Terfenadine reduced the mean maximum serum levels of zafirlukast by about 70% and reduced its AUC by about 60% in one study. Terfenadine serum levels remained unchanged and no ECG alterations occurred.
The reduction in zafirlukast serum levels would be expected to reduce its antiasthmatic effects, but this needs clinical assessment. The combination need not be avoided but be alert for a reduced response.
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