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[Title & authors         ]
Clinical Trial
Ann Intern Med
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. 2000 Mar 7;132(5):354-63.
doi: 10.7326/0003-4819-132-5-200003070-00004.

Effects of fexofenadine, diphenhydramine, and alcohol on driving
performance. A randomized, placebo-controlled trial in the Iowa
driving simulator

J M Weiler^  1 , J R Bloomfield, G G Woodworth, A R Grant, T A Layton
, T L Brown, D R McKenzie, T W Baker, G S Watson
Affiliations Expand

Affiliation

  * ^1 Department of Internal Medicine, University of Iowa, Iowa City
    52242-1081, USA. john-weiler@uiowa.edu

  * PMID: 10691585
  * DOI: 10.7326/0003-4819-132-5-200003070-00004

Item in Clipboard
Clinical Trial

Effects of fexofenadine, diphenhydramine, and alcohol on driving
performance. A randomized, placebo-controlled trial in the Iowa
driving simulator

J M Weiler et al. Ann Intern Med. 2000.
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Ann Intern Med
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. 2000 Mar 7;132(5):354-63.
doi: 10.7326/0003-4819-132-5-200003070-00004.

Authors

J M Weiler^  1 , J R Bloomfield, G G Woodworth, A R Grant, T A Layton
, T L Brown, D R McKenzie, T W Baker, G S Watson

Affiliation

  * ^1 Department of Internal Medicine, University of Iowa, Iowa City
    52242-1081, USA. john-weiler@uiowa.edu

  * PMID: 10691585
  * DOI: 10.7326/0003-4819-132-5-200003070-00004

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Abstract

Background: Sedating antihistamines may impair driving performance as
seriously as alcohol.

Objective: To compare the effects of fexofenadine, diphenhydramine,
alcohol, and placebo on driving performance.

Design: Randomized, double-blind, double-dummy, four-treatment,
four-period crossover trial.

Setting: The Iowa Driving Simulator.

Participants: 40 licensed drivers with seasonal allergic rhinitis who
were 25 to 44 years of age.

Intervention: One dose of fexofenadine (60 mg), diphenhydramine (50
mg), alcohol (approximately 0.1% blood alcohol concentration), or
placebo, given at weekly intervals before participants drove for 1
hour in the Iowa Driving Simulator.

Measurements: The primary end point was coherence, a continuous
measure of participants' ability to match the varying speed of a
vehicle that they were following. Secondary end points were
drowsiness and other driving measures, including lane keeping and
response to a vehicle that unexpectedly blocked the lane ahead.

Results: Participants had significantly better coherence after taking
alcohol or fexofenadine than after taking diphenhydramine. Lane
keeping (steering instability and crossing the center line) was
impaired after alcohol and diphenhydramine use compared with
fexofenadine use. Mean response time to the blocking vehicle was
slowest after alcohol use (2.21 seconds) compared with fexofenadine
use (1.95 seconds). Self-reported drowsiness did not predict lack of
coherence and was weakly associated with minimum following distance,
steering instability, and leftlane excursion.

Conclusions: Participants had similar performance when treated with
fexofenadine or placebo. After alcohol use, participants performed
the primary task well but not the secondary tasks; as a result,
overall driving performance was poorer. After participants took
diphenhydramine, driving performance was poorest, indicating that
diphenhydramine had a greater impact on driving than alcohol did.
Drowsiness ratings were not a good predictor of impairment,
suggesting that drivers cannot use drowsiness to indicate when they
should not drive.

Comment in

  * Nonsedating antihistamines should be preferred over sedating
    antihistamines in patients who drive.
    Hennessy S, Strom BL. Hennessy S, et al. Ann Intern Med. 2000 Mar
    7;132(5):405-7. doi: 10.7326/0003-4819-132-5-200003070-00011. Ann
    Intern Med. 2000. PMID: 10691592 No abstract available.
  * Drug effects on driving performance.
    de Waard D, Brookhuis KA. de Waard D, et al. Ann Intern Med. 2000
    Oct 17;133(8):656; author reply 657-8. doi: 10.7326/
    0003-4819-133-8-200010170-00021. Ann Intern Med. 2000. PMID: 
    11033599 No abstract available.
  * Drug effects on driving performance.
    Lee TH, Dudley J, Demonaco HJ. Lee TH, et al. Ann Intern Med.
    2000 Oct 17;133(8):656-7; author reply 657-8. doi: 10.7326/
    0003-4819-133-8-200010170-00022. Ann Intern Med. 2000. PMID: 
    11033600 No abstract available.
  * Drug effects on driving performance.
    Angello JT, Druce HM. Angello JT, et al. Ann Intern Med. 2000 Oct
    17;133(8):657; author reply 657-8. doi: 10.7326/
    0003-4819-133-8-200010170-00023. Ann Intern Med. 2000. PMID: 
    11033601 No abstract available.

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    Fulgham P, Haumschild R, Rupp K, Tyler T, Moellman J. Blaiss MS,
    et al. Adv Ther. 2022 Jan;39(1):178-192. doi: 10.1007/
    s12325-021-01999-x. Epub 2021 Dec 4. Adv Ther. 2022. PMID: 
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  * A Randomized, Double-Blind, Placebo-Controlled Trial of a
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    Pepa P, Eby DW, Merle D, Kelley-Baker T, Jones V, Pitts S. Hill
    LL, et al. Inj Epidemiol. 2020 Aug 3;7(1):38. doi: 10.1186/
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