10/16/2026
Antihistamines for MCAS with Bryana Burken, PharmD, RPh
Why might someone with Mast Cell Activation Syndrome (MCAS) need more than one antihistamine to manage their symptoms? In this episode, Bryana Burken, Pharmacist and Physician Liaison with Physicians Preference Pharmacy, explains how histamine functions in the body and why maintaining proper histamine balance is essential for overall health. She discusses how excess histamine can contribute to symptoms such as hives, itching, digestive discomfort, food sensitivities, respiratory issues, and heart palpitations. Bryana also explains the differences between H1 and H2 antihistamines and why targeting different histamine receptors may provide more comprehensive symptom relief.
The discussion explores how various antihistamines work, including the differences between first-generation and second-generation medications, their potential sedating effects, and how treatment can be tailored to an individual's symptoms and lifestyle. Bryana explains why compounded antihistamines may be particularly beneficial for individuals with MCAS. She also discusses how customized strengths and slow-release formulations may help patients better tolerate their medications while addressing histamine-related symptoms.
Throughout the episode, Bryana emphasizes the importance of personalized treatment. A knowledgeable physician and pharmacist can help create a treatment plan that addresses symptoms while supporting long-term wellness.
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