FEXOFENADINE
Place in Therapy
Place in Therapy
Second generation anti-histamines, such as fexofenadine are considered first-line therapy for mild urticaria. Upon provocation, mast cells and basophils release histamine. Anti-histamines work to prevent histamine from binding to the H1 receptor, thus preventing allergic symptoms like urticaria and rhinitis.
Compared to first generation antihistamines, second generation antihistamines are more selective for the H1 receptor. Therefore, second generation antihistamines are non-sedating, do not need to be dosed as frequently and do not have anti-cholinergic adverse effects. They also have a relatively fast onset of action and do not have a lot of significant drug interactions.
References:
1. Kamei H, Isaji A, Noda Y, et al. Effects of single therapeutic doses of promethazine, fexofenadine and oloptadine on psychomotor function and histamine-induced weal-and flare-responses: a randomized double-blind, placebo-controlled study in healthy volunteers. Arch Dermatol Res. 2012; 3-4:263-272.
2. Bingham CO. New Onset Urticaria. UpToDate. Wolters Kluwer Health. 2014.
3. Schoepke N, Church MK, Maurer M. The Inhibition by Levocetirizine and Fexofenadine of the Histamine-induced Wheal and Flare Response in Healthy Caucasian and Japanese Volunteers. Acta Derm Venereol. 2013; 93:286-293.
4. Smith SM, Gums JG. Fexofenadine: biochemical, pharmacokinetic and pharmacodynamic properties and its unique role in allergic disorders. Expert Opin. Drug Metab. Toxicol. 2009; 5(7)813-822.
5. Zuberbier T, Asero R, Bindslev-Jensen C, et al. EAACI/GA2LEN/EDF/WAO guideline: manegemnt if urticaria. Allergy. 2009; 64:1427-1443
Second generation anti-histamines, such as fexofenadine are considered first-line therapy for mild urticaria. Upon provocation, mast cells and basophils release histamine. Anti-histamines work to prevent histamine from binding to the H1 receptor, thus preventing allergic symptoms like urticaria and rhinitis.
Compared to first generation antihistamines, second generation antihistamines are more selective for the H1 receptor. Therefore, second generation antihistamines are non-sedating, do not need to be dosed as frequently and do not have anti-cholinergic adverse effects. They also have a relatively fast onset of action and do not have a lot of significant drug interactions.
References:
1. Kamei H, Isaji A, Noda Y, et al. Effects of single therapeutic doses of promethazine, fexofenadine and oloptadine on psychomotor function and histamine-induced weal-and flare-responses: a randomized double-blind, placebo-controlled study in healthy volunteers. Arch Dermatol Res. 2012; 3-4:263-272.
2. Bingham CO. New Onset Urticaria. UpToDate. Wolters Kluwer Health. 2014.
3. Schoepke N, Church MK, Maurer M. The Inhibition by Levocetirizine and Fexofenadine of the Histamine-induced Wheal and Flare Response in Healthy Caucasian and Japanese Volunteers. Acta Derm Venereol. 2013; 93:286-293.
4. Smith SM, Gums JG. Fexofenadine: biochemical, pharmacokinetic and pharmacodynamic properties and its unique role in allergic disorders. Expert Opin. Drug Metab. Toxicol. 2009; 5(7)813-822.
5. Zuberbier T, Asero R, Bindslev-Jensen C, et al. EAACI/GA2LEN/EDF/WAO guideline: manegemnt if urticaria. Allergy. 2009; 64:1427-1443