Allegra
fexofenadine hydrochloride
Pharmacologic class: Peripherally selective piperidine, selective histamine1-receptor antagonist
Therapeutic class: Antihistamine (nonsedating type), second-generation
Pregnancy risk category C
Action
Blocks effects of histamine at peripheral histamine1-receptor sites, decreasing allergy signs and symptoms
Availability
Capsules: 60 mg
Oral suspension: 30 mg/5 ml (6 mg/ml)
Tablets: 30 mg, 60 mg, 180 mg
Tablets (orally disintegrating): 30 mg
Indications and dosages
➣ Seasonal allergic rhinitis; chronic idiopathic urticaria
Adults and children age 12 and older: 60 mg P.O. b.i.d. or 180 mg once daily (conventional tablets)
Children ages 6 to 11: 30 mg P.O. b.i.d. (conventional tablets or ODT tablets)
➣ Seasonal allergic rhinitis
Children ages 2 to 11: 30 mg P.O. b.i.d. (oral suspension and ODT)
➣ Chronic idiopathic urticaria
Children ages 6 months to less than 2 years: 15 mg P.O. b.i.d.(oral suspension and ODT)
Dosage adjustment
• Renal impairment
Contraindications
• Hypersensitivity to drug, terfenadine, or their components
Precautions
Use cautiously in:
• renal impairment
• concurrent ketoconazole or erythromycin therapy
• elderly patients
• pregnant or breastfeeding patients.
Administration
• Give capsules and conventional tablets with water; don't give with apple, orange, or grapefruit juice.
• Don't remove orally disintegrating tablets from original blister package until time of administration.
• Administer orally disintegrating tablets on an empty stomach; allow tablets to disintegrate on the tongue and then have patient swallow tablets with or without water.
• Don't break or use partial orally disintegrating tablets
• Know that orally disintegrating tablets contain phenylalanine.
• Don't give antacids within 2 hours of fexofenadine.
Adverse reactions
CNS: drowsiness, fatigue, headache
EENT: otitis media
GI: nausea, dyspepsia
Metabolic: dysmenorrhea
Respiratory: upper respiratory tract infection
Other: viral infection
Interactions
Drug-drug. Antacids containing aluminum and magnesium: decreased absorption and efficacy of fexofenadine
Drug-diagnostic tests. Skin allergy tests: false-negative results
Drug-food. Apple, orange, and grapefruit juice: decreased absorption and efficacy of fexofenadine
Patient monitoring
• Monitor renal function.
• Watch for signs and symptoms of viral infection.
Patient teaching
• Instruct patient to take conventional tablets with water, and not with apple, orange, or grapefruit juice.
• Instruct patient not to remove orally disintegrating tablets from original blister package until time of administration.
• Instruct patient to take orally disintegrating tablets on an empty stomach at least 1 hour before or 2 hours after a meal, to allow tablet to disintegrate on the tongue, and then to swallow with or without water. Advise patient not to chew tablets.
• Tell patient not to break or use partial orally disintegrating tablets.
• Tell patient to stop taking drug 4 days before diagnostic skin tests, to avoid interference with test results.
• Advise patient to report signs or symptoms of viral infection, especially upper respiratory tract infection.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
• Advise female patient to inform prescriber if she is pregnant or breastfeeding.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs, tests, and foods mentioned above.
fexofenadine
(fex-oh-fen-a-deen) fexofenadine,Allegra
(trade name)Classification
Therapeutic: allergy cold cough remediesIndications
Action
Therapeutic effects
Pharmacokinetics
Time/action profile (antihistaminic effect)
| ROUTE | ONSET | PEAK | DURATION |
|---|---|---|---|
| PO | within 1 hr | 2–3 hr | 12–24 hr |
Contraindications/Precautions
Adverse Reactions/Side Effects
Central nervous system
- drowsiness
- fatigue
Gastrointestinal
- dyspepsia
Endocrinologic
- dysmenorrhea
Interactions
Drug-Drug interaction
Magnesium and aluminum-containing antacids ↓ absorption and may decrease effectiveness.Apple, orange, and grapefruit juice ↓ absorption and may decrease effectiveness.Route/Dosage
Renal Impairment
Oral (Adults) 60 mg once daily as a starting dose.Availability (generic available)
Nursing implications
Nursing 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.
Potential Nursing Diagnoses
Ineffective airway clearance (Indications)Risk for injury (Adverse Reactions)
Implementation
- Do not confuse Allegra with Viagra.
- Oral: Administer with food or milk to decrease GI irritation. Capsules and tablets should be taken with water or milk, not juice.
Patient/Family Teaching
- Instruct patient to take medication as directed. Take missed doses as soon as remembered unless almost time for next dose.
- Inform patient that drug 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.
- Instruct patient to contact health care professional if symptoms persist.
Evaluation/Desired Outcomes
- Decrease in allergic symptoms.
- Decrease in urticaria.