Fexofenadine
Clinical data | |
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Trade names | Allegra, others |
AHFS/Drugs.com | Monograph |
MedlinePlus | a697035 |
License data |
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Pregnancy category |
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H1 receptor antagonist | |
ATC code | |
Legal status | |
Legal status | |
Pharmacokinetic data | |
Bioavailability | 30–41%[8] |
Protein binding | 60–70%[9] |
Metabolism | Hepatic (≤5% of dose)[9] |
Elimination half-life | 14.4 hours |
Excretion | Feces (~80%) and urine (~10%) as unchanged drug[9] |
Identifiers | |
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JSmol) | |
Chirality | Racemic mixture |
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Fexofenadine, sold under the brand name Allegra among others,
Therapeutically, fexofenadine is a selective peripheral H1 blocker. It is classified as a second-generation antihistamine because it is less able to pass the blood–brain barrier and cause sedation, compared to first-generation antihistamines.[12][13]
It was patented in 1979 and came into medical use in 1996.[14] It is on the World Health Organization's List of Essential Medicines.[15] Fexofenadine has been manufactured in generic form since 2011.[16] In 2021, it was the 262nd most commonly prescribed medication in the United States, with more than 1 million prescriptions.[17][18]
Medical uses
Fexofenadine is used for relief from physical symptoms associated with seasonal
Efficacy
For the treatment of allergic rhinitis, fexofenadine is similarly effective to cetirizine, but is associated with less drowsiness than cetirizine.[20] Fexofenadine was also shown to inhibit histamine-induced wheal and flare to a significantly greater degree than loratadine or desloratadine,[21] but was slightly less effective than levocetirizine.[22]
Fexofenadine at doses above 120 mg a day does not appear to provide additional efficacy in the treatment of allergic rhinitis.[23][24]
Side effects
The most common
Overdose
The safety profile of fexofenadine is quite favorable, as no
Pharmacology
Pharmacodynamics
Fexofenadine is a
Fexofenadine also exhibits no
Pharmacokinetics
- Absorption: After oral application, maximum plasma concentrations are reached after 2–3 hours. Fexofenadine should not be taken with a high-fat meal, as mean concentrations of fexofenadine in the bloodstream are seen to be reduced from 20 to 60% depending on form of medication (tablet, ODT, or suspension).[5]
- Distribution: Fexofenadine is 60–70% bound to plasma proteins, mostly albumin.[5]
- Metabolism: Fexofenadine is a substrate of CYP3A4, but only about 5% is metabolized by the liver, indicating that hepatic metabolism is relatively minor in clearance from the body.[5]
- Elimination: Most of the substance is eliminated unchanged via the feces (80%) and urine (11–12%).[5]
Interactions
Taking erythromycin or ketoconazole while taking fexofenadine does increase the plasma levels of fexofenadine, but this increase does not influence the QT interval. The reason for this effect is likely due to transport-related effects, specifically involving p-glycoprotein (p-gp).[5] Both erythromycin and ketoconazole are inhibitors of p-gp, a transporter protein involved in preventing the intestinal absorption of fexofenadine. When p-gp is inhibited, fexofenadine may be better absorbed by the body, increasing its plasma concentration by more than intended.[citation needed]
Fexofenadine is not to be taken with apple, orange, or grapefruit juice because they could decrease absorption of the drug. Therefore, it should be taken with water.[5] Grapefruit juice can significantly reduce the plasma concentration of fexofenadine.[27]
History
The older antihistaminic agent
In January 2011, the FDA approved over-the-counter sales of fexofenadine in the United States, and Sanofi Aventis' version became available in March 2011.[30] In December 2020, the MHRA reclassified fexofenadine from prescription only to allow general sales in the United Kingdom.[31]
Society and culture
Brand names
Fexofenadine is marketed under many brand names worldwide.[10]
As of January 2017, it is marketed as a combination drug with pseudoephedrine under brand names including: Alerfedine D, Allegra-D, Allergyna-D, Allevia, Altiva-D, Dellegra, Fexo Plus, Fexofed, Fixal Plus, Ridrinal D, Rinolast D, Telfast D, and Treathay.[10]
As of January 2017, it is marketed as a combination drug with montelukast under brand names including Fexokast, Histakind-M, Monten-FX, Montolife-FX, Montair-FX and Novamont-FX.[10]
References
- ^ "Fexofenadine Use During Pregnancy". Drugs.com. 1 April 2019. Retrieved 26 July 2020.
- ^ "Telfast 30mg Film-coated Tablets - Summary of Product Characteristics (SmPC)". (emc). 25 October 2019. Retrieved 20 June 2021.
- ^ "Almerg 180 mg Film-Coated Tablets - Summary of Product Characteristics (SmPC)". (emc). Retrieved 20 June 2021.
- ^ "Fexofenadine Hydrochloride 120 mg Film-Coated Tablets - Summary of Product Characteristics (SmPC)". (emc). 22 March 2021. Archived from the original on 24 June 2021. Retrieved 20 June 2021.
- ^ a b c d e f g h i j k l m "Allegra (fexofenadine hydrochloride) tablet, orally disintegrating for oral use Allegra (fexofenadine hydrochloride) tablet, film coated for oral use Allegra (fexofenadine hydrochloride) suspension for oral useInitial U.S. Approval: 1996". DailyMed. 15 December 2008. Retrieved 13 February 2022.
- ^ "Allegra Allergy- fexofenadine hydrochloride tablet, coated". DailyMed. Retrieved 12 February 2022.
- ^ "ALLEGRA (fexofenadine hydrochloride) Product Monograph" (PDF). Sanofi Consumer Health Inc. 7 November 2019.
- PMID 20307657.
- ^ S2CID 19048690.
- ^ a b c d "Fexofenadine - international brand names". Drugs.com. Retrieved 18 January 2017.
- PMID 19539095.
- ^ PMID 21969990.
- PMID 14651723.
- ISBN 9783527607495.
- hdl:10665/345533. WHO/MHP/HPS/EML/2021.02.
- ^ "Dr. Reddy's announces the launch of Over-the-Counter Fexofenadine HCl and Pseudoephedrine HCl extended release tablets". Dr. Reddy's Laboratories Ltd. 30 August 2011. Archived from the original on 12 October 2016. Retrieved 27 May 2016.
- ^ "The Top 300 of 2021". ClinCalc. Archived from the original on 15 January 2024. Retrieved 14 January 2024.
- ^ "Fexofenadine - Drug Usage Statistics". ClinCalc. Retrieved 14 January 2024.
- PMID 30059791.
- PMID 14582814.
- PMID 17345837.
- PMID 11868924.
- PMID 10389553.
- PMID 10550734.
- PMID 10748947.
- PMID 9330784.
- S2CID 17532347.
- .
- ISBN 978-0-471-24510-0.
- ^ "Allegra FAQs". Sanofi-Aventis. Archived from the original on 20 May 2011. Retrieved 5 July 2011.
- ^ "PAR: Reclassification of Allevia 120mg tablets from Prescription Only Medicine (POM) to General Sales List (GSL)". MHRA. 22 December 2020.