Controlling the pain of IC with OTC medications: Antihistamines
Some patients report a decrease in interstitial cystitis (IC) symptoms using antihistamines or medicines with antihistamine properties. The reason for this has to do with the pathophysiology of IC. A common finding in IC is an increased number of Mast cells in biopsies taken from the bladder lining. Mast cells are involved with an inflammatory response and, once stimulated, will release a number of substances, one of which is histamine. Histamine attaches to your cells causing them to swell and leak fluid. This cell destruction leads to increased inflammation and IC pain. Antihistamines prevent histamine from attaching to your cells and stop the pain producing cycle.
Yes, the same histamine that tortures you with seasonal allergies could also be making your bladder pain worse.
For some people, using antihistamines decreases their IC symptoms, and that is why we have included what are most commonly thought of as allergy meds. Though the most widely used antihistamine to treat IC is hydroxyzine (which is only available via prescription), some people with IC find relieve from Claritin, Benadryl, and Zyrtec, which are all available OTC.
Zyrtec (cetiridine) & Claritin (loratadine)
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The side effect profiles for both of these drugs are very similar. Mild side effects caused by both medications include:
feeling drowsy or tired
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Because Benadryl is an older antihistamine (1st generation), it is less specific when targeting histamine receptors and tends to have more profound side effects like sedation and dry mouth. See the “further reading” link to read more about all of the side effects and warnings with this drug. For me personally, Benadryl is a no-no unless I want to spend the whole afternoon snoozing on the couch.
Further Reading on using antihistamines for IC:
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