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Based on clinical opinion, potential secondary treatment effect modifiers were identified as race/ethnicity, proportion of diabetic/prediabetic participants at baseline, and OSA

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Recommended antihistamine options: Cetirizine (Zyrtec): 10mg once daily, non-drowsy, fast-acting (within 1 hour), most effective for injection site itch Loratadine (Claritin): 10mg once daily, non-drowsy, good for mild reactions Fexofenadine (Allegra): 180mg once daily, non-drowsy, least sedating option Diphenhydramine (Benadryl): 25 to 50mg every 6 hours, causes drowsiness but strongest anti-itch effect, best for severe reactions or nighttime use Strategic timing approach: Take a non-drowsy antihistamine 1 hour before your scheduled injection