Letzte Aktualisierung am 7. December 2023 von Dr. Michael Zechmann-Khreis
Active medical ingredients or medication and histamine intolerance (HIT)
Many people ask themselves which medications or active ingredients are suitable for histamine intolerance. What is an “anti-histamine”? We have compiled a list of suitable and incompatible medications for histamine intolerance here.
Some medications can inhibit the activity of diamine oxidase (DAO ) or release histamine. These medications are problematic in the case of histamine intolerance or allergies (e.g. active pollen allergy). In certain situations, the medication can be “tolerated” by following an even stricter histamine-free diet. On the other hand, you can take special medication to prevent this (H1 receptor blockers1)). You should always discuss this very carefully with your doctor!
Not all doctors know about this. You are welcome to print out this table and take it with you to your doctor’s appointment! This is not to denigrate the quality or training of the doctor, but to make it clear that modern doctor-patient relationships should be based on dialog.
Some anti-inflammatory drugs or substances inhibit the allergen-specific release of histamine and are therefore more suitable for histamine intolerant people. These include ibuprofen, fenbufen and levamisole(1).
| Substance class | Active ingredients | Examples** |
|---|---|---|
| Analgesics | Morphine, pethidine, NSAIDs, ASA, metamizole | Aspirin, Novalgin, Buscopan comp. |
| Antibiotics | Cefuroxime, cefotiam, isoniazid, Pentamidine, clavulanic acid, chloroquine | Resochin, Amoclav, Amoxiclav, Augmentan, Aziclav, InfectoSupramox, Xiclav, Augmentin, Isozid, Curocef, Elobact, Zinacef, Zinnat, and many more! |
| Antidepressants | Amitriptyline | Limbritol, tryptizol, sarotene |
| Antihypertensives | Verapamil, alprenolol, dihydralazine | Isoptin |
| Antihypotonics | Dobutamine | Inotope |
| Antiarrhythmics | Propafenone | Rythmol (USA) |
| Broncholytics | Aminophylline | Myocardon, Euphyllin, Mundiphyllin |
| Diuretics | Amiloride | Amiloretik, Comilorid, Diaphal, Diursan |
| H2 receptor antagonists | Cimetidine | Cimetag, CimLich, Neutromed, Ulcostad |
| Local anesthetics | Prilocaine | Xylonest, Emla |
| Motility-influencing agents | Metoclopramide | Paspertin, Cerucal, Gastronerton, Gastrosil, Metogastron, Primperan, Geffer |
| Muscle relaxants | Pancuronium, Alcuronium | Pavulon, Alloferin |
| Mucolytics | Acetylcysteine, Ambroxol | Aeromuc, Mucosolvan, Ambrobene, ACC, Helvetussin |
| Narcotics | Thiopental | Pentothal (CH), Trapanal (D) |
| X-ray contrast medium* | ||
| Cytostatics | Cyclophosphamide | Endoxan |
* Iodine allergy” or “contrast medium allergy” are frequently used – but incorrect – terms. This is an intolerance to certain contrast media (mainly ionic), as these probably release histamine. This is problematic for sensitive people (histamine intolerants, allergy sufferers who are currently exposed to their allergen). You should tell your doctor about your histamine intolerance or allergy before undergoing a contrast medium examination! Premedication with H1 and H2 receptor blockers may be useful(1).
** The brand names mentioned are examples. No claim to completeness, on the contrary: there are usually a myriad of preparations and generics!
Sources:
(1) Jarisch, R. “Histaminunverträglichkeit”, Thieme Verlag TB 2nd edition, 2004, pp. 123ff
(2) Maintz, L; Bieber, T; Novak, N; “Histamine Intolerance in Clinical Practice”, Dtsch Arztebl 2006; 103(51-52): A-3477, modified according to Table 2
