in syrup, and can also be used in babies starting from 6 months of age. Erius is a remedy that in pediatric allergology very well helps against various forms of itching, including urticaria, successfully fights against allergic edema of the mucous membranes, even with spasm of smooth muscle muscles.

It is important that funds are never prescribed for prevention, but only for the treatment of the condition that has already arisen. For example, this is the relief of acute rhinorrhea with allergic rhinitis, itching in the eyes with allergic forms of conjunctivitis, or with severe itching, if there is urticaria. Babies aged 1 year and older, up to the age of five, need to be given 2.5 ml of syrup daily, once a day. The medicine is taken orally, regardless of food intake, and washed down with a small amount of liquid.

In the form of syrup, Erius for babies is produced in a dosage of 0.5 mg per 1 ml, in one bottle of 60 ml, that is, the total dosage in a package is 30 mg. This syrup will cost from 420 to 680 rubles, produced by the well-known pharmaceutical company Schering-Plow. Exactly the same syrup called Blogir-3 is produced by the Croatian company Belupo, and it will cost a little cheaper, from 300 to 430 rubles. with European quality.

Advantages and disadvantages

The big plus of Erius is the almost complete absence of a sedative effect, its good tolerance. Nevertheless, Erius can cause side effects, and most often it is a headache, dry mouth, and increased fatigue. Erius has not found a particularly strong and significant interaction with other drugs, but due to the lack of clinical data, it is still not recommended to use it in pregnant and lactating women.

Fenistil (dimetindene)

Popularity rating: 4.6

Fenistil is a very popular drug, which is available in the form of a gel and in the form of drops, and is indicated for use from a very early age, and at present, it is very 'popularized' on all television channels, and it has no analogues. It can be used even by babies from the age of one month. Fenistil is a drug from the group of histamine receptors, and is well tolerated, since Fenistil practically does not have a pronounced anticholinergic action that causes dry mouth, dysuric disorders.

It is shown, in addition to food allergies, with hay fever, Quincke's edema, insect bites, especially since it is produced in the form of a gel, atopic dermatitis and chickenpox. For babies, it is necessary to apply 2 drops per 1 kg of body weight per day, and divided into 3 doses. So, a baby weighing 9 kg per day will receive 18 drops, that is, 6 drops 3 times a day. Produced by Fenistil Novartis Consumer Health, Switzerland, and a pack of 20 ml drops will cost 340 – 405 rubles.

Advantages and disadvantages

Fenistil is, perhaps, the only histamine blocker that can be used in babies from 1 month of age, it is a very, very safe remedy. However, if you get too carried away and an overdose occurs, then there may be tachycardia, dilated pupils and dry mouth, since the anticholinergic effect in case of an overdose will still be pronounced, and especially in babies. Such effects as urinary retention and fever can give rise to false diagnoses of respiratory viral infections and neurological disorders. Of the contraindications to taking Fenistil, it is imperative to take into account bronchial asthma, which may be in children. Other contraindications apply to adults, for example, angle-closure glaucoma, or prostate adenoma, but the condition with bronchial asthma must be taken into account, as well as the presence of obstructive pulmonary diseases.

First generation antihistamines

As mentioned above, first-generation drugs are good for very short courses, for the relief of sudden and rather severe allergic conditions, and one of the most effective drugs belonging to this generation, which is used in pediatrics, is Tavegil (clemastine). Let's take a closer look at it. Also, we will not ignore Diphenhydramine, which was mentioned above, and as for other drugs of this generation, they cannot be used for one-year-old babies yet. So, Diazolin tablets are indicated for admission only from the age of five, and Diazolin pills can be taken from 7 years old. The antiallergic drug Fenkarol is very good, but despite the love of children's allergists for this drug, it cannot be taken in children under the age of three, but after 3 years, please. And although it does not penetrate the blood-brain barrier, does not cause drowsiness, it is still better for parents of babies who are only one year old to refrain from taking it.

Clemastine (Tavegil)

Popularity rating: 4.9

It is the most effective and widely used 1st generation antihistamine approved for use in children. It has a long-term effect, the sedative effect is not expressed due to the fact that the drug does not penetrate the blood-brain barrier. Tavegil also reduces vascular permeability, causes a mild situation, which is sometimes indicated when a child is agitated, associated with itching, but does not have a hypnotic effect.

Tavegil is produced by a large number of foreign companies, currently in the Russian Federation you can purchase a medicine made in Italy, for 20 tablets you will pay from 190 to 220 rubles. The indications for the use of Tavegil are the same, ranging from contact dermatitis, urticaria, allergic rhinitis and conjunctivitis, and ending with insect bites and eczema.

Children need to give Tavegil only in syrup, at the age of 1 to six years – one teaspoon of syrup, once or twice a day at a dosage of 0.67 mg. Spoon included. Tavegil is also produced by the pharmaceutical companies Nycomed, Sandoz, Takeda, and the Hungarian company Egis. Such a large number of the best foreign manufacturers suggests that this is a really good and high-quality drug, and it is all the more interesting that it has no generics at all, including Russian-made ones.

Advantages and disadvantages

The merits of Tavegil were mentioned above. It is used with success in pediatric practice, but it is contraindicated just before the age of one year, and it also cannot be prescribed to babies who have a suspicion of bronchial asthma. Children from 1 year old are shown reception only in the form of syrup. However, there may be side effects such as excessive sedation, dizziness, and lethargy. Children quite often have the opposite side effect, which boils down to a stimulating effect. These are irritability and anxiety, nervousness and manifestations of insomnia, in rare cases – a convulsive state. There can also be an overdose, which is usually manifested by dry mouth, dilated pupils, and redness of the upper half of the body.

Diphenhydramine

Popularity rating: 4.8

What good can you say about Diphenhydramine? First of all, it is widespread everywhere, in the most seedy village drugstore it will be present, but, however, it will only be sold to you by prescription, despite all its cheapness. The cheapest diphenhydramine costs from 2 rubles. 50 kopecks for 10 tablets! As an antihistamine, it is very good, especially if it is necessary to induce an additional hypnotic effect or sedation. However, the same 'roughness' of work is at the same time its side effect, since it penetrates well into the structures of the central nervous system through the blood-brain barrier. Side effects are manifested by severe drowsiness, and with prolonged use – dry skin, the development of constipation, the appearance of tachycardia.

How is Diphenhydramine prescribed for children? It was said above that a single dose for children under 1 year old is from 2 to 5 mg, and from 2 to 5 years, the dose can be from 5 to 15 milligrams. However, there are no tablets on sale that contained a dose of 5 mg, and only 0.05 g tablets are produced, 10 times more than necessary. Yes, if they released a children's form, then it should not be pills, but drops, or syrup. Therefore, it is still advisable for parents not to use Diphenhydramine in children of the first year of life and older.

After all, parents on their own will not be able to choose the dosage correctly and give it to the child, so here we are talking only about ambulance doctors, who will give Diphenhydramine to the baby, if necessary, in the form of injections. Parents better not mess with him.

The same can be said about such a popular drug as Suprastin. It is actively used for all allergic conditions in children from 1 year old and older, but only in the form of intramuscular injections, no syrup or solution for internal use is provided. And drugs in ampoules are administered only by a doctor, or an ambulance paramedic, or in a medical institution during hospitalization, or at a day hospital.

It is this small number of drugs that limits the range of antihistamines that are shown to children aged 1 year and up to 3-4 years of age.

The popularity rating is based on the analysis of demand data from the wordstat.yandex.ru service.

---

Attention! This rating is subjective and does not constitute an advertisement and does not serve as a purchase guide. Before buying, you need to consult with a specialist.