Antihistamines without gloss. Controversial issues surrounding the use of cetirizine and levocetirizine in light of evidence-based medicine

The demand for H1–blockers in modern clinical practice is beyond doubt. The multiplicity of histamine-mediated effects in various immune-dependent pathologies, along with the increasing severity of allergic diseases and the growing role of comorbidity in modern patients, necessitates the study of personalized therapy selection based on disease immunophenotypes. Among the second-generation H1–blockers, which are active metabolites, the most studied are cetirizine and levocetirizine, which, along with their effectiveness, demonstrate high safety in patients of different age groups, patients with comorbidity, including during long-term use and high-dose administration. Among the main adverse events described in the literature when taking cetirizine, drowsiness is indicated in 7% of cases (according to the instructions for the drug). However, emerging information in periodicals about another adverse event—itching after discontinuation of the drugs—is subject to targeted analysis from the perspective of evidence-based medicine, as it creates significant problems in confident routine clinical practice.