MedPath

Over-the-Counter Antihistamines & Heat Stress

Phase 4
Recruiting
Conditions
Sudomotor Sympathetic Dysfunction
Heat Illness
Allergic Rhinitis
Heat Injury
Interventions
Registration Number
NCT06217367
Lead Sponsor
Lakehead University
Brief Summary

Allergic rhinitis (AR) currently affects \~25% of Canadians, and due to factors of climate change, this number is expected to increase over the coming decade. AR symptoms can significantly impact individuals' quality of life by compromising sleep, productivity, and social interactions. To alleviate AR symptoms, North Americans tend to rely on H1 antihistamine medications available over-the-counter (OTC) at most pharmacies. However, public health authorities currently suggest restraining all antihistamines during heat waves due to beliefs that M3 muscarinic receptor and H1 receptor antagonism, independent pharmacological mechanisms of H1 antihistamines, might suppress thermoregulatory responses to heat stress and increase individuals' susceptibility to heat-related illness/injury. To date, studies using supramaximal doses of antihistamines have demonstrated reductions in sweating, however these doses and administration routes are not the typical use case. Additional studies utilizing fexofenadine, a second-generation H1 antihistamine, have linked H1 receptor antagonism to reductions in skin blood flow, potentially impacting thermoregulation by reducing peripheral blood redistribution. Empirical evidence supporting OTC H1 antihistamines impacting thermoregulatory control at recommended doses is scarce. Thus, this study aims to systematically assess whether three common OTC H1 antihistamines, taken as prescribed, alter thermoregulatory responses during thermal stress.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
16
Inclusion Criteria
  • Male or Female between ages 19 and 39 years
  • Fully vaccinated against COVID-19
  • Able to provide informed consent
  • Body-mass index under 30
Exclusion Criteria
  • Body-mass index over 30
  • Currently taking sedative or autonomic nervous system depressant medication
  • Hypersensitivity to diphenhydramine, loratadine, or desloratadine
  • History of cardiovascular disease, cancer, type 1 or 2 diabetes, chronic obstructive pulmonary disorder, or cystic fibrosis
  • Have smoked tobacco products less than 12 months prior to participation
  • Pregnant/Breastfeeding

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
5 mg Desloratadine5 mg Desloratadine-
50 mg Diphenhydramine50 mg Diphenhydramine-
10 mg Loratadine10 mg Loratadine-
Placebo (Sugar pill)Placebo (Sugar Pill)-
Primary Outcome Measures
NameTimeMethod
Local Sweat RateFor each study arm (all completed within 4 months), measured before heating, and at every 0.25C increase in core temperature (+0.25C, +0.50C, +0.75C, +1.0C, +1.25C, and +1.5C), or every ~15 minutes of (up to ~90 minutes) and immediately after heating

Measured using ventilated sweat capsules affixed to forearm and chest

Heart RateFor each study arm (all completed within 4 months), measured before heating, and at every 0.25C increase in core temperature (+0.25C, +0.50C, +0.75C, +1.0C, +1.25C, and +1.5C), or every ~15 minutes of (up to ~90 minutes) and immediately after heating

Measured using electrocardiogram

Whole-Body Sweat LossesFor each study arm (all completed within 4 months), measurements taken immediately before heating protocol & immediately following the heating protocol

Difference in participants' pre/post body mass

Skin Blood FlowFor each study arm (all completed within 4 months), measured before heating, and at every 0.25C increase in core temperature (+0.25C, +0.50C, +0.75C, +1.0C, +1.25C, and +1.5C), or every ~15 minutes of (up to ~90 minutes) and immediately after heating

Measured using laser-doppler skin blood blow sensor affixed to forearm

Mean Arterial PressureFor each study arm (all completed within 4 months), measurements taken at baseline before heating, and every 10 minutes throughout heating protocol (up to ~ 90 minutes), and immediately after heating

Measured using brachial blood pressure cuff

Secondary Outcome Measures
NameTimeMethod
Thermal ComfortFor each study arm (all completed within 4 months), measured before heating, and at every 0.25C increase in core temperature (+0.25C, +0.50C, +0.75C, +1.0C, +1.25C, and +1.5C), or every ~15 minutes of (up to ~90 minutes) and immediately after heating

Self-assessments of thermal comfort using four-point analog scale where 1 is "Not uncomfortable" and 4 is "Very uncomfortable"

Mental AcuityFor each study arm (all completed within 4 months), measurements taken 2 hours before heating (pre-pill ingestion), 5-minutes before initiating heating, and within 5-minutes after the heating protocol

Indexed with digital Stroop test

Sleepiness/Fatigue levelFor each study arm (all completed within 4 months), measurements taken 2 hours before heating (pre-pill ingestion), 5-minutes before initiating heating, and within 5-minutes after the heating protocol

Measured using Stanford Sleepiness Scale (min: 1, max: 7 (more fatigued))

Thermal SensationFor each study arm (all completed within 4 months), measured before heating, and at every 0.25C increase in core temperature (+0.25C, +0.50C, +0.75C, +1.0C, +1.25C, and +1.5C), or every ~15 minutes of (up to ~90 minutes) and immediately after heating

Self-assessments of thermal sensation using a 7-point analog scale where -3 is "Cold" and +3 is "Hot".

Trial Locations

Locations (1)

Lakehead University C.J Sanders Fieldhouse

🇨🇦

Thunder Bay, Ontario, Canada

© Copyright 2025. All Rights Reserved by MedPath