Systemic Antihistamines

Systemic antihistamines counter histamine released from mast cells in the skin and mucous membranes. They are sedating, and workers should not operate equipment after taking them.

Diphenhydramine (Benadryl) is used in a dosage of 25 to 50 mg, three to four times daily. Hydroxyzine hydrochloride (Atarax) 25 mg three or four times a day is useful for reversing pruritus (8,9).

Doxepin (Sinequan) 10 to 30 mg at night is effective as an antipruritic but can cause anticholinergic effects. A 5% doxepin cream (Zonalon) is also effective (8,9).

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