What s better than Benadryl for hives

Benadryl Vs. Zyrtec: What Is The Difference?

Aug 10, 2018

Sami asked

Can you let me know how Benadryl and Zyrtec are different? What characteristics separate them?

At a glance

• There are several differences between Zyrtec and Benadryl, even though they are both antihistamines.
• Most notably, Benadryl is a 'first-generation' antihistamine, which are known to cause sedation. Zyrtec is a 'second-generation' antihistamine and has a lower risk of sedative effects.
• Additional differences between the two include how long they last per dose and what they can be used for.

Answer

While Benadryl (diphenhydramine) and Zyrtec (cetirizine) are both classified as antihistamines, there are significant differences between them, including:

• Classification
• Dosing
• Indications
• Effectiveness
• Side Effects

Below, we discuss each of these differences in detail and provide information to help you decide which will be best for you in a given situation.

Benadryl Vs. Zyrtec: Classification

Antihistamines are grouped largely by their 'generation' in regard to the time in which they were developed and made commercially available.

Benadryl is a 'first-generation' antihistamine in the ethanolamine class of drugs. 'First-generation' antihistamines are typically associated with:

• A relatively short duration of action (around 4-12 hours).
• Significant sedative and anticholinergic effects.

Zyrtec is a "second-generation" antihistamine in the piperazine class of drugs. They are structurally related to ethanolamines but have a:

• Longer duration of action (12-24 hours).
• Low to moderate sedative and anticholinergic effects.

Benadryl Vs. Zyrtec: Dosing

How each is dosed shows significant differences in the duration of action of each.

Benadryl

Benadryl has a duration of action of around 4 to 6 hours, although this can be prolonged in those with liver disease or in the certain populations like the elderly. In addition, some individuals can be 'slow-metabolizers' or 'fast-metabolizers' of Benadryl, which alters how long the effects last for.

Benadryl is typically dosed at 25 to 50 mg at 4 to 6 hour intervals.

Zyrtec

Zyrtec has a duration of action of 24 hours, which is the claim to fame of most 'second-generation' antihistamines. This long duration of action allows it to be dosed only once a day, which is ideal for treating perennial and seasonal allergy symptoms.

The most common dose of Zyrtec is 10 mg once daily, although low doses of Zyrtec twice daily can be used in young children for certain indications, like atopic dermatitis (i.e. eczema).

Benadryl Vs. Zyrtec: Indications

Both Benadryl and Zyrtec can be used to treat allergy symptoms. When it comes to seasonal or perennial allergies, Zyrtec is more often preferred due to its longer duration of action.

Other than your run-of-the-mill allergy symptoms, both can be effective for:

• Runny nose
• Watery eyes
• Urticaria (hives)
• Itching
• Dermatitis

In addition to the above, Benadryl is commonly used as an over the counter sleep aid, due to its sedative effects and short duration of action. In fact, diphenhydramine is an active ingredient in many over the counter products marketed for sleep including ZzzQuil.

Lastly, it comes to allergic reactions (e.g. drug induced), there is some controversy in regard to which is more effective.

This is discussed in the next section but it should be noted that Benadryl still hold preferential treatment for most allergic reactions.

This is best exemplified by the ACIP (Advisory Committee on Immunization Practices) recommendations to use diphenhydramine (active ingredient in Benadryl) for vaccine induce anaphylaxis, although the specific recommendation is injectable diphenhydramine.

Benadryl Vs. Zyrtec: Effectiveness

Both Benadryl and Zyrtec have shown comparable activity and efficacy when it comes to the treatment of allergic symptoms, and choice of either is typicality based on patient preference and desired characteristics (e.g. duration of action) .

It is commonly thought that 'first-generation' antihistamines like Benadryl are more effective for allergic reactions (e.g. bee stings, drug related, food related) than newer agents, but a variety of studies have reported that Zyrtec not only has similar efficacy, but it also works just as fast.

A popular and informative way antihistamines are tested is by inducing a 'wheal and flare' reaction in an individual via an injection of histamine and measuring response to a given drug in terms of relief of inflammation, redness and itching. Zyrtec consistently produces results comparable to Benadryl.

For the treatment of atopic dermatitis (i.e. eczema), results from studies are mixed. Efficacy is similar between Zyrtec and Benadrylbut Benadryl certainly has more published evidence.

It is important to note that Zyrtec is used 'off-label' for atopic dermatitis while Benadryl is FDA approved for the symptomatic treatment of it.

Benadryl Vs Zyrtec: Side Effects

Perhaps the biggest difference between Benadryl and Zyrtec is the side effect profile of each.

Benadryl is well known to cause both sedation and somnolence. Zyrtec on the other hand, being a 'second-generation' antihistamine, is less associated with sedation. While most second-generation antihistamines (e.g. Claritin) are in fact 'non-drowsy', Zyrtec is not labeled as such, but produces far less sedation than Benadryl.

Multiple studies have reported that Benadryl, when compared to antihistamines like Zyrtec, is more strongly associated with:

• Sedation
• Drowsiness
• Decreased mental performance
• Decrease motor performance
• Decreased ability to concentrate

Per the prescribing information for Zyrtec, the overall incidence of sedation and somnolence is around 10-15%. Benadryl causes sedation in more than 20-30% of individuals. The doses of Benadryl used for sleep (50 mg) cause an even higher incidence.

Lastly, due to stronger anticholinergic effects, Benadryl is also associated with a slightly higher incidence of:

• Dry mouth
• Dry eyes
• Constipation
• Heart palpitations (high doses)
• Respiratory depression (high doses)

Final Words

Choosing between Benadryl and Zyrtec depends on what you are looking for in either drug.

For consistent allergy symptoms, Zyrtec is likely the better choice due to its long duration of action and lower incidence of sedation. For the treatment of insomnia, Benadryl is likely more effective due to its strong sedating effects.

For allergic reactions to food and drugs, evidence is mixed. Zyrtec may be just as beneficial as Benadryl and offer a lower risk of side effects. This is a more commonly accepted use of Benadryl however and it is the recommended agent of choice for vaccine induced allergic reactions (via IM injection).

Let us know which antihistamine you prefer and your experiences with them in the comment section below!

Does Benadryl Help With Hives?

Jul 05, 2018

shley asked

Does Benadryl help with hives? I have red and itchy bumps on my arm and I think they are due to allergies.

Answer

Benadryl (Diphenhydramine) is a first generation antihistamine used in the treatment of allergies, urticaria (hives), insomnia and motion sickness. Benadryl (Diphenhydramine) can be used to help manage hives. Hives are swollen, red patches of skin that can occur as a reaction to allergens or for unknown reasons.

Benadryl For Hives

Most times, hives can be itchy. Benadryl (Diphenhydramine) can help reduce the swelling of hives and alleviate the itching. While Benadryl (Diphenhydramine) will help with the symptoms of hives, the best treatment is to determine the cause of the hives and remove that allergen.

Some common causes according toAmerican College of Allergy, Asthma & Immunologyare:

• Foods like peanuts, nuts, eggs and shellfish
• Drugs like antibiotics (penicillins and sulfa drugs), aspirin and NSAIDs (Ibuprofen and Naproxen)
• Insect bites and stings
• Pets
• Outside allergens such as pollen, trees and grasses
• Bacterial and viral infections
• Latex exposure

If hives continue to occur and a cause cannot be determined, an allergist should be consulted. In the meantime, Benadryl (Diphenhydramine) is a good choice of treatment to get some relief from the hives. More information on Benadryl (Diphenhydramine) can be found below.

Benadryl (Diphenhydramine) Information

Benadryl (Diphenhydramine) is a first generation antihistamine. First generation antihistamine are sedating antihistamines that can cause a significant amount of drowsiness. As such, caution should be taken when driving or operating machinery until the full effects of the medication are known. Some additional side effects of Diphenhydramine include:

• Drowsiness or sedation
• Dizziness
• Nausea or vomiting
• Coordination problems
• Thickening of mucus in the nose or throat

SinceBenadryl (Diphenhydramine) can cause drowsiness or sedation, care should be used when used in elderly patients due to an increased risk of falls. Care should also be taken when patients are on other medications that can cause drowsiness. If there are any questions about taking medications together, patients should talk to their pharmacist or other health care providers.

Conclusion

When patients get hives, the first thing on most patients mind is getting relief from the symptoms. Benadryl (Diphenhydramine) is a good choice to help with the swelling and itchiness that can occur with hives. For hives that continue with unknown causes, a trip to the allergist is needed to determine the cause of the hives and further treatment.

What Is The Best Antihistamine For Hives?

Jul 28, 2018

Rajat 8910 asked

Which is the best tablet for urticaria?I have tried cetirizine 10mg as well as levocetrizine 10mg but sometimes even these drugs are not able to control it.

Answer

Urticaria, or hives, is a skin rash that may be caused by foods, medications, insect bites or infections. The hives can also be from an unknown reason too. Thefirst line of treatmentis the use of a second generation antihistamine. In the U.S., the following drugs are considered second generation antihistamines:

• Allegra (Fexofenadine)
• Claritin (Loratadine)
• Zyrtec (Cetirizine)
• Xyzal (Levocetirizine)
• Clarinex (Desloratadine)

Second generation antihistamines are known to cause little to no drowsiness compared to first generation antihistamines, like Benadryl (Diphenhydramine), which typically cause a significant amount of drowsiness.

Is One Antihistamine Better Than Another For Hives?

There is not one particular second generation antihistamine that is recommended over another. A couple of considerations when choosing a second generation antihistamine is the dosage schedule and likelihood of drowsiness a drug may have. Most second generation antihistamines are once daily medications. The exception to this is Allegra (Fexofenadine). This is usually dosed every 12 hours (but can be 24 hours as well). As stated before, most second generation antihistamines cause little to no drowsiness. Zyrtec (Cetirizine), however, has been known to cause some drowsiness in some patients. Patients should be aware of this and take the necessary precautions when driving or operating machinery.

Some studies have reported that Zyrtec maybe more effective than other second generation antihistamines for hives, but this is not seen in all individuals. If you get hives often, it is important to try several options and see what you best respond to and tolerate well.

Regardless of the particular drug, patients should stick with that particular drug for at least 2 weeks to see the full benefits. It is not recommended in the treatment of urticaria that patients just take the antihistamine as they feel they need it. It should be taken continuously for at least 2 weeks. If after 2 weeks relief is not seen, then it is time to visit the doctor for further treatment. It may be necessary to increase the dose of the antihistamine above recommended dosages (under the supervision of a doctor only) or change to a different type of drug class to help in the relief of the hives.

Lastly, if an antihistamine doesn't completely control your symptoms, you should speak to your doctor about the addition of other medications.Multiple studies have shown experiencing better relief of hives when an antihistamine is used in combinationwith the following:

H2 blockers include over the counter medications such as Zantac and Pepcid. Although commonly used for acid reflux, they can also help with hives for some.Leukotriene receptor antagonists (e.g. Singulair) are available by prescription and are most commonly used for allergies and asthma.

Conclusion

Second generation antihistamines are the drug of choice in the treatment of urticaria or hives. While there is not a preferred second generation antihistamine, patients should stick with one particular drug for at least 2 weeks when treating hives. If after 2 weeks no relief is seen, it will be necessary to go to the doctor and seek other treatment options.