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# Fexofenadine (Allegra)
## Overview
Fexofenadine is a second-generation antihistamine used for the symptomatic relief of allergic conditions. It is a selective peripheral H1 receptor antagonist with minimal to no significant anticholinergic or sedative effects.
## Primary Indications
* Seasonal allergic rhinitis (hay fever)
* Perennial allergic rhinitis
* Chronic idiopathic urticaria (hives)
## Adult Dosing
* **Allergic Rhinitis:** 180 mg orally once daily.
* **Chronic Idiopathic Urticaria:** 180 mg orally once daily.
* **Maximum dose:** 180 mg daily.
## Pediatric Dosing
Dosing varies by age and formulation. Always consult product-specific information for precise pediatric dosing.
* **Seasonal Allergic Rhinitis / Chronic Idiopathic Urticaria:**
* **6 to 11 years:** 30 mg orally twice daily.
* **2 to 5 years:** 30 mg orally once daily.
* **6 months to 2 years:** 15 mg orally twice daily.
* **Note:** Oral suspension is often preferred for younger children.
## Dose Adjustments
* **Renal Impairment:** No dose adjustment is typically required. Fexofenadine is primarily eliminated by biliary excretion.
* **Hepatic Impairment:** No dose adjustment is typically required.
## Contraindications
* Hypersensitivity to fexofenadine or any component of the formulation.
## Adverse Effects
Common adverse effects include headache, dizziness, nausea, and fatigue. Sedation is significantly less common than with first-generation antihistamines.
## Key Drug Interactions
* **Antacids containing aluminum and magnesium:** May decrease fexofenadine absorption. Separate administration by at least 2 hours.
* **Fruit juices (e.g., grapefruit, orange):** May decrease fexofenadine absorption. Avoid concurrent administration.
## Monitoring
* Monitor for symptom relief.
* Assess for potential adverse effects, although they are generally well-tolerated.
## Clinical Pearls
* Fexofenadine is generally considered non-sedating.
* Onset of action is typically within 1 hour, with peak effects at 2-3 hours.
* Duration of action is up to 24 hours, allowing for once-daily dosing.
* For optimal absorption, avoid administration with fruit juices and antacids containing aluminum/magnesium.
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**Disclaimer:** This information is intended for healthcare professionals and is not a substitute for professional medical advice. Always consult the most current prescribing information and relevant guidelines before making any treatment decisions. Dosing and recommendations may vary based on patient-specific factors and local protocols.
