Nondrowsy antihistamines stop allergy symptoms while making you feel less sleepy than others. They selectively block histamine production and are available over the counter (OTC) and on prescription.
Medically reviewed by Jennie Olopaade, PharmD, RPH
If you have an allergy, antihistamines may help you get relief from your symptoms. But, with that relief can also come the unwanted side effect of sleepiness.
The first antihistamines made by drug companies, known as first-generation antihistamines, often caused sedation, leading to a risk of coordination problems and slow reaction time.
The nondrowsy options offer relief with less chance of sleepiness.
Nondrowsy antihistamine options
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Drowsiness is possible for all antihistamines, but the nondrowsy options are less sedating.
You can choose a nondrowsy antihistamine if you want to try and avoid the sleepiness side effect. Nondrowsy options are typically known as second- or third-generation antihistamines.
A prescription-only option is desloratadine (Clarinex).
Although Zyrtec and Xyzal are both available OTC, you may have to get a doctor’s prescription for the generic version of these drugs.
Everyone responds to drugs a little differently, so some people may find even nondrowsy antihistamines make them sleepy, and some options may have a stronger sedating effect than others.
An older 2000 study looked at the risk of sedation from four antihistamines, including loratadine, cetirizine, and fexofenadine. Based on data from 43,363 people, researchers found the risk of sedation or drowsiness was low in all four drugs. However, the risk was lower in loratadine and fexofenadine than in cetirizine.
Options that may make you drowsy
Even if nondrowsy medications are effective in relieving allergy symptoms, there are many first-generation antihistamines available to buy.
First-generation antihistamines that may cause excessive drowsiness include:
You may want to work with a doctor or pharmacist to find the medication that works best for you.
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Histamine is a chemical in the body. It has many functions, like helping you feel awake. It is also an important part of the body’s immune system. To protect the body from infections, histamine, and other chemicals promote inflammation which can help white blood cells manage infections and other harmful substances.
When you have allergies, your immune system goes into a state of heightened activity. Your body makes too much histamine, even when there’s no real threat resulting in allergy symptoms like:
sneezing
runny nose
coughing
wheezing or feeling out of breath
itchy skin
pain, tenderness, or swelling of the face
Antihistamines work by blocking histamine, and when this happens, they also block other functions of histamine, like helping you stay awake. That’s why some antihistamines make you drowsy.
Antihistamines also work as antagonists at the body’s histamine receptors at the cellular level. In effect, they stop the body from making histamine.
First-generation antihistamines block all histamine production, while newer medications only block some, resulting in less drowsiness because they are more selective in the receptors they affect. That’s why they might block only some antihistamine activity, such as that which causes allergy symptoms.
Antihistamine side effects
Side effects depend on the type of antihistamine. In general, first-generation antihistamines might cause:
sedation, sleepiness, or drowsiness
slow reaction
reduced coordination
dry mouth
blurry vision
difficulty peeing
Nondrowsy antihistamines might cause:
drowsiness
headache
dry mouth
nausea
You should review the information label that comes with your antihistamine for a full list of possible side effects.
Contacting a doctor for your allergies
If you have regular or frequent allergy symptoms, you may want to consult with a doctor. They can refer you to an allergist who can help identify your allergy triggers and develop a treatment plan.
If you often experience sneezing, congestion, or wheezing, it may also be a good idea to seek medical advice.
Additionally, if your allergies make daily life difficult, or if the OTC medications aren’t working, a doctor can help you find the right solution.
Summary
Nondrowsy antihistamines can provide relief from allergy symptoms with less sleepiness than other antihistamines.
They work by only stopping histamine activity associated with the immune system and not the histamine that helps you to feel awake. However, all antihistamines could cause some drowsiness.
If your allergy symptoms are bothersome and are affecting your day-to-day life, or if OTC medications don’t help, you may want to speak with a doctor or healthcare professional about other treatment options.
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