Antihistamine History Form

This is an Antihistamine History Form so that we can determine which drugs your pet was on and how they worked.

Please let us know how the various antihistamine drugs worked for your pet.

• Chlorpheniramine (Chlor-Trimeton)-helped a little–helped a lot–didn’t help at all–sedated

Duration­­­­­ of treatment: _________

• Diphenhydramine (Benadryl)-helped a little–helped a lot–didn’t help at all–sedated

Duration of treatment: _________

• Hydroxyzine (Atarax, Vistaril)-helped a little–helped a lot–didn’t help at all–sedated

Duration­­­­­ of treatment: _________

• Doxepin (Silenor, Zonalon, Prudoxin)-helped a little–helped a lot–didn’t help at all–sedated

Duration­­­­­ of treatment: _________

• Loratadine (Claritin, Alavert, Fad, Select)-helped a little–helped a lot–didn’t help at all–sedated

Duration­­­­­ of treatment: _________

• Cetirizine (Zyrtec)-helped a little–helped a lot–didn’t help at all–sedated

Duration­­­­­ of treatment: _________

• Clemastine (Tavist 1.34mg)-helped a little–helped a lot–didn’t help at all–sedated

Duration of treatment: _________

• Clemastine (Tavist 2.68mg)-helped a little–helped a lot–didn’t help at all–sedated

Duration­­­­­ of treatment: _________

• Trimeprazine with prednisone (Temaril-P) helped a little-helped a lot–didn’t help at all–sedated

Duration­­­­­ of treatment: _________

• Amitriptyline (Elavil)-helped a little-helped a lot–didn’t help at all–sedated

Duration of treatment: _________

• Fexofenadine (Allegra)-helped a little–helped a lot–didn’t help at all–sedated

Duration­­­­­ of treatment: _________