1. Introduction
Allegra is a brand name for fexofenadine, a third-generation antihistamine known for:
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Non-sedating properties (minimal CNS penetration)
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Rapid onset of action
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24-hour duration with single daily dose
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Cardiovascular safety (no QT prolongation)
2. Key Specifications
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Generic Name:Â Fexofenadine hydrochloride
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Brand Names:Â Allegra (global), Telfast (some markets)
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Dosage Forms:
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Tablets (30mg, 60mg, 120mg, 180mg)
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Oral suspension (30mg/5mL)
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Disintegrating tablets (30mg)
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Manufacturer:Â Sanofi (originator), multiple generics
3. Therapeutic Advantages
✔ No sedation (unlike 1st-gen antihistamines)
✔ No cardiac effects (safe in cardiac patients)
✔ No food interactions (newer formulation)
✔ Pediatric-friendly formulations
4. Mechanism of Action
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Selective peripheral H1-receptor antagonist
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Minimal crossing of blood-brain barrier
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Additional anti-inflammatory effects:
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Reduces ICAM-1 expression
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Inhibits eosinophil migration
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5. Approved Indications
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Allergic rhinitis (seasonal/perennial)
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Chronic idiopathic urticaria
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Allergic conjunctivitis (off-label)
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Atopic dermatitis (adjunct therapy)
6. Dosage & Administration
Standard Dosing:
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Adults/Children ≥12 yrs: 180mg once daily or 60mg BID
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Children 6-11 yrs:Â 30mg BID
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Children 2-5 yrs:Â 15mg BID (oral suspension)
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Renal impairment:Â Reduce dose by 50% (CrCl <80mL/min)
Administration Tips:
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Take with water (avoid fruit juices)
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Can be taken with/without food
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Morning dosing preferred for 24-hour coverage
7. Safety Profile
Common ADRs (≤2%):
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Headache (1.5%)
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Dizziness (0.8%)
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Nausea (0.6%)
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Fatigue (0.3%)
Rare Effects:
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Hypersensitivity reactions
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Back pain
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Dysmenorrhea
8. Pharmacokinetics
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Onset:Â 1-2 hours
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Peak:Â 2-3 hours
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Duration:Â 24 hours
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Protein binding:Â 60-70%
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Half-life:Â 14-18 hours
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Excretion:Â Biliary (80%) and renal (10%)
9. Comparative Advantages
Parameter | Fexofenadine | Cetirizine | Loratadine |
---|---|---|---|
Sedation | None | Moderate | Minimal |
Cardiac safety | Excellent | Good | Good |
Food effects | Avoid juice | None | None |
Cost | Higher | Lower | Moderate |
10. Important Precautions
âš Â Contraindications:
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Hypersensitivity to fexofenadine
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Severe renal impairment (CrCl <30mL/min)
âš Â Special Populations:
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Pregnancy: Category C (use if benefits>risks)
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Elderly: May need dose adjustment
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Children: Safe ≥2 years (suspension available)
âš Â Drug Interactions:
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Fruit juices (orange, apple, grapefruit) decrease absorption
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Antacids (aluminum/magnesium) decrease absorption
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Erythromycin/Ketoconazole increase levels
11. Storage Requirements
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Store at 20-25°C
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Protect from moisture
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Suspension: Stable for 30 days after opening
12. Clinical Pearls
• First choice for pilots/drivers (non-sedating)
• Preferred option for patients with cardiac concerns
• Best taken in morning for 24-hour coverage
• Avoid with fruit juices (take with water)
13. Conclusion
Allegra represents the gold standard in non-sedating antihistamines, offering excellent safety and efficacy for allergic conditions. Its unique pharmacokinetic profile and lack of CNS effects make it ideal for patients requiring alertness during treatment.
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