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Comment by Spare_account | Hacker News Reader

My goto anti-hayfever drugs are Loratadine and Cetrizine in generic non-branded packets for cost reasons. OP's article worried me because I regularly take one or both of them for two months straight over summer.

The article states that Loratadine is recommended as an alternative for the relief of allergies. The article didn't explicitly mention Cetirizine but I have done some research and came across another article from 2012 which does include Cetirizine in the same category as Loratadine:

http://www.pharmacytimes.com/publications/issue/2012/april20...

I believe I am safe to continue using Cetirizine and thought some of you may have the same question. I am not an expert on these issues so if I'm mis-understood any of this please let me know.

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The linked study (not OP's article) only mentions first generation antihistamines, and Cetrizine and Loratadine are both second-gen ("non-drowsy"). This study[1] alleges that Cetrizine does not have a cholinergic response associated with it (good), but that Loratadine did show anticholinergic activity (bad).

The OP article says:

> Those with allergies can take a second-generation antihistamine like loratadine (Claritin)

But perhaps Cetrizine is more safe, and we should not be taking Loratadine if we can avoid it. Thoughts, anybody?

[1] https://www.ncbi.nlm.nih.gov/pubmed/15627436

The linked chart dated 2012 lists cetrizine and loratadine as "possible" anticholinergics. It appears they will equally put you at risk. So what are allergy sufferers alternatives? I'm dependent on loratadine and a little dismayed to just now learn of this even if the correlation is not clear.

Guess I'll just have to start eating a bunch of honey...

[1] http://www.agingbraincare.org/uploads/products/ACB_scale_-_l...?

Fexofenadine/Allegra was reviewed and not added. This is fortunate as it's the only OTC allergy medication that actually works for me.

Same - just took a generic fexofenadine, in fact. Of course, 5 years ago, everybody thought diphenhydramine was safe, too.

But is there a "safe minimum frequency"? Generally, I try to avoid taking any medication more/longer than necessary, and my bottle of diphenhydramine is still mostly full after many years...

Sorry the honey thing is totally bogus.

http://www.slate.com/articles/health_and_science/medical_exa...

Bit of a thinking-outside-the-box suggestion here, but have you tried something like mindfulness? Allergy, inflammation and stress seem to be linked in some way, so changing your mindset might reduce the response that you are blocking with loratadine. I personally (in a totally unscientific way) think that low level stress acts like an amplifier for these sorts of conditions.

montelukast (sadly not OTC in the US) isn't known to have an anticholinergic effect, same with most nasal sprays afaik (with the exception of ipratropium bromide). i've had great success with montelukast+cetirizine+flonase.

(and ditto the other comment saying the honey thing is bogus - i eat a lot of local honey because it's tasty, but it makes no impact on my seasonal allergies.)

IIRC the theory is that loratidine and cetirizine don't pass the blood-brain barrier.

My wife who has very bad allergies has switched to a saline nasal rinse twice a day. It has eliminated the need for any allergy meds except on really exceptional days (which might simply require 3 rinses but that experiment hasn't been done yet.)

Are you referring to a Neti pot?

https://en.wikipedia.org/wiki/Nasal_irrigation

Actually she uses this product: http://www.walgreens.com/store/c/neilmed-sinus-rinse-starter... which is something her sister used. It seems to be a packaged version of a Neti pot.

Basically any antihistamine that doesn't make you feel drowsy/loopy doesn't have much anticholinergic activity

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