Evidence Hub

Antihistamines and driving ability: evidence from on-the-road driving studies during normal traffic

Verster JC, Volkerts ER

Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 2004

154 citations

Abstract

BACKGROUND: All antihistamines are capable of crossing the blood-brain barrier and thus may cause sedation. Most antihistamine users are ambulatory patients and therefore presumably drive a car.

OBJECTIVE: To summarize the effects of antihistamine drugs on driving ability.

DATA SOURCES AND STUDY SELECTION: A literature search (MEDLINE and cross-references) was performed using the keywords driving and antihistamine. Sixteen studies using the on-the-road driving test during normal traffic were included in the review. Studies were double-blind and placebo-controlled and included a positive control.

RESULTS: First-generation antihistamines (diphenhydramine, triprolidine, terfenadine, dexchlorpheniramine, clemastine) significantly impair driving performance after both one-time and repeated (daily) administration. Second-generation antihistamines (cetirizine, loratadine, ebastine, mizolastine, acrivastine, emedastine, mequitazine) may also impair driving performance, but the magnitude and extent of impairment depend on the administered dose, sex, and time between testing and treatment administration. Tolerance develops after 4 to 5 days of administration, but impairment is not absent. Third-generation antihistamines (fexofenadine and levocetirizine) have been shown to produce no driving impairment after both one-time and repeated administration.

CONCLUSIONS: First- and second-generation antihistamines may significantly impair driving performance. In the context of driving safety…

Read the paper

Related studies

Go deeper in Evidence Hub

Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.

Open this study Sign up free