1 The effect of ketotifen was compared with that of clemastine and chlorpheniramine, known antihistamines, and sodium cromoglycate, a drug considered to have mast cell 'stabilizing' properties on histamine and allergen wealing reactions in human skin, in random order, double-blind, placebo controlled studies. 2 Ketotifen was significantly more potent in the inhibition of both histamine (P < 0.001) and allergen (P < 0.001) skin wealing reactions than either clemastine or chlorpheniramine. Sodium cromoglycate had no significant effect on either histamine or allergen skin wealing reactions in any of the concentrations tested. 3 However ketotifen, like clemastine, had a significantly greater inhibitory effect on histamine than on allergen induced weals (P < 0.001) and both drugs were shown to act as competitive antagonists of histamine. 4 Ketotifen has been shown to be a potent anti-histamine but there is no evidence from these in vivo studies to suggest that it has any additional inhibitory activity on release of mediators from mast cells in human skin.