Antihistamines for children

Antihistamine can be very helpful when your child has a runny nose or watery eyes because of their allergies. But it’s important only to give children medicine that’s suitable for their age. Certain antihistamines are more likely to have side effects and children may be sensitive to the drug.

Maybe you’ve read reports of serious reactions in kids to older antihistamines. It’s a good idea to speak to your doctor before giving your child this symptom-relieving allergy medicine for the first time. They’ll help you find the right antihistamine and tell you what, if any, adverse symptoms to look out for. Details will also be on the information leaflet for that medication.

Maybe you’ve read reports of serious reactions in kids to older antihistamines.

Families all around the world rely on prescription and over-the-counter antihistamines to treat allergy symptoms. Read on to find out which ones are suitable for kids. Antihistamines and other symptom-relieving medications may not adequately control your child’s symptoms. So we’ll look at a long-term allergy treatment that might be available too.

Which antihistamine can children take?

Antihistamines for children

Young girl taking an antihistamine tablet with water to relieve her allergy symptoms, while mom sits beside them watching

It’s a good idea to speak to your doctor before giving your child this symptom-relieving allergy medicine for the first time. They’ll help you find the right antihistamine and tell you what, if any, adverse symptoms to look out for. Details will also be on the information leaflet for that medication.

Families all around the world rely on prescription and over-the-counter antihistamines to treat allergy symptoms. Read on to find out which ones are suitable for kids. Antihistamines and other symptom-relieving medications may not adequately control your child’s symptoms. So we’ll look at a long-term allergy treatment that might be available too.

Which antihistamine can children take?

Antihistamines have been helping to treat the symptoms of year-round and seasonal allergies since 1942. Canadian medical societies recommend the newer second-generation types now. These include cetirizine, loratadine and fexofenadine. The correct dose will depend on your child’s age and weight.

First-generation antihistamines tend to list more possible side effects. The medication packaging will usually say they can cause drowsiness. (Newer antihistamines are also known as non-drowsy.) Kids’ academics and extracurricular activities can also suffer, in the same way as adults’ driving, while taking first-generation antihistamines. Other adverse reactions can be severe and even life-threatening for children.

How does antihistamine work?

Antihistamines block the effects of histamine. This is one of the chemicals the body releases in an allergic reaction. It happens when your immune system feels threatened by a substance like pollen or a certain food. Antihistamine helps ease the resulting inflammation which is behind your child’s stuffy nose and other allergy symptoms.

Infographic about common allergy medicines for kids and how they work. Details of the infographic listed below
Infographic about common allergy medicines for kids and how they work. Details of the infographic listed below

Can it treat any of children’s allergy symptoms?

Antihistamines may help ease these common allergic conditions:

  • Allergic rhinitis (hay fever): sneezing, runny nose or nasal congestion
  • Allergic conjunctivitis (allergic pink eye): itchy, watery eyes
  • Urticaria (hives) or contact dermatitis (allergic eczema): itchy rash
  • Mild allergic reactions to food

What antihistamine can’t do is improve symptoms in the long run. It only works as long as it’s in the body. Also antihistamine doesn’t work fast enough to be the immediate first-line treatment if your child has anaphylaxis. This is a severe systemic allergic reaction, typically to a food, insect sting or drug, and it can be life-threatening. Symptoms may include a sudden drop in blood pressure, chest pain and difficulty breathing, which antihistamine cannot treat. Children at risk of anaphylaxis would usually be prescribed epinephrine.

What’s the best antihistamine for kids and when should they take them?

There is no one best antihistamine. Every child is different and so is their allergy. Some antihistamines need to be given every four to six hours. For others it’s once or twice a day. If you’re a parent with kids in school or childcare this could be a factor.

Taking these different types at the right time is important if they’re to be effective:

  • For fast-acting antihistamines, that could be 30 minutes before a summer picnic or a playdate with a friend who has a pet.

Be prepared

Anaphylaxis is an emergency and requires immediate medical attention. Learn to recognize the signs and symptoms early so you can respond appropriately.

Taking these different types at the right time is important if they’re to be effective:

  • For fast-acting antihistamines, that could be 30 minutes before a summer picnic or a playdate with a friend who has a pet.
  • Timed release antihistamines are best started 3 or 4 days before your child has symptoms but may have contact with their allergen. This allows levels to build up in their body, for instance in time for their pollen season. 

Also an antihistamine before bed could help reduce the typical very early morning symptoms. Children may then start the day feeling better than they otherwise would.

Your doctor can recommend an antihistamine, as well as when and how to give it to your child. Again, read the drug information leaflet carefully.

 Allergist in a white coat reassuring a child with a pat on their shoulder and explaining how antihistamines work

Your doctor can recommend an antihistamine, as well as when and how to give it to your child. Again, read the drug information leaflet carefully.

Topical antihistamines for children

This may be the right choice for treating symptoms affecting one part of the body. Some medications are approved for babies and toddlers. Others only from a certain age. Antihistamine nasal sprays may
ease congested nasal passages from breathing in pollen, dust mites, mold or pet dander. There are also combined antihistamine and steroid nasal sprays.

Eye drops may help with symptoms of allergic conjunctivitis. Corticosteroids are often the preferred topical treatment for itching, swelling and rashes. But antihistamine cream may also ease your child’s allergic skin condition or insect bite. There are gels and sprays too.

Eye drops may help with symptoms of allergic conjunctivitis. Corticosteroids are often the preferred topical treatment for itching, swelling and rashes. But antihistamine cream may also ease your child’s allergic skin condition or insect bite.13 There are gels and sprays too.

Oral antihistamines for children

Oral antihistamines can help with a broader range of allergy symptoms at once. They may also calm hives and contact dermatitis, and help with mild reactions to food. Depending on the age of your child, they may be able to have tablets (some of them chewable), capsules, liquid or syrup. Most do take around 30 minutes to take effect. Some are over-the-counter antihistamines, while others need a prescription.

It's interesting to note that using saline nasal sprays from the pharmacy to clear your child’s blocked nose may help their oral antihistamine to work better and reduce their need to take it.

Dad helping his daughter use an antihistamine nasal spray to clear her stuffy nose from hay fever

How to use antihistamines safely with children

Talk to your doctor and read the information leaflet very carefully. There may be drug-drug interactions if your child is taking other medications at the same time as an antihistamine for their allergy symptoms. Also, cough and cold remedies and decongestants can contain antihistamine so your child could end up with a double dose. Read the active ingredients listed on the packaging. And check the minimum age as these remedies are often not suitable for babies and toddlers.

Talk to your doctor and read the information leaflet very carefully. There may be drug-drug interactions if your child is taking other medications at the same time as an antihistamine for their allergy symptoms. Also, cough and cold remedies and decongestants can contain antihistamine so your child could end up with a double dose.

By the way, it’s generally fine for moms with allergies to take antihistamines while breastfeeding. Only a tiny amount tends to pass through into the milk, such that it’s likely to be undetectable in one to five hours. But talk to your doctor anyway as certain antihistamines can affect your milk production.1 Get medical advice if you’re pregnant too.

Read the active ingredients listed on the packaging. And check the minimum age as these remedies are often not suitable for babies and toddlers.

By the way, it’s generally fine for moms with allergies to take antihistamines while breastfeeding. Only a tiny amount tends to pass through into the milk, such that it’s likely to be undetectable in one to five hours. But talk to your doctor anyway as certain antihistamines can affect your milk production. Get medical advice if you’re pregnant too.

Find an allergist

Need to take your little one to see a specialist? We can help you find one so you can ask your doctor for a referral.

Child in a white coat playing at being a doctor – they’re using a stethoscope to examine their teddy bear
Child in a white coat playing at being a doctor – they’re using a stethoscope to examine their teddy bear

What if antihistamine and other symptom-relieving allergy medicine don’t help?

They won’t always. If your child still has uncomfortable allergy symptoms and they’re 5 years old or more, they may be a candidate for allergy immunotherapy. This long-term treatment aims to retrain their immune system. It can help reduce children’s symptoms and their need for medications like antihistamine. Allergy immunotherapy is available as tablets (SLIT) or injections (allergy shots or SCIT) depending on the allergy. Your doctor can give you more information and help find the right treatment plan for your child. In the meantime, read more about allergy medicines for kids here.

The short version

Antihistamine is one of the most common allergy medicines. It can give children short-term relief from their stuffy itchy nose, sneezes and other annoying symptoms. Kids’ antihistamines may have the same active ingredient as adult medication. But the dosage and instructions will be different for different ages.

The risk of side effects and adverse reactions is much lower with second-generation antihistamines. These are less likely to cause drowsiness and preferred for children. There are topical and oral forms, with many available as over-the-counter or OTC antihistamines and others only with a prescription. Ask your doctor for advice on which is the right one. They can also tell you about longer term treatment.

We’re here for parents

Helping with kids with allergies can be a tricky business, even if you have allergies yourself. We’d love to know what you think about our antihistamine for children article. If you have questions or want to share your story, you can email us or visit our Facebook page or Instagram.

klarify takes allergy science and makes it simple, and we have rigorous process for doing this. We use up-to-date and authoritative sources of information. Medical experts review our content before we share it with you. They and the klarify editorial team strive to be accurate, thorough, clear and objective at all times. Our editorial policy explains exactly how we do this. 

Last medically reviewed on 24 October 2023

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