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Azelastine is safe and well tolerated in both adults and children with allergic rhinitis. [ 17 ] [ 18 ] [ 19 ] Bitter taste, headache, nasal burning and somnolence are the most frequently reported adverse events.
The most common adverse effects noted for second-generation agents include drowsiness, fatigue, headache, nausea and dry mouth. [ 4 ] Continuous and/or cumulative use of anticholinergic medications, including first-generation antihistamines, is associated with higher risk for cognitive decline and dementia in older people.
A subsequent 1990 study found that the elimination half-life of diphenhydramine was 5.4 hours in children, 9.2 hours in young adults, and 13.5 hours in the elderly. [7] A 1998 study found a half-life of 4.1 ± 0.3 hours in young men, 7.4 ± 3.0 hours in elderly men, 4.4 ± 0.3 hours in young women, and 4.9 ± 0.6 hours in elderly women. [84]
Older people are more likely to experience drowsiness from antihistamine use than younger people. [1] Continuous and/or cumulative use of anticholinergic medications, including first-generation antihistamines, is associated with higher risk for cognitive decline and dementia in older people.
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Antihistamine drugs can have undesirable side-effects, the most notable one being drowsiness in the case of oral antihistamine tablets. First-generation antihistamine drugs such as diphenhydramine cause drowsiness, while second- and third-generation antihistamines such as fexofenadine and loratadine are less likely to. [52] [53]
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