Q: My son is prone to asthma symptoms from indoor allergens such as dust mites and dander. Would it be helpful to take daily antihistamines to help with his winter asthma control?
Dr. Bassett: Home allergen exposure is an important trigger to those with common allergies, such as house dust mites and dog and cat dander. So what can those with allergic asthma do to reduce symptom flare-ups during winter months, with so much indoor time?
Current guidelines do not list oral antihistamines in combination with nasal steroid sprays as a treatment for asthma, and some studies suggest that antihistamines have little effect on asthma symptoms.
However, one study did identify a reduction in emergency visits and hospital stays for asthma when either (or both) nasal steroid sprays or antihistamine pills were being used to treat rhinitis symptoms.
Research into combining antihistamines with oral leukotrienes (such as montelukast) suggests the results may be greater than when leukotrienes are used alone, but this needs further study.
While it may be premature to add a daily antihistamine to your son’s regimen, national asthma treatment guidelines do wisely suggest working closely with an allergist or other asthma provider to ensure optimal asthma control. That means having an individualized asthma action plan, which takes into account all of his allergic triggers and exposures for successful asthma management.
Dr. Clifford Bassett, allergist and asthma specialist, is the Medical Director of Allergy & Asthma Care of New York (Allergyreliefnyc.com; Twitter @allergyreliefny). He is on the faculty of NYU School of Medicine and Weill Cornell Medical College in New York City and is also the author of The New Food Allergy Solution: Supercharge Resistance, Slash Medication, Stop Suffering.
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