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Allergic Rhinitis: Hay Fever Treatments |
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Tuesday, 26 February 2008 |
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Page 10 of 16
Medication continued... | Drug Name | Fexofenadine (Allegra); fexofenadine and pseudoephedrine (Allegra-D) | | Description | Second-generation agent with a rate of sedation not significantly different from that of placebo. Competes with histamine for H1 receptors in GI tract, blood vessels, and respiratory tract, reducing hypersensitivity reactions. Available in qd and bid preparations. Fexofenadine and pseudoephedrine combination is tolerated well, with a rate of sedation not significantly different from that of placebo. | | Adult Dose | Fexofenadine: 60 mg PO bid or 180 mg PO qd
Fexofenadine 60 mg/pseudoephedrine 120 mg (Allegra-D): 1 tab PO bid | | Pediatric Dose | Fexofenadine:
<6 years: Not established
6-12 years: 30 mg PO bid
>12 years: Administer as in adults Fexofenadine and pseudoephedrine:<12 years: Not established | | Contraindications | Documented hypersensitivity; in combination with pseudoephedrine, do not use if severe hypertension or coronary artery disease present; do not use within 14 d of MAOIs | | Interactions | Levels may increase with coadministration of erythromycin or ketoconazole; pseudoephedrine antagonizes antihypertensives; may cause increased ectopic pacemaker activity with digitalis | | Pregnancy | C - Safety for use during pregnancy has not been established.
| | Precautions | Adjust dose in renal impairment (can be used safely in hepatic impairment without dose reduction); caution in pregnancy and breastfeeding, narrow-angle glaucoma or increased intraocular pressure, mild-to-moderate hypertension, diabetes, hyperthyroidism, prostatic hypertrophy, urinary retention, seizure disorders, elderly population; anxiety or insomnia may occur because of pseudoephedrine component; can be used safely with hepatic impairment without a reduction of dose | | Drug Name | Loratadine (Claritin), desloratadine (Clarinex) | | Description | Loratadine selectively inhibits peripheral histamine H1 receptors. Tolerated well, with rate of sedation not significantly different from placebo. Desloratadine is a long-acting tricyclic histamine antagonist selective for H1 receptor. Major metabolite of loratadine, which is extensively metabolized to active metabolite 3-hydroxydesloratadine after ingestion. | | Adult Dose | Loratadine: 10 mg PO qd
Desloratadine: 5 mg PO qd | | Pediatric Dose | Loratadine
<2 years: Not established
2-5 years: 5 mg PO qd
>5 years: Administer as in adults
Desloratadine
<12 years: Not established
>12 years: Administer as in adults | | Contraindications | Documented hypersensitivity | | Interactions | Ketoconazole, erythromycin, procarbazine, cimetidine, and alcohol may increase loratadine levels; limited data exist for desloratadine; erythromycin and ketoconazole increase desloratadine and 3-hydroxydesloratadine plasma concentrations, but no increase observed in clinically relevant adverse effects, including QTc | | Pregnancy | B - Usually safe but benefits must outweigh the risks.
| | Precautions | Desloratadine is pregnancy category C; initiate therapy at lower dose in liver and renal impairment; caution in pregnancy and breastfeeding; may rarely cause pharyngitis or dry mouth | | Drug Name | Loratadine and pseudoephedrine (Claritin-D 24 Hour, Claritin-D 12 Hour) | | Description | Tolerated well, with rate of sedation not significantly different from that of placebo. Some patients may notice anxiety or insomnia owing to pseudoephedrine component. | | Adult Dose | 10 mg loratadine/240 mg pseudoephedrine (Claritin-D 24 Hour): 1 tab PO qd
5 mg loratadine/120 mg pseudoephedrine (Claritin-D 12 Hour): 1 tab PO bid | | Pediatric Dose | <12 years: Not established | | Contraindications | Documented hypersensitivity; severe hypertension or coronary artery disease; do not use within 14 d of MAOIs | | Interactions | Ketoconazole, erythromycin, procarbazine, cimetidine, and alcohol may increase loratadine levels; pseudoephedrine antagonizes antihypertensives; may cause increased ectopic pacemaker activity with digitalis | | Pregnancy | B - Usually safe but benefits must outweigh the risks.
| | Precautions | Initiate therapy at lower dose in renal impairment; avoid use with hepatic impairment; caution in pregnancy and breastfeeding, narrow-angle glaucoma or increased intraocular pressure, mild-to-moderate hypertension, diabetes, hyperthyroidism, prostatic hypertrophy, urinary retention, seizure disorders, elderly population |
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