OTC antihistamines for allergy relief in children

According to the American Academy of Pediatrics (AAP), antihistamines have been found ineffective in children aged 2 years and younger. I am unclear whether second-generation antihistamines (e.g., cetirizine [Zyrtec]) can be safely prescribed for allergy relief in these children. Instead, I recommend nasal saline flushes for rhinorrhea and honey for cough (if older than 12 months) to help my patients with allergy and cold symptoms.
—ESTHER CARLSON, MSN, ARNP, FNP, Solomon, Kan.

The second-generation antihistamines that are available OTC warn against use in children younger than age 2 years. In addition, the FDA held a hearing in 2008 on the use of nine OTC cough medicines in children up to age 4 years. When the results came in, the manufacturers agreed to voluntarily revise the labeling to state “do not use in children under age 4” (AAP News. 2008;29:13). The AAP also recommends use of a cool mist humidifier for relief of cold symptoms in children of any age (www.aap.org/publiced/BR_Infections.htm, accessed September 14, 2009).
—Julee B. Waldrop, MS, PNP
(132-10)

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