What Antihistamines Are Safe For Seniors?

Written By: Irene Lefever
Reviewed By: William Rivers
Published: March 22, 2022
Last updated: September 24, 2023

Allergies are more common for younger people, but that doesn’t mean seniors are exempted. Research has shown that aging affects the immune system, putting older people at risk for autoimmune illnesses, infections, and allergic inflammation. 

Not all allergy medications are safe for seniors because some antihistamines don’t mix well with other drugs. Safe antihistamines for seniors include second-generation antihistamine medications such as loratadine, cetirizine, and fexofenadine. 

Antihistamines That Are Safe For Seniors

Loratadine, cetirizine, and fexofenadine have been shown to be safe for both children and elderly patients. Studies on drug interactions, elevated-dose studies, and clinical trials have all confirmed their cardiovascular safety.

Newer antihistamines such as Claritin® (loratadine) and Allegra® (fexofenadine) are safer and better tolerated by elderly patients. These medications are effective for symptoms such as itching, sneezing, and runny nose, and they have fewer sedative side effects than Benadryl®.

Nasal Sprays

Antihistamine nasal sprays, such as Astepro® (azelastine) and Patanase® (olopatadine), are also available on prescription. Their effectiveness and safety make them ideal for seniors with nasal congestion who don't respond to traditional antihistamines.

Nasal sprays aren't absorbed as well as oral antihistamines, so they have fewer negative side effects. They're also beneficial if you're dealing with persistent symptoms that range from moderate to severe.

Antihistamines That Seniors Should Avoid

Antihistamines such as chlorpheniramine and diphenhydramine, which are first-generation or "older" antihistamines, are useful in lowering allergy symptoms. Despite the efficacy of these medications, elderly patients have been observed to experience adverse side effects.

Sedation caused by first-generation antihistamines impairs driving abilities and lowers the ability to perform tasks that require focused awareness.

According to Christopher Randolph, M.D., of the American Academy of Allergy, Asthma, and Immunology (AAAAI), senior patients who have taken first-generation antihistamines can experience side effects such as:

  • Anxiety
  • Drowsiness
  • Urine Retention
  • Dizziness
  • Constipation

Seniors who are experiencing cognitive disorders such as dementia and Alzheimer’s are also advised to stay away from first-generation antihistamines, as they can interfere with other medications.

Ways To Manage Allergies In Seniors

Besides administering the proper medication, caregivers can help their loved ones deal with allergy season by following these tips.

Consult A Doctor

A person's allergy symptoms can be easily overshadowed by more serious symptoms such as discomfort, sadness, and mood swings. Patients who have Alzheimer's disease or other forms of dementia may be unable to express their distress. If you suspect that your loved one has allergies, don't hesitate to talk to their doctor about it.

Take Immediate Action

For seniors with pre-existing heart disease or lung condition, allergy symptoms like nasal congestion, cough, and irritable throat can pose a serious threat. As a result, actions should be taken immediately to address allergies in the elderly properly.

Explore Drug-Free Options

Reducing your exposure to allergens is an effective method for minimizing allergic reactions. Certain lifestyle modifications, such as limiting outside activities while allergy levels are extremely high, can help. Instead of taking a walk in the park, you can try indoor activities such as yoga exercises for seniors.

Bottom Line

Older adults may face more significant challenges during allergy season, ones that can affect their health and wellbeing. Fortunately, there are several effective ways to help at-home seniors cope during allergy season.

If you want to learn how to make life easier for a senior loved one, head over to Senior Strong for more recommendations.

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Irene Lefever is a senior advisor whose role is to make sure that senior citizens’ physical, mental, psychological, and emotional needs are catered to. Lefever got her degree in Multimedia Arts at the University of California, Riverside.
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