Fexofenadine a First-Line Option for Seasonal Allergic Rhinitis and Chronic Idiopathic Urticaria

In This Article

In Brief and Introduction

Fexofenadine, the active metabolite of terfenadine, is a selective histamine H1 receptor antagonist that is effective in the alleviation of symptoms associated with seasonal allergic rhinitis and chronic idiopathic urticaria. Like other nonsedating H1 receptor antagonists such as loratidine and cetirizine, fexofenadine reduces sneezing, rhinorrhoea, itchy nose, palate or throat, and itchy, watery, red eyes in adults and adolescents with seasonal allergic rhinitis. Compared with placebo, once daily fexofenadine reduced the symptoms of chronic idiopathic urticaria for up to 6 weeks. Importantly, it appears that fexofenadine is free of adverse cardiac events; it has not been associated with prolongation of the QTc interval or torsades de pointes. Evidence indicates that there is no cognitive or psychomotor impairment with fexofenadine at dosages up to 240 mg/day.

Urticaria (hives) is characterised by transient erythema and wheals on the skin, often accompanied by intense itching. Episodes of urticaria that last for more than 6 weeks are considered chronic. Most cases of chronic urticaria are idiopathic; an exact external cause cannot be determined.[1] Symptoms of chronic idiopathic urticaria are thought to result from activation of mast cells in the skin with subsequent histamine release.[1]

Allergic rhinitis is characterised by the temporal relationship of symptoms to allergen exposure. Allergens can include animal dander, house dust mites and mould. Allergic rhinitis may be classified as seasonal allergic rhinitis if symptoms are pollen-induced. The natural history of seasonal allergic rhinitis is marked by acute exacerbations, especially when pollen counts are high, and remissions.

Seasonal allergic rhinitis, or hay fever, is an inflammatory disorder whose symptoms are mediated by the release of histamine.

It is characterised by 1 or more of the following symptoms:[2]

  • sneezing

  • nasal congestion

  • itching of the nose

  • rhinorrhoea

  • postnasal drainage

  • ocular symptoms (itchy, red, watery eyes)

  • ear symptoms (congestion, popping, reduced hearing, pain)

  • sinus symptoms (sinus pressure or pain, headaches)


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