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I Jáuregui1, M Ferrer2,
J Montoro3, I Dávila4, J Bartra5,
A del Cuvillo6, J Mullol7, J
Sastre8, A Valero5 |
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1Allergy Department,
Basurto University Hospital, Bilbao, Spain
2Allergology Department, University Clinic of
Navarra, Pamplona, Spain
3Allergy Unit, Arnau de Vilanova University
Hospital, Faculty of Medicine, Catholic University of
Valencia "San Vicente Mártir", Valencia, Spain
4Immunoallergy Department, Salamanca
University Welfare Complex, IBSAL, Salamanca, Spain
5Allergy Unit, Pneumology and Respiratory
Allergy Department, Hospital Clínic (ICT), Barcelona,
Spain
6Dr. Lobatón Clinic, Cadiz, Spain
7Rhinology and Olfactory Clinical Unit,
Otorhinolaryngology Department, Hospital Clínic (ICT),
Barcelona, Spain
8Allergy Department, Jiménez Díaz Foundation,
Madrid, Spain |
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Abstract |
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The most commonly
occurring allergic
diseases can involve
a daytime drowsiness
associated with the
condition itself.
The antihistamines
used in their
treatment can also
have central effects
and affect certain
occupations
concerned with risk,
road safety and
maritime and air
navigation.
Cognitive tests,
experimental studies
and epidemiological
data recommend
avoiding 1st
generation
antihistamines for
people who must
drive regularly
and/or professions
concerned with
safety. Although
there are no
comparative studies
on real driving
between 1st and 2nd
generation
antihistamines, in
this type of
patients there
should be a
preference for
prescribing those
with least possible
central effect,
especially those
which are a good
substrate for
transmembrane
transporter pumps
such as
P-glycoprotein and
therefore have a low
capacity for
crossing the
hematoencephalic
barrier, thus
allowing a broader
window for therapy.
In this sense,
bilastine is a good
P-glycoprotein
substrate and shows
good tolerance at
CNS level, in both
psychometric trials
and real driving
test protocols, even
at double the dose
recommended in the
technical file.
Key words:
Antihistamine.
Bilastine. Real
driving studies.
P-glycoprotein.
Cognitive tests.
Road safety. Central
nervous system.
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