7 ms·
Effects of fexofenadine, diphenhydramine, and alcohol on driving performance
- stordoff 4y agoIs 60mg a typical dose of fexofenadine? I'm only familiar with it as 180mg tablets (I was initially prescribed 180mg twice daily for dermatographic urticaria, and currently take 360mg twice daily).
- volkl48 4y ago60mg is the dosage sold for "12hr". 180mg is the "24hr" dosage.
- tyrfing 4y ago2nd gen antihistamines (Fexofenadine, Cetirizine, Loratidine) are definitely what you want for allergies. 1st gen like Benadryl/Diphenydramine have awful side effects. I highly recommend nasal sprays like Fluticasone as well, available OTC in the US these days and amazing stuff.
- iancmceachern 4y agoFluticasone changed my life. It's a wonder drug.
- amluto 4y agoI would argue that, whatever “generation” it is, cetirizine does not deserve credit for being second generation. I know plenty of people with extremely obvious CNS effects from it. In contrast, loratadine seems innocuous.
- tyrfing 4y agoFor me, loratadine was ineffective, and I can't distinguish cetirizine and fexofenadine - both are maybe 50-60% effective with no notable side effects, and allergy season means extra fatigue no matter what. Cetirizine does have the shortest half life.
- isoprophlex 4y agoSecond that, cetirizine definitely feels more like clemastine or meclizine than a proper second gen "non sedating" antihistamine. And with hay fever AND an allergy to nuts, I've tried them all, haha.
- imdvayn 4y agoUnfortunately its justifiably classified as 2nd gen and IIRC studies show that it's generally more effective for hay fever. Personally, I've found that loratadine is pretty ineffective, especially after regular use.
- jostmey 4y agoI found loratadine very effective but it takes time to work. At least a week
- _moof 4y agoCetirizine is a "no go" for pilots. Fexofenadine and loratadine are OK to fly on though, as is fluticasone.
- imdvayn 4y ago+1 to Fexofenadine (Allegra) and Fluticasone. Loratadine (Claritin) is too weak for my needs and Cetrazine (Zyrtec) has side effects are too similar to a stimulant for me.
- hammock 4y ago> Fluticasone A corticosteroid, it has awful side effects as well
- dfsegoat 4y agoMaybe. But I would say for me the benefits of not suffering "breakthrough" hayfever attacks far outweigh the side effects. Antihistamines are great - but the nasal corticosteroids are what really control my hayfever (1) when used consistently. 1 - Hayfever so bad that I used to have to get custom serum shots containing the local pollen profile, every 2 weeks as a kid. Had anaphylaxis twice.
- deleted 4y ago[deleted]
- rhexs 4y agoBest to limit corticosteroids if you can. Azelastine was approved to go OTC last year and is a half-decent antihistamine nasal spray. Hopefully it will be available stores this summer. Nothing works quite as good as a corticosteroid of course, but azelastine controls my symptoms without having to rely on steroids.
- danachow 4y agoAdministered nasally it has very poor systemic bioavailability.
- hammock 4y agoI thought so at first. My personal experience was different though.
- sjmm1989 4y agoIronically, whilst having terrible hayfever... Not taking Antihistamines at all seems to have had the most profound effect on me between the gen 1 and 2 meds. If I didn't know any better, I would almost figure I was having some sort of rebound effect from taking them in the first place. Which is odd, because I have been diagnosed with having Allergic Sinusitis, which triggers an inflammatory asthma if not careful. I used 1st gen stuff like Chlorpheniramine and Diphenhydramine to start. Tried some second gen stuff not too long ago, and it worked pretty well too; but not as well just not taking any? It's weird. Meanwhile if I have an actual allergy attack, I keep Benadryl around for just in case. Because again, not taking any of these seems to just leave me without any allergies now? Or as bad at least. But Benadryl seems to still have some effect, where as I need a couple days of taking the 2nd gen stuff to actually get any effect; if any at all. All in all, I'm confused now as to which I should even take considering everything in how my reactions have been to it all. So I just don't take any unless things are real bad now. Which they usually aren't. Maybe I outgrew my allergies? I doubt it, cause I still sneeze around cats and stuff. heh.
- rhexs 4y agoThese are great. Europe has some even newer 2nd (or "3rd gen") antihistamines such as bilastine and rupatadine. They're apparently even more effective than what we have in the states. Would love to try them out, but unfortunately I don't think they're seeking FDA approval. Anyone abroad have any experience with these compared to loratadine/cetirizine?
- chillingeffect 4y agoBeware of corticosteroid side effects [0][1]. Not stated directly here is retinopathy [0] https://www.mayoclinic.org/drugs-supplements/corticosteroid-oral-route-parenteral-route/side-effects/drg-20070491 https://www.mayoclinic.org/drugs-supplements/corticosteroid-... [1] https://www.mayoclinic.org/drugs-supplements/corticosteroid-oral-route-parenteral-route/side-effects/drg-20070491 https://www.mayoclinic.org/drugs-supplements/corticosteroid-...
- omarhaneef 4y agoThis is the context I was missing (brand names) https://www.drugs.com/ingredient/diphenhydramine.html https://www.drugs.com/ingredient/diphenhydramine.html
- jmalicki 4y agoYes, it's marketed as ZzzQuil an OTC sleeping aid! (as well as benadryl)
- jmalicki 4y agoThe article is extremely short, but comparing 2-4 OTC doses of diphenhydramine to a level of alcohol concentration above what constitutes a DUI in most places seems like an odd choice? Or is that just a matter of proof of concept, go for the big obvious demonstration first?
- runnerup 4y ago2 doses of diphenhydramine can have very noticeable and profound effects on many people, 50mg total isn't a light dose by any metric. That seems fine as a comparison to 0.1% BAC. But 60mg Fexofenadine makes no sense to me in comparison. It's usually 180mg in a single pill.
- sjmm1989 4y agoHate to break it to you, but 50mg is pretty much a common dosage for most people taking Diphen. At least where I lived over the past few decades... This is mostly due to the effect of 'if 1 pill is almost enough to do the job, then 2 pills should be adequate'. You see this a lot with people who take Tylenol and/or Advil. Tylenol overdoses are more common because of the frequency of acetaminophens use in other medications in combination with people taking Tylenol not realizing they are doubling/tripling their doses. So having people end up driving on 50mg+ doses of the dryl is not uncommon in places like Canada. Pair it with a dose or two of pseudoephidrine hydrochloride as well, and you basically have a breath easy cocktail that might put you to sleep, or might keep you awake all night.
- runnerup 4y ago> So having people end up driving on 50mg+ doses of the dryl is not uncommon in places like Canada. Yeah this makes sense to me. We have lots of people driving around at 0.1% BAC too.
- pharrington 4y agoThe directions I'm looking at for a store brand diphenhydramine say to take 1-2 of the 25mg tablets as needed, so I'd expect that's the typical therapeutic dose.
- etaioinshrdlu 4y ago50mg diphenhydramine is quite a bit! Anyone who has ever taken that amount for sleep effects will tell you so.
- retrac 4y agoIt is, but 25 - 50 mg every 4 - 6 hours, with no more than 200 mg over 24 hours, is also the instructions on the OTC bottle I have. I made that mistake once in university. Took two capsules for a moderate skin reaction and slept the entire afternoon away. Fortunately I was at home! Just willing myself to get up long enough to disrobe and turn the lights off was excruciating.
- ta988 4y agoLook on Reddit some people are taking much much more recreationally and the usage reports are pretty daunting.
- Trouble_007 4y agoFYI: Antihistamines : https://psychonautwiki.org/wiki/Antihistamine https://psychonautwiki.org/wiki/Antihistamine Diphenhydramine : https://psychonautwiki.org/wiki/Diphenhydramine https://psychonautwiki.org/wiki/Diphenhydramine
- 0xdeadb00f 4y agoOne not mentioned on this page is dexchlorpheniramine. In my personal experience, exceeding the recommended dose and fighting the drowsiness effect leads to quite a pleasant high and mild aphrodisiac effect.
- the_only_law 4y agoThat’s kinda interesting. I’ve only ever heard of DPH and Doxylamine (which I’ll on occasion use as a terrible sleep aid). I knew other antihistamines exist, but was never curious about their effects.
- Trouble_007 4y agoAdded to the information on Antihistamines : https://en.wikipedia.org/wiki/Antihistamine https://en.wikipedia.org/wiki/Antihistamine Prescription Drug Information, Interactions & Side Effects : https://www.drugs.com https://www.drugs.com drugs.com posted by 'omarhaneef' <-thanks-> : https://news.ycombinator.com/user?id=omarhaneef https://news.ycombinator.com/user?id=omarhaneef
- Trouble_007 4y ago>One not mentioned on this page is dexchlorpheniramine. < Yes, I'm afraid the site is not comprehensive, and a bare-bones entry at wikipedia; Dexchlorpheniramine : https://en.wikipedia.org/wiki/Dexchlorpheniramine https://en.wikipedia.org/wiki/Dexchlorpheniramine
- 0xdeadb00f 4y agoIndeed that article is very bare-bones. I was definitely surprised to find basically nothing about (ab)using dexchlorpheniramine recreationally after noticing the effects over dosing had.
- mberning 4y agoI didn’t see it in the abstract but how are the alcohol and placebo administered? If they were ingested the participant surely knew they got alcohol or a placebo. And I assume that may have some impact on their performance aside from possibly being intoxicated. I suppose all 4 could be IV administered, but it doesn’t sound like that.
- 988747 4y agoWell, you can give non-alcoholic beer to the subject telling them it is a real thing. Or make them a cocktail, such as Mojito, just a virgin one. Or the opposite: give them a soda secretly spiced with vodka. The possibilities are endless. But the problem is: people usually are familiar with how being drunk feels (and 0.1% BAC is pretty drunk), so it's almost impossible to hide the fact from them. So I guess "placebo group" is only with relation to drugs, not to alcohol.
- danachow 4y ago> But the problem is: people usually are familiar with how being drunk feels The problem is people know how alcohol tastes. Have you ever had a non-alcoholic beer?
- bradknowles 4y agoThere are alcoholic beers that taste as bad or worse as the non-alcoholic ones. And there are alcoholic drinks that taste like they have no alcohol in them at all. Or drinks where you cannot tell if they have any alcohol in them. There are ways to make these things blinded.
- danachow 4y ago> Or drinks where you cannot tell if they have any alcohol in them. Proving this for a sample is pretty much impossible because you’re simply masking it and the sensory performance of humans is highly variable. You can get some imperfect approximation of blinding but it will be a compromise.
- hammock 4y agoTo play devil’s advocate: People forget that drunk driving laws started as the result of activist campaigns from special interest groups only a few decades ago. It is itself a victimless crime; we have existing laws against reckless driving, causing accidents, vehicular manslaughter, etc.; and as this study shows there are plenty of common, less regulated (i.e. showing no signs of impairment yet blowing into a measurement device cannot get you nailed) driving conditions which are as bad or worse than drunk driving.
- ipsin 4y agoIt seems like a "victimless crime" in the same way that a hit and run is a victimless crime, as long as you get away with it. Someone has willfully chosen to make life more dangerous for everyone else. It's possible they won't be caught, but ignoring the act carries a real possibility of harm. There are people who would drive drunk every single day, if they could get away with it.
- hammock 4y ago> hit and run is a victimless crime Not clear on your logic. A hit and run has a victim: whoever is the owner of the person or property you damaged. In contrast, a drunk driver who is not under excess influence of the alcohol in his system and who gets from point A to point B safely, has victimized no one.
- jjulius 4y ago>In contrast, drunk driver who is not under excess influence of the alcohol in his system and who gets from point A to point B safely, has created no victims. And what of the drunk driver under excess influence who creates a victim?
- nyolfen 4y agopresumably he is still subject to the laws that relate to creating a victim
- deleted 4y ago[deleted]
- weberer 4y agoI can't imagine trying to drive for an hour after taking diphenhydramine. It usually knocks me out hard within 20 minutes.