Management of Seasonal Allergic Rhinitis: Comparative Efficacy of the Newer-Generation Prescription Antihistamines


  • Kathleen Conboy-Ellis RN, PhD, MHA, CPNP, AE-C

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      Kathleen Conboy-Ellis, RN, PhD, MHA, CPNP, AE-C, is an Assistant Professor of Nursing at the University of Tampa, Tampa, FL 33606.

  • Conflict of interest disclosure
    Financial support for this review article was provided by the sanofi-aventis Group, manufacturer of fexofenadine (Allegra®).

Contact Ms. Conboy-Ellis by e-mail at



To discuss the efficacy and safety of second-generation prescription antihistamines, cetirizine, desloratadine, and fexofenadine, and to inform nurse practitioners (NP) who are in a position to optimally manage patients presenting with seasonal allergic rhinitis (SAR).

Data sources

Selected published clinical trials.


NP, who are ideally placed to successfully manage the majority of patients with SAR, should be fully aware of the treatment options available. Although first-generation over-the-counter antihistamines are convenient to use and are readily accessible, patients run the risk of experiencing adverse effects, such as sedation. For this reason, second-generation antihistamines should be considered a better alternative; however, they need to be evaluated individually on the basis of their proven efficacy and safety. Both cetirizine and fexofenadine are equally effective at relieving the symptoms of SAR; however, cetirizine has been shown to be more likely to cause sedation and impairment.

Implications for practice

If left untreated, SAR can have a substantial effect on patients’ quality of life, resulting in fatigue, irritability, sleep disorders, and cognitive impairment.