fexofenadine hydrochloride

fexofenadine hydrochloride

(fecks oh fen' a deen)

Allegra

Pregnancy Category C

Drug class

Antihistamine (nonsedating type)

Therapeutic actions

Competitively blocks the effects of histamine at peripheral H₁-receptor sites; has no anticholinergic (atropine-like) or sedating effects.

Indications

·        Symptomatic relief of symptoms associated with seasonal allergic rhinitis in adults and children > 6 yr

·        Chronic idiopathic urticaria in adults and children > 6 yr

Contraindications and cautions

·        Contraindicated with allergy to any antihistamines, pregnancy, lactation.

·        Use cautiously with hepatic or renal impairment, in geriatric patients.

Available forms

Tablets—30, 60, 180 mg; capsules—60 mg

Dosages

ADULTS AND PATIENTS > 12 YR

·        Allergic rhinitis: 60 mg PO bid or 180 mg once/day.

·        Chronic idiopathic urticaria: 60 mg PO bid.

PEDIATRIC PATIENTS 6–11 YR

·        Allergic rhinitis and chroninc idiopathic urticaria: 30 mg PO bid.

GERIATRIC PATIENTS OR PATIENTS WITH RENAL IMPAIRMENT

For geriatric patients or adults with renal impairment, use 60 mg PO daily. For children 6–11 yr with renal impairment, use 30 mg PO daily.

Pharmacokinetics

Route	Onset	Peak
Oral	Rapid	2.6 hr

Metabolism: Hepatic; T_1/2: 14.4 hr

Distribution: Crosses placenta; may enter breast milk

Excretion: Feces, urine

Adverse effects

·        CNS: Fatigue, drowsiness

·        GI: Nausea, dyspepsia

·        Other: Dysmenorrhea, flulike illness

Interactions

Drug-drug

·        Increased levels and possible toxicity with ketoconazole, erythromycin; fexofenadine dose may need to be decreased

·        Decreased effects when taken with antacids

Nursing considerations

Assessment

·        History: Allergy to any antihistamines, renal impairment, pregnancy, lactation

·        Physical: Mucous membranes, oropharynx, R, adventitious sounds; skin color, lesions; orientation, affect; renal function tests

Interventions

·        Arrange for use of humidifier if thickening of secretions, nasal dryness become bothersome; encourage adequate intake of fluids.

·        Provide supportive care if flulike symptoms occur.

Teaching points

·        Avoid excessive dosage; take only the dosage prescribed.

·        Do not take at the same time as antacids.

·        You may experience these side effects: Dizziness, sedation, drowsiness (use caution if driving or performing tasks that require alertness); thickening of bronchial secretions, dryness of nasal mucosa (use of a humidifier may help); menstrual irregularities; flulike symptoms (medication may be helpful).

·        Report difficulty breathing, severe nausea, fever.

Adverse effects in Italic are most common; those in Bold are life-threatening.