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All medicines have side effects
  1. Karel Allegaert1,2,
  2. Imti Choonara3
  1. 1Intensive Care and Department of Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
  2. 2Department of Development and Regeneration, KU Leuven, Leuven, Belgium
  3. 3Academic Division of Child Health, University of Nottingham, Derbyshire Children's Hospital, Derby, UK
  1. Correspondence to Professor Imti Choonara, Academic Unit of Child Health, The Medical School, University of Nottingham, Derbyshire Children's Hospital, Uttoxeter Road, Derby DE22 3NE, UK; imti.choonara{at}nottingham.ac.uk

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Antihistamines are a widely used group of medicines. As well as being prescribed, they are available over the counter in many countries. A recent study from France highlighted that each year almost one in three children will receive an antihistamine and that in children aged between 2 and 5 years, almost one in two will receive an antihistamine.1 The paper by Vries and Hunsel from the Netherlands highlights reported suspected adverse drug reactions (ADRs) to first-generation and second-generation systemic antihistamines.2

Skin eruptions and ADRs involving the central nervous system (headache, somnolence, aggression, agitation, hyperactivity and seizures) were the most commonly reported ADRs to second-generation antihistamines. These ADRs are also the ADRs most frequently associated with first-generation antihistamines. Second-generation antihistamines are thought to be associated with fewer side effects. Their findings do not suggest that we should stop using antihistamines in children. They do, however, highlight that medicines we consider to be safe do have side effects.

We know that many side effects are not recognised as such …

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