What to take instead of Benadryl for an allergic reaction

By Isabella Storyclaire

last updated September 16, 2024

Contributions sourced from

Is Benadryl Good for Allergic Reactions?

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[blog updated April 2019]

Is Benadryl the Best Option for Treating Allergic Reactions?

Dr. Dean Mitchell, Board Certiallergic-reactions-and-benadryl.jpgfied Allergist in NYC, discusses why Benadryl is not the best antihistamine for allergic reactions.

For so many years people have thought that they should take Benadryl for

allergic reactions

. Its common to get Benadryl in the ER when you are having an allergic reaction and when people go to the drugstore they think Benadryl is the best antihistamine to take to help alleviate their allergies.

Just because Benadryl is the oldest antihistamine doesnt make it the best one to use when you have an allergic reaction. In fact, I rarely recommend using Benadryl for allergic reactions.

Today, there are better choices when you have an allergic reaction such as Claritin, Allegra, Zyrtec, and Sublingual Allergy Drops.

Benadryl vs Claritin

This is a non-sedating antihistamine which means it doesnt cross the blood-brain barrier so it doesnt make you tired. It also works quickly. In fact, today they have a Claritin ready-tab which you just put on your tongue and it works instantly. You can carry around these tabs in your wallet if you are prone to getting allergic reactions you cant predict.

Benadryl vs Allegra

Allegra maybe even stronger than Claritin. It lasts longer and also doesnt affect your blood-brain barrier so you dont get tired. This is one of my favorite antihistamines for patients who get chronic allergies.

Benadryl vs Zyrtec

This is based on an older antihistamine called hydroxyzine which is very powerful. Zyrtec is probably the most powerful of all the antihistamines listed but it can be sedating. People can get tired from it and as a result, its not always tolerated well. It is not always my first choice for allergic reactions. It can also last in your body for several weeks.

Best Option Sublingual Allergy Drops

If you are really suffering from chronic allergies frequently and you want to get to the underlying problem and treat it more permanently something like sublingual allergy immunotherapy drops can really make a difference.

In fact, sublingual allergy drops can even be used now to help you find relief from food allergies.

Sublingual allergy drops are pain-free and can be taken from the comfort of your home. They are a safer alternative than allergy shots and more effective than over-the-counter medications like Benadryl, Claritin or Zyrtec. They help your body gradually build up a resistance to the allergen you are allergic to. And after some time, you will find complete relief from your allergy and annoying allergy symptoms.

I suggest that you see your doctor and you ask them if you have been or can be allergy tested. Once you have been tested ask if they can arrange for you to get allergy drops so you can have lasting allergy protection.

Dr. Dean Mitchell, M.D.Mitchell Medical Group in NYC & Long Island

About the Author Dr. Dean Mitchell, M.D.

Dr. Dean Mitchell M.D. is a Board-Certified Allergist and Immunologist based out of NYC. He graduated from the Sackler School of Medicine and completed training at the Robert Cooke Allergy Institute in New York City. He is also a Professor of Clinical Immunology at Touro College of Osteopathic Medicine, a fellow of the American Academy of Allergy, Asthma and Immunology, and the author of Allergy and Asthma Solution: The Ultimate Program for Reversing Your Symptoms One Drop at a Time. Dr. Dean Mitchell, M.D. has also been featured in The New York Times, The Huffington Post, Fitness Magazine, Dr. Oz and News NY 1. Dr. Mitchell also hosts the podcast The Smartest Doctor in the Room a combination of a lively, personal and in-depth interview with top healthcare specialists.

What Antihistamines Are Most Similar To Benadryl?

Hello and thanks for reaching out!

I'm more than happy to discuss this topic.

You're certainly not the first person to write to us looking for recommendations on antihistamines and it's not uncommon I hear about other antihistamines not working as well to treat allergy symptoms as Benadryl.

Even though Benadryl and the other drugs that come up often in this discussion (e.g. Claritin, Allegra, Xyzal, Zyrtec, etc...) are classified as 'antihistamines', there are several different classes of antihistamines, each with different properties, and thus, different effects.

Differentiating Antihistamines

There are several ways to group antihistamines. The two most common ways are by:

Antihistamine Generation

In regard to generation, you may have heard the term 'first-generation' or 'second-generation' antihistamine.

'First-generation' antihistamines are older and have been on the market for a longer period of time than the 'second-generation' ones.

In general, first-generation antihistamines are shorter-acting(around 4-6 hours per dose) and more sedating. Second-generation ones are longer-actingand less sedating.

Most antihistamines when broken down into generations follow this pattern so, for example, Claritin (a second-generation antihistamine) is both longer-acting and far less sedating than Benadryl (a first-generation antihistamine).

Antihistamine Class

As mentioned, antihistamines can also be grouped by chemical class, and in many ways, the class an antihistamine is grouped in is more closely correlated to their overall effects. The following chemical classes are the most common:

Alkylamines
Piperazines
Piperidines
Ethanolamines

You stated in your question that you get the best effects from taking Benadryl, which is classified as an 'ethanolamine' antihistamine.

Ethanolamine antihistamines, in general, have much more pronounced 'anticholinergic' effects than other antihistamines, which include effects like sedation and 'drying'. This is why Benadryl is used often to help sleep and tends to be more effective at treating a runny nose and watery eyes.

These effects aren't always positive though.

Sedation isn't always an effect that is wanted, especially if you need to take something that works throughout the day for seasonal allergies. Drugs like Benadryl can also cause confusion and dry mouth, which can be both bothersome and dangerous.

Nevertheless, you asked about Benadryl and about how it works differently for you when compared to other antihistamines, and what I wrote above is why. You likely have symptoms that are simply better treated with the effects you get from Benadryl.

Antihistamine Breakdown

Below is a chart showing a breakdown of the most common antihistamines by generation andchemical class so you can compare them.

Chemical Class	First-Generation	Second-Generation
Alkylamines	Brompheniramine, Chlorpheniramine	Acrivastine
Piperazines	Hydroxyzine, Meclizine	Cetirizine (Zyrtec), Levocetirizine (Xyzal)
Piperidines	Cyproheptadine, Ketotifen	Desloratadine (Clarinex), Ebastine, Fexofenadine (Allegra), Loratadine (Claritin), Olopatadine
Ethanolamines	Clemastine, Dimenhydrinate, Diphenhydramine, Doxylamine	--
Ethylenediamines	Antazoline, Pyrilamine, Tripelennamine	--
Phenothiazines	Promethazine	-

What Is Most Like Benadryl?

Since you're specifically looking for an over-the-counterantihistamine option that is closest to the effects Bendaryl had for you, you should be looking for other first-generation antihistamines in the ethanolamine class or alkylamine class.

These drugs include:

Doxylamine
Clemastine
Brompheniramine
Chlorpheniramine

The closest to Benadryl structurally, and in terms of the overall effect, are doxylamine and clemastine.

Doxylamine is generally onlymarketed as a sleep aid (it is one of the active ingredients in NyQuil) but is an effective antihistamine nonetheless.

Clemastine is also available over the counter and is more often than doxylamine, actually marketed as an antihistamine. It is the active ingredient in the brand name product Tavist and DayHist.

If I had to pick one antihistamine, available over the counter, that is most similar to Benadryl in terms of effect, I would pick clemastine.

After doxylamine and clemastine, your next closest options are brompheniramine and chlorpheniramine.

These drugs have an advantage over Benadryl in that theylast longer(8-12 hours versus 4-6). They are in a different chemical class, but, again, have similar overall effects.

Brompheniramine can be found in Dimetapp products while chlorpheniramine can be found in stand-alone products, like Chlor-Trimeton.

What About Other Options?

I won't spend too much time on second-generation antihistamines since you said they didn't work well for you.

I will say that moststudies show that the second-generation antihistamines are just as effective as the first-generation ones and have the added benefit of having fewer side effects.

Nevertheless, there are certainly people who feel they get better allergy relief from first-generation ones than second-generation ones.

Aside from antihistamines, I would suggest you consider a steroid nasal spray for allergies as well, such as Flonase or Nasonex.

Nasal steroids have been shown to generally be moreeffective than oral antihistamines for seasonal allergy symptoms and are convenient in that they only need to be dosed once a day.