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SELECTED ARTICLES FROM THE RECENT LITERATURE 2006
9/28/06
Comparison of the sedative effects of levocetirizine and desloratadine
Summary
Background - There is a low incidence of sedative effects of most of the recently developed antihistamines (AH). But how do such frequencies of sedation compare during use of individual AH agents?
Findings - Leyton et al of the Drug Safety Research Unit in Southampton, UK and the Univ of Portsmouth in the UK carried out a questionnaire study in over 24,000 patients prescribed levocetirizine (Lev) or desloratadine (Des) for a variety of conditions. They found a very low incidence of sedation with Lev and Des However, sedation was more common with the use of Lev (0.37%) than with Des (0.08%), particularly in those with allergic rhinitis without asthma (Odds Ratio= 6.75).
The authors concluded that the extensive use of these AH makes even such low frequencies of sedation quite important. Physicians should keep the somewhat greater incidence of sedation during Lev treatment in mind when such sedation may be a factor in work/school/driving performance.
Reference
Drug Sat 2006;29; 897-909
Editor's Comments
Some previous studies have shown that some degree of sedation occurs in 10-14% of adults with cetirizine (Zyrtec) 10 mg daily. Lev, a derivative of cetirizine is thought to be less sedating than cetirizine but still somewhat more than Des (marketed as Clarinex). However, my impression is that both cetirizine and Lev are more effective AH than are Claritin and Clarinex. A preferable choice in my opinion would be fexofenadine (Allegra). Fexofenadine, in an adult dose of 180 mg once daily, appears to be as effective an AH as cetirizine in most patients (although there is a significant variability in responses among individual patients). And fexofenadine is almost always non-sedating.
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