Selecting optimal second-generation antihistamines for allergic rhinitis and urticaria in Asia

Table 5 Clinical profile differences and second-generation antihistamine usage based on collective experiences of clinicians surveyed

	Bilastine	Cetirizine	Desloratadine	Fexofenadine	Levocetirizine	Loratadine	Rupatadine^a
Indicated for:
Allergic rhino-conjunctivitis	✓	✓	X	X	✓	X	✓
Urticaria	✓	✓	✓	✓	✓	✓	✓
Allergic rhinitis	✓	✓	✓	✓	✓	✓	✓
Most frequently prescribed for allergic rhinitis	Cetirizine
Most frequently prescribed for urticaria	Cetirizine Levocetirizine
Observations on efficacy	Excellent	Good	Fair/good	Excellent	Excellent	Good	Good
Commonly prescribed daily dose	20 mg OD	10 mg OD	5 mg OD	180 mg OD	5 mg OD	10 mg OD	10 mg OD
Duration of treatment	2 weeks and above (depending on severity of symptoms)
Dose adjustment requirements	None	Severe renal impairment	Severe renal impairment	None	Severe renal impairment	Severe hepatic impairment	None
Contraindications and adverse effects	None	Severe renal impairment Sedation	None Light sedation	None Very occasional worsening (could be due to allergy to dye of pill)	Severe renal impairment Light sedation	None Sedation	Interaction with ketoconazole, erythromycin, and statins

Data based on United Kingdom SmPCs and/or clinician survey. In some APAC countries, only certain formulations of cetirizine are approved for allergic rhinoconjunctivitis
OD once daily
^aRupatadine is not available in Malaysia and was only recently introduced into the Philippines and Thailand; hence, experience using this drug may be limited

ISSN: 1476-7961