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## Overview
Fexofenadine is a second-generation antihistamine (H1 antagonist) used for symptomatic relief of allergic conditions. It is a non-sedating agent.
## Primary Indications
* Seasonal allergic rhinitis (hay fever)
* Chronic idiopathic urticaria (hives)
## Adult Dosing
* **Seasonal allergic rhinitis:** 180 mg orally once daily.
* **Chronic idiopathic urticaria:** 180 mg orally once daily.
## Pediatric Dosing
* **Seasonal allergic rhinitis:**
* 6 years to 11 years: 30 mg orally twice daily.
* 12 years and older: 180 mg orally once daily.
* **Chronic idiopathic urticaria:**
* 6 months to 11 years: Dosing depends on weight and formulation. For oral suspension, common starting doses include 2.5 mL (15 mg) twice daily for 6-11 years, and 5 mL (30 mg) twice daily for children on a weight-based dosing schedule (e.g., 10 mg twice daily for 11-20 kg, 15 mg twice daily for 21-85 kg if using preferred weight-based dosing).
* 12 years and older: 180 mg orally once daily.
*Note: Specific pediatric dosing may vary based on formulation (tablets, chewable tablets, oral suspension) and weight-based recommendations. Refer to product labeling or local protocols for precise pediatric dosing.*
## Dose Adjustments
No dose adjustment is typically required for renal or hepatic impairment.
## Contraindications
* Hypersensitivity to fexofenadine or any component of the formulation.
## Adverse Effects
* **Common:** Headache, nausea, dizziness, fatigue.
* **Less Common:** Nervousness, insomnia, rash.
## Key Drug Interactions
* **Antacids containing aluminum or magnesium:** May decrease fexofenadine absorption. Separate administration by at least 2 hours.
* **Fruit juices (e.g., grapefruit, orange):** May decrease fexofenadine absorption, particularly with higher doses.
## Monitoring
* Monitor for relief of allergic symptoms.
* Assess for potential adverse effects, particularly CNS effects (though less common than first-generation antihistamines).
## Clinical Pearls
* Fexofenadine is a metabolite of terfenadine, an antihistamine that was withdrawn due to cardiac side effects (QT prolongation and torsades de pointes). Fexofenadine does not exhibit these effects.
* Avoid co-administration with antacids containing magnesium or aluminum to optimize absorption.
* The extended-release formulation is not indicated for pediatric use.
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***Disclaimer:** This information is intended for clinical use and does not substitute for professional medical advice. Always consult the most current prescribing information and product labeling for complete details, including indications, contraindications, warnings, precautions, adverse reactions, and potential drug interactions, before making any treatment decisions.*
