Branded medicines
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Antihistamine Tablets South Africa
Antihistamine tablets are the standard treatment for allergy symptoms throughout the body: sneezing, a runny nose, itchy eyes, itchy skin and hives. The main decision when buying them is whether you can afford to feel drowsy.
Independent and evidence-basedInformation only, not a pharmacy
Ingredient type
Medicine category
Common uses
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Class
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South Africa access
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Common forms
Tablets, sprays
Key safety note
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What this category covers
Antihistamines block histamine, the chemical the body releases during an allergic reaction. Because histamine causes most allergy symptoms, blocking it addresses several at once, which is why a tablet suits general symptoms better than treating each site separately.
They work best for sneezing, itching, a runny nose, hives and reactions to insect bites. They work least well on a blocked nose, which responds better to a nasal spray.
Most are available from pharmacies without a prescription in standard strengths.
The two generations
The practical division is between older and newer antihistamines.
Older, sedating antihistamines such as chlorphenamine, diphenhydramine and promethazine cross into the brain and cause drowsiness. They work well and are inexpensive, and their sedative effect is occasionally useful at night. They are the ones to avoid before driving, working or studying.
Newer, less sedating antihistamines such as loratadine, cetirizine and fexofenadine cause far less drowsiness for most people and generally last a full day on one dose. Cetirizine is the exception that catches people out, since a meaningful minority do feel sleepy on it.
See Non Drowsy Allergy Tablets South Africa for that comparison in detail.
How to choose
If you will be driving, working, studying or supervising children, start with a newer antihistamine. If one does not suit you, another in the same group often will, since people respond differently.
For seasonal allergy, take it regularly through your season rather than only on bad days, and start before the season peaks where you can predict it.
For hives or an itchy rash, a tablet is the right route even though the symptom is on the skin, because the cause is internal.
For a persistently blocked nose, add or switch to a nasal spray rather than increasing the tablet.
Safety, interactions and when to ask a pharmacist
The most common error is doubling up. Cold and flu remedies very often contain an antihistamine already, so adding an allergy tablet means taking two. Read the ingredient list on everything.
Sedating antihistamines combine badly with alcohol and with other medicines that cause drowsiness. They affect older adults more strongly and contribute to falls and confusion.
Ask a pharmacist before use if you have glaucoma, an enlarged prostate or difficulty passing urine, epilepsy, liver or kidney problems, or severe asthma, and if you are pregnant or breastfeeding.
For children, use age appropriate products and doses. Never use a sedating antihistamine to make a child sleep.
Get emergency help for swelling of the face, lips, tongue or throat, difficulty breathing or swallowing, or a widespread rash with faintness. Call 10177 from a landline or 112 from a mobile phone.
Related pages
See Allergy Medicine South Africa for the full category. Return to the Medicine Categories hub to browse by symptom.
Common questions
Which antihistamine tablet should I choose?
A newer, less sedating one if you need to drive or work. An older one may suit at night, but not before driving.
Do antihistamines help a blocked nose?
Not much. A nasal spray works better for congestion.
Can I take one every day?
Newer antihistamines are commonly taken daily through an allergy season. Ask a pharmacist about longer term use.
Why do I feel drowsy on a non drowsy tablet?
Cetirizine causes drowsiness in some people despite the label. Try a different one in the same group.
Can I take one with a cold remedy?
Check the ingredients first. Many cold remedies already contain an antihistamine.
Information only and not a substitute for medical advice. Check the medicine leaflet and ask a pharmacist, doctor or qualified healthcare professional for guidance about your own situation.
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