What are examples of antihistamines that should be stopped prior to the first visit?

  1. Common antihistamines including:
    • Allergra/fexofenadine
    • Benadryl/diphenhydramine
    • Claritin/loratadine
    • Clarinex/desloratadine
    • Xyxal/levocetirizine
    • Zyrtec/cetirizine
  2. Over the counter cold and cough medications that may contain antihistamines (often have the wording “allergy,” “cold,” or “cough”)
  3. Some antihistamine nasal sprays such as Dymista, Astelin, Astepro, and Patanase ideally should be stopped 3-5 days before the first visit as they may interfere with skin testing
  4. Most of these medications:
    • Actifed
    • Alka-seltzer cold
    • Atarax/hydroxizine
    • Chlorpheniramine
    • Chlor-trimeton
    • Cyproheptadine
    • Dimetapp
    • Comtrex
    • Dristan
    • Drixoral
    • Hydroxizine
    • Nyquil
    • Pediacare cough and cold
    • Periactin/cyproheptadine
    • Phenergan
    • Robitussin night time
    • Theraflu
    • Triminic
    • Tylenol Allergy

How long will the first Allergy visit last?

The initial evaluation may involve skin testing and a breathing test (spirometry).  Allow 1- 2 hours for the first visit.  For venom skin testing and pencillin skin testing, allow 2-3 hours since there are often 3 different steps of skin testing with a 15 minute waiting time between each step.

For children, bring some favorite toys and books to help keep him/her occupied. Please know that you may need to help hug and hold your child (who is the patient) to prevent him/her from scratching the test areas.  

Why do I need to stop antihistamines?

Antihistamines block the skin test response.  This means that we may not be able to tell what your or your child’s allergies are from skin testing.  Sometimes blood tests can be done (to check immunoglobulin E or IgE) but in general, skin testing is a better way to screen for most allergies.

Are there some patients that should NOT stop antihistamines?

YES.  For certain chronic conditions such as chronic hives, angioedema (intermittent episodes of swelling), and severe eczema, antihistamines may be helping to control symptoms.  Stopping antihistamines may cause a severe flare of symptoms.  In these cases, antihistamines can be continued and at the first visit, you can discuss with the allergist if a return visit for skin testing (after stopping antihistamines) may be necessary and/or beneficial.

What if I can’t stop an antihistamine?

If stopping an antihistamine may cause a severe flare of symptoms, you can continue taking antihistamines.  At the first visit, you can discuss with the allergist if a return visit for skin testing (after stopping antihistamines) may be necessary and/or beneficial or if blood tests can be done instead.

Do I need to stop any other medications?

NO.  Especially any medications that are for chronic conditions such as high blood pressure, diabetes, seizures, high cholesterol.

PLEASE DO NOT STOP

  • Asthma medications including inhalers and Singulair/montelukast,
  • Any nasal sprays such as Nasonex, Flonase/fluticasone, Nasacort, Rhinocort, Veramyst
  • Any topical steroid medications