A large number of oral H1-receptor antagonists are available with and without prescription for the treatment of mast cell–mediated diseases, such as acute and chronic urticaria, angioedema, and cutaneous mastocytosis. Until relatively recently, two major limita-tions of the available antihistamines, such as diphenhy-dramine (Benadryl), hydroxyzine (Atarax), prometh-azine (Phenergan), and cyproheptadine (Periactin), were their short half-lives and sedative effects. New-genera-tion long-acting antihistamines pass the blood-brain bar-rier much less readily and are theoretically less likely to cause somnolence. Examples of these relatively nonse-dating drugs are fexofenadine (Allegra), cetirizine (Zyrtec), and loratadine (Claritin).
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