fexofenadine

Therapeutic Classification: allergy, cold and cough remedies

Pharmacologic Classification: antihistamines

Indications ⬆ ⬇

REMS

Relief of symptoms of seasonal allergic rhinitis.
Management of chronic idiopathic urticaria.

Action ⬆ ⬇

Antagonizes the effects of histamine at peripheral histamine–1 (H₁) receptors, including pruritus and urticaria.
Also has a drying effect on the nasal mucosa.

Therapeutic effects:

Decreased sneezing, rhinorrhea, itchy eyes, nose, and throat associated with seasonal allergies.
Decreased urticaria.

Pharmacokinetics ⬆ ⬇

Absorption: Rapidly absorbed after oral administration.

Distribution: Unknown.

Metabolism/Excretion: 80% excreted in urine, 11% excreted in feces.

Half-Life: 14.4 hr (↑ in renal impairment).

Time/Action Profile ⬆ ⬇

(antihistaminic effect)

ROUTE	ONSET	PEAK	DURATION
PO	within 1 hr	2–3 hr	12–24 hr

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity.

Use Cautiously in:

Renal impairment (↑ dosing interval recommended);
OB: Use only if potential maternal benefit justifies potential fetal risk;
Lactation: Safety not established in breastfeeding.

Adv. Reactions/Side Effects ⬆ ⬇

GI: dyspepsia

GU: dysmenorrhea

Neuro: drowsiness, fatigue

Interactions ⬆ ⬇

Drug-drug:

Magnesium and aluminum-containing antacids↓ absorption and may decrease effectiveness.

Apple, orange, and grapefruit juice↓ absorption and may decrease effectiveness.

Route/Dosage ⬆ ⬇

PO (Adults and Children ≥12 yr): 60 mg twice daily, or 180 mg once daily.
PO (Children 2–11 yr): 30 mg twice daily.
PO (Children 6 mo–2 yr): 15 mg twice daily.

Renal Impairment

PO (Adults ): 60 mg once daily as a starting dose.
PO (Children 6–11 yr): 30 mg once daily as a starting dose.

Availability ⬆ ⬇

(Generic available)

Tablets: 60 mg^OTC; 120 mg^OTC; 180 mg^OTC
Orally disintegrating tablets: 30 mg^OTC
Suspensionberry flavor: 30 mg/5 mL^OTC
In combination with: pseudoephedrine (Allegra-D). See Appendix [not included in this PDA edition].

Assessment ⬆ ⬇

Assess allergy symptoms (rhinitis, conjunctivitis, hives) before and periodically during therapy.
Assess lung sounds and character of bronchial secretions. Maintain fluid intake of 1500–2000 mL/day to decrease viscosity of secretions.

Lab Test Considerations:

Will cause false-negative reactions on allergy skin tests; discontinue 3 days before testing.

Implementation ⬆ ⬇

Do not confuse Allegra with Viagra. Do not confuse Allegra (fexofenadine) with Allegra Anti-Itch Cream (diphenhydramine/allantoin).
PO: Administer with food or milk to decrease GI irritation. Administer capsules and tablets with water or milk, not juice. Shake solution bottle well before use.

Patient/Family Teaching ⬆ ⬇

Instruct patient to take medication as directed. Take missed doses as soon as remembered unless almost time for next dose. Do not take more than recommended.
Instruct patient or parents to avoid taking fexofenadine with fruit juices (apple, orange, grapefruit) or antacids containing aluminum or magnesium; may decrease effectiveness of fexofenadine.
Inform patient that fexofenadine may cause drowsiness, although it is less likely to occur than with other antihistamines. Avoid driving or other activities requiring alertness until response to drug is known.
Rep: Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.
Instruct patient to contact health care professional if symptoms persist.

section name header

Pronunciation ⬇

Classifications ⬆ ⬇