Allergic conjunctivitis due to inhalant allergens and foods.
Mild, uncomplicated allergic skin manifestations of urticaria and angioedema.
Dermatographism.
Anaphylaxis (as adjunct to epinephrine after acute manifestations controlled).
Allergic reactions to blood or plasma.
Action⬆⬇
Antagonizes the effects of histamine at H1–receptor sites; does not bind to or inactivate histamine. Significant CNS depressant and anticholinergic properties.
Therapeutic effects:
Decreased symptoms of histamine excess (sneezing, rhinorrhea, nasal/ocular pruritus, ocular tearing/redness and skin itching/urticaria).
Pharmacokinetics⬆⬇
Absorption: Well absorbed following oral administration
Distribution: Unknown
Metabolism/Excretion: Extensively metabolized by the liver, inactive metabolites excreted in urine. Negligible renal elimination of unchanged drug.
PO (Adults and Children ≥12 yr): Immediate-release tablets or solution: 4–8 mg 3–4 times daily; Extended-release suspension: 6–16 mg every 12 hr.
PO (Children 6–11 yr): Immediate-release tablets or solution: 2–4 mg 3–4 times daily; Extended-release suspension: 6–12 mg every 12 hr.
PO (Children 4–5 yr): Immediate-release solution: 1–2 mg 3–4 times daily; Extended-release suspension: 3–8 mg every 12 hr.
PO (Children 2–3 yr): Immediate-release solution: 1–2 mg 3–4 times daily; Extended-release suspension: 3–4 mg every 12 hr.
Availability⬆⬇
(Generic available)
Immediate-release tablets: 4 mg; 6 mg
Immediate-release oral solution banana bubble gum flavor: 4 mg/5 mL
Extended-release oral suspension (contains metabisulfite)strawberry banana flavor: 4 mg/5 mL
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:
May case ↑ uric acid levels.
Implementation⬆⬇
Begin with lowest dose and increase as needed and tolerated. Dose is based on condition severity and patient response.
PO: Administer twice daily.
Use a calibrated measuring device for accurate dose; household tablespoon is not accurate and could lead to overdose. May be fatal if administered to children under 2 yr.Shake well before using.
Patient/Family Teaching⬆⬇
Instruct patient to take medication as directed
May cause dizziness and drowsiness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known
Advise patient to avoid taking alcohol or other CNS depressants concurrently with this drug, may cause overdose.
Advise patient that good oral hygiene, frequent rinsing of mouth with water, and sugarless gum or candy may minimize dry mouth. Patient should notify dentist if dry mouth persists >2 wk
Rep: Instruct females of reproductive potential to notify health care professional if pregnancy is planned or suspected and avoid breastfeeding during therapy.
