Which medications in the drug class Antihistamines are used in the treatment of Pediatric Chickenpox?

Updated: Nov 30, 2018
  • Author: Kirsten A Bechtel, MD; Chief Editor: Russell W Steele, MD  more...
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These agents may control pruritus by blocking the effects of endogenous release of histamine. Pruritus can be severe in varicella, preventing sleep and possibly leading to scarring or secondary infection. Nonsedating antihistaminics lack sufficient antipruritic action. The value of local preparations (eg, calamine, antihistamines) is unproved. Topical antihistamines can cause significant sedation from absorption through injured skin.

These agents act by competitive inhibition of histamine at the H1 receptor and mediate wheal and flare reactions, bronchial constriction, mucous secretion, smooth muscle contraction, edema, hypotension, central nervous system (CNS) depression, and cardiac arrhythmias.

Diphenhydramine (Benadryl)

Diphenhydramine is an antihistamine that has a sedating effect and is effective for pruritus. It is available as a liquid containing 12.5 mg/5 mL, capsule containing 25 and 50 mg, and injection containing 50 mg/mL.

Hydroxyzine (Vistaril)

Hydroxyzine antagonizes H1 receptors in the periphery. It may suppress histamine activity in subcortical region of the CNS. It is a second-line agent useful for pruritus when diphenhydramine is ineffective.

Hydroxyzine may only be given orally or intramuscularly (IM). It is available as a 25- or 50-mg capsule; 10 mg/5 mL suspension; 10-, 25-, or 50-mg tablet; or 25-mg/mL and 50-mg/mL for intramuscular injection.

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