Non-Drowsy Antihistamines: Which One to Choose
Medically Reviewed by Dr. Pedro Yelamo Vera, MD
Licensed Physician No. 484814280 · Official Medical College of Bizkaia (Spain)Last reviewed: 31 October 2026
Non-drowsy vs drowsy antihistamines, which ones a Spanish pharmacy sells without a prescription, UK and US names, and when to see a doctor.
You don't have to figure this out alone
Dr. Pedro Yelamo Vera is an independent, bilingual GP licensed in Spain. Book a 15-minute video consultation in English or Spanish for €50, with a private electronic prescription issued under Spanish law when clinically appropriate.
Antihistamines ease allergy symptoms such as sneezing, a runny nose, itchy eyes and hives. Non-drowsy antihistamines are usually the first choice. In Spain, some packs of cetirizine, loratadine and a few other non-drowsy tablets are sold without a prescription. Most other packs and brands need one. None of them treats a severe allergic reaction.
- Antihistamines block histamine, the chemical behind itching, sneezing and hives.
- Non-drowsy types include cetirizine, loratadine, fexofenadine, bilastine and ebastine. Older types, such as dexchlorpheniramine, often cause sleepiness.
- In Spain, some packs are over the counter and most need a prescription. The pharmacist will tell you which one you can buy.
- Ask a pharmacist or doctor first if you are pregnant, breastfeeding, older, or buying for a young child.
- Antihistamine tablets do not treat anaphylaxis. Use an adrenaline pen if you have one and call 112.
Dr. Pedro Yelamo Vera is a GP licensed in Spain (Colegiado No. 484814280).
For a medical emergency, call 112 or go to the nearest local emergency department. Do not wait for a video consultation or an online reply.
What are antihistamines and what do they treat?
When you meet something you are allergic to, your body releases histamine. Histamine causes the itching, watery eyes, runny nose, sneezing and rashes of an allergy. Antihistamines block it. The NHS lists these common uses:
- Hay fever and other nose allergies (rinitis alérgica). See our hay fever and seasonal allergy care.
- Hives, an itchy raised rash (urticaria).
- Itchy, red eyes from allergy.
- Insect bites and stings.
- Some older types are also used for travel sickness or short-term sleep problems.
They work best when you take them before you meet the allergen. They can still help once symptoms have started. They come as tablets, liquids, eye drops, nasal sprays and creams.
Drowsy or non-drowsy: which is which?
Older antihistamines pass into the brain more easily, so they often make you sleepy. Newer ones are less likely to. The MSD Manual notes that older types can also cause dry mouth, blurred vision, constipation, confusion and trouble passing urine.
| Medicine (Spanish name) | Type | Our guide |
|---|---|---|
| Cetirizine (cetirizina) | Non-drowsy, but some people feel sleepy | Cetirizine in Spain |
| Loratadine (loratadina) | Non-drowsy | — |
| Fexofenadine (fexofenadina) | Non-drowsy | — |
| Bilastine (bilastina, Bilaxten) | Non-drowsy | Bilaxten in Spain |
| Ebastine (ebastina, Ebastel) | Non-drowsy | Ebastel in Spain |
| Dexchlorpheniramine (dexclorfeniramina, Polaramine) | Drowsy | Polaramine in Spain |
| Hydroxyzine (hidroxizina) | Drowsy | — |
The NHS says non-drowsy types are usually preferred. A drowsy one may suit someone whose itch keeps them awake at night.
Which antihistamines can you buy without a prescription in Spain?
Spain sorts medicines by pack, not just by name. The same medicine can be over the counter in one pack and prescription-only in another. Our guide to prescription status in Spain checked each one in CIMA, the database of the Spanish medicines agency (AEMPS).
| Medicine | Spain | UK (for comparison) |
|---|---|---|
| Cetirizine | Some packs without prescription; most need one. Zyrtec needs one. | Over the counter |
| Loratadine | One pack without prescription; most need one | Over the counter |
| Fexofenadine | One pack without prescription; others need one | Over the counter (one strength) |
| Desloratadine | Some packs without prescription; most need one | Prescription only |
| Bilastine | Some packs without prescription; every form of Bilaxten needs one | Prescription only |
| Ebastine | Some packs without prescription; every form of Ebastel needs one | Not sold |
| Dexchlorpheniramine tablets and syrup | Prescription only (the Polaracrem cream is not) | Not sold |
| Hydroxyzine | Prescription only | Prescription only |
Coming from the US? You may know these as Claritin (loratadine), Zyrtec (cetirizine), Allegra (fexofenadine), Clarinex (desloratadine) and Xyzal (levocetirizine). Bilastine is not sold there. In a Spanish pharmacy, ask for the medicine by its Spanish name. The pharmacist will tell you which pack you can take home.
Allergy symptoms not settling with what the pharmacy can sell you?
You can book a video visit with a GP licensed in Spain, in English or Spanish. He goes through your symptoms and the medicines you have tried, and helps you plan the next step.
Which antihistamine is best?
The NHS says there is not much evidence that any one antihistamine is better than another. People respond differently. You may need to try more than one to find the right fit.
- You drive or work with machines: pick a non-drowsy type, and check how it affects you first.
- Itch keeps you awake: a doctor may suggest a drowsy one at night.
- Blocked nose from hay fever: a steroid nasal spray often helps more. The NHS lists it next to antihistamines. See our Nasonex guide.
- Itchy eyes: antihistamine eye drops are an option.
Can you take antihistamines when pregnant, breastfeeding or for a child?
Ask a pharmacist or doctor first. The NHS says loratadine is usually the one recommended in pregnancy. Loratadine or cetirizine are usually considered suitable while breastfeeding.
For children, MedlinePlus says most antihistamines are safe from age 2. The MSD Manual warns that drowsy antihistamines should not be given to children under 2. It also says mixed antihistamine and decongestant products should not be given under 12. Always check the leaflet (prospecto) and ask which product suits your child's age.
Who should check with a doctor first?
- Older people. The MSD Manual says older drowsy types are a particular problem for them.
- People with glaucoma, an enlarged prostate or trouble passing urine.
- People with epilepsy, heart disease, high blood pressure, liver or kidney disease, diabetes or an overactive thyroid.
- Anyone taking other medicines, including some antidepressants, stomach medicines and cold remedies that already contain an antihistamine.
Can you drink alcohol or drive on antihistamines?
MedlinePlus advises no alcohol while you take them. Alcohol adds to the sleepiness, above all with the drowsy types. The NHS says do not drive or use machines after a drowsy antihistamine. Even with a non-drowsy one, find out how it affects you before you drive.
When are antihistamines not enough?
See a doctor if your symptoms are getting worse, or have not improved with pharmacy medicines. The NHS says a GP may then suggest a steroid treatment, or refer you for allergy immunotherapy. Also see a doctor if hives keep coming back, or if you are not sure the problem is an allergy.
Call 112 straight away if someone has swelling of the throat or tongue, trouble breathing or swallowing, a hoarse voice, feels faint, or turns pale, blue or grey. These are signs of anaphylaxis. Use an adrenaline auto-injector if there is one. The MSD Manual is clear: adrenaline comes first, and antihistamine tablets do not open narrowed airways. Read more about adrenaline pens.
Talking it through with a doctor by video
Dr. Yelamo is a GP licensed in Spain. He sees adults, children and pregnant patients by video, every day from 07:30 to 20:30 (Spain time). In the visit he will:
- Ask what sets off your symptoms and when they are worst.
- Look at a rash or red eyes on camera.
- Go through the antihistamines and sprays you have already tried.
- Explain whether a different antihistamine, a nasal spray, eye drops or an allergy referral fits you.
He does not promise any test or prescription before the visit. Where clinically appropriate, following a genuine evaluation. Treatment and prescriptions are issued solely at the doctor's discretion based on evidence-based clinical guidelines.
A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.
See how the Urgent Care video visit works. It lasts 15 minutes and costs €50.
This guide is general information. It does not replace the package leaflet or the advice of your doctor or pharmacist.
Frequently asked questions
Can I buy antihistamines without a prescription in Spain?
Yes, some packs. Small packs of cetirizine and loratadine are sold over the counter, and a few packs of fexofenadine, desloratadine, bilastine and ebastine too. Most other packs and brands, such as Zyrtec, Bilaxten and Ebastel, need a prescription.
What is the best non-drowsy antihistamine?
There is little evidence that one is better than another. Cetirizine, loratadine, fexofenadine, bilastine and ebastine are all less likely to cause sleepiness. You may need to try more than one.
What is Claritin called in Spain?
Claritin is loratadine. In a Spanish pharmacy, ask for loratadina. Zyrtec is cetirizina and Allegra is fexofenadina.
Which antihistamine is safe in pregnancy?
The NHS says loratadine is usually the one recommended in pregnancy. Ask a pharmacist or doctor before you take any medicine while pregnant.
Can I give my child an antihistamine?
Most antihistamines are safe from age 2, but drowsy types should not be given under 2. Check the leaflet and ask a pharmacist which product suits your child's age.
Do antihistamines stop a severe allergic reaction?
No. Anaphylaxis needs adrenaline. Use an auto-injector if there is one and call 112.
Sources
- NHS: Antihistamines
- NHS: Hay fever
- NHS: Anaphylaxis
- MedlinePlus: Antihistamines for allergies
- MSD Manual: Overview of allergic reactions
Related guides
Medical Citations & Sources
This content is written and reviewed by a licensed physician with reference to the following official health authorities.
