FEXOFENADINE
| FEXOFENADINE (fex-o-fen'a-deen) Allegra Classifications: antihistamine; h1-receptor antagonist, non-sedating; Therapeutic: antihistamine; non-sedating h1-receptor antagonist Prototype: Loratadine Pregnancy Category: C |
Availability
30 mg, 60 mg, 180 mg tablets; 60 mg capsules; 30 mg orally disintegrating tablet
Action
Competes with free histamine for binding at the H1-receptor. This competitive antagonism blocks effects of histamine on H1-receptors in bronchial smooth muscle. This also results in decreased formation of edema, flare, and pruritus that result from histaminic activity.
Therapeutic Effect
Inhibits antigen-induced bronchospasm and histamine release from mast cells. Efficacy is indicated by reduction of the following: nasal congestion and sneezing; watery or red eyes; itching nose, palate, or eyes.
Uses
Relief of symptoms associated with seasonal allergic rhinitis, and chronic urticaria.
Contraindications
Hypersensitivity to fexofenadine or terfenadine; neonates; pregnancy (category C).
Cautious Use
Mild to severe renal and hepatic insufficiency, hypertension, diabetes mellitus, ischemic heart disease, increased ocular pressure, hyperthyroidism, renal impairment, or prostatic hypertrophy; young children.
Route & Dosage
| Allergic Rhinitis Adult/Child (>12 y): PO 60 mg b.i.d. OR 180 mg q.d. Child (6–11 y): PO 30 mg b.i.d. Chronic Urticaria Adult: PO 60 mg b.i.d. OR 180 mg q.d. Child (2–11 y): PO 30 mg b.i.d. Infant (>6 mo): PO 15 mg b.i.d. Renal Impairment Clcr <80 mL/min: reduce to one dose per day |
Administration
Oral- Reduce starting dose for those with decreased kidney function.
- Do not give within 15 min of an aluminum- or magnesium-containing antacid.
- Store at 20°–25° C (68°–77° F). Protect from excess moisture.
Adverse Effects (≥1%)
CNS: Headache, drowsiness, fatigue. GI: Nausea, dyspepsia, throat irritation.Interactions
Drug: antacids will decrease serum level of fexofenadine. Herbal: St. John's wort will decrease serum level of fexofenadine. Food: Grapefruit juice may decrease efficacy.Pharmacokinetics
Absorption: Rapidly from GI tract, 33% reaches systemic circulation. Onset: 1 h. Peak: 2–3 h. Duration: At least 12 h. Distribution: 60–70% bound to plasma proteins. Metabolism: Only 5% of dose metabolized in liver. Elimination: 80% in urine, 11% in feces. Half-Life: 14.4 h.Nursing Implications
Assessment & Drug Effects
- Monitor therapeutic effectiveness, which is indicated by decreased nasal congestion, sneezing, watery or red eyes, and itching nose, palate, or eyes.
Patient & Family Education
- Note: Drug is well tolerated and causes minimal adverse effects.
Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; 
Canadian drug name; 
Prototype drug