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# Allegra (fexofenadine)
## Overview
Second-generation antihistamine; selective peripheral H1-receptor antagonist. Non-sedating at recommended doses. Onset ~1–2 hours, duration 12–24 hours.
## Primary Indications
- Seasonal allergic rhinitis
- Chronic idiopathic urticaria
## Adult Dosing
- **Rhinitis**: 60 mg twice daily OR 180 mg once daily
- **Urticaria**: 60 mg twice daily OR 180 mg once daily
- Maximum: 180 mg/day
## Pediatric Dosing
- **6–11 years**: 30 mg twice daily (max 60 mg/day)
- **12 years and older**: Same as adult dosing
- **2–5 years**: Liquid formulation: 30 mg twice daily (max 60 mg/day); use syrup or oral suspension per local product specifics
- Under 2 years: Not established; consult pediatric specialist
## Dose Adjustments
- **Renal impairment (CrCl < 80 mL/min)**: Use 60 mg once daily for adults; pediatric dose frequency reduction per clinical judgment
- No adjustment for hepatic impairment
## Contraindications
- Hypersensitivity to fexofenadine or any component
## Adverse Effects
- Most common (≈3%): Headache, drowsiness (less than first-gen antihistamines), dizziness, nausea, fatigue
- Rare: Hypersensitivity reactions, palpitations
## Key Drug Interactions
- **Antacids (aluminum/magnesium)**: Reduce absorption; separate by ≥2 hours
- **Fruit juices (apple, orange, grapefruit)**: Decrease oral bioavailability; avoid concurrent intake; take with water only
- Not a significant CYP inhibitor/inducer
## Monitoring
- Symptom control; renal function if dosing adjustment needed
- No routine laboratory monitoring required
## Clinical Pearls
- Less sedating than diphenhydramine; may still cause mild sedation in some patients
- Take on an empty stomach with water; avoid fruit juices for absorption
- Maximum effect develops over a few days of regular use
- Safe for long-term use; no tachyphylaxis reported
**Educational Disclaimer:** The information provided is for educational purposes and not a substitute for professional medical judgment. Always verify current prescribing information, local protocols, and product labeling before making clinical decisions.
