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Adverse drug reactions are most commonly associated with the first-generation H1-antihistamines. This is due to their relative lack of selectivity for the H1-receptor.

The most common adverse effect is sedation; this "side effect" is utilised in many OTC sleeping-aid preparations.

Other common adverse effects in first-generation H1-antihistamines include: dizziness, tinnitus, blurred vision, euphoria, uncoordination, anxiety, insomnia, tremor, nausea and vomiting, constipation, diarrhoea, dry mouth, and dry cough. Infrequent adverse effects include: urinary retention, palpitations, hypotension, headache, hallucination, and psychosis

The main side effect of the older antihistamines is sedation (drowsiness). After taking the drugs for a few days, this effect may fade. Other side effects of older antihistamines can include headache, dry mouth and blurred vision.

Antihistamine creams can sometimes cause hypersensitivity of the skin, which means the skin overreactes to stimulation such as touch. Topical antihistamines should not be applied to skin with eczema and should not be used for longer than three days at a time.

Newer, non-sedating antihistamines are far less likely to cause drowsiness, but it does sometimes occur; avoid driving until you know how the drug affects you.

Terfenadine, which may be prescribed for hay fever treatment, has a particular set of side effects, including making your heart beat fast and in an irregular way.

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