Delfex Tablet

Introduction

Delfex Tablet 180 mg is a second-generation antihistamine used to alleviate symptoms associated with allergic rhinitis and chronic urticaria (hives). It is known for its ability to reduce allergy symptoms without causing significant drowsiness, making it suitable for daytime use.

Uses

Fexofenadine is used to treat various allergic conditions, including:

• Seasonal allergic rhinitis (hay fever), which includes symptoms such as sneezing, runny or itchy nose, and itchy or watery eyes.
• Chronic idiopathic urticaria, characterized by persistent hives and itching without an obvious cause.

Mechanism of Action

Fexofenadine works as a selective antagonist of the H1 histamine receptor. By blocking these receptors, it prevents histamine from binding and triggering allergic symptoms such as itching, sneezing, and swelling. Unlike first-generation antihistamines, fexofenadine has a minimal effect on the central nervous system, reducing the likelihood of sedation.

How Long Does It Take to Work?

Fexofenadine typically starts to relieve allergy symptoms within 1 to 2 hours of administration. Peak effects are generally observed within 2 to 3 hours, and the medication provides symptomatic relief for up to 24 hours, making it suitable for once-daily dosing.

Absorption

Fexofenadine is well absorbed from the gastrointestinal tract, with peak plasma concentrations reached approximately 2 to 3 hours after oral administration. Food intake, particularly high-fat meals, can delay the absorption but does not significantly affect the overall bioavailability of the drug.

Route of Elimination

Fexofenadine is primarily eliminated via the feces. Approximately 80% of the dose is excreted in the feces, with the remainder being excreted in the urine. It is metabolized minimally in the liver, which contributes to its lower potential for drug interactions compared to other antihistamines.

Dosage

• Tablet: 60 mg twice daily or 120 mg once daily or 180 mg once daily
• In case of impaired renal function: 60 mg once daily

• Tablet: 30 mg twice daily or 60 mg once daily
• In case of impaired renal function: 30 mg once daily

• Suspension: 30 mg or 5 ml twice daily
• In case of impaired renal function: 30 mg or 5 ml once daily

• Tablet: 60 mg twice daily or 120 mg once daily or 180 mg once daily 
• In case of impaired renal function: 60 mg once daily

• Tablet: 30 mg twice daily or 60 mg once daily
• In case of impaired renal function: 30 mg once daily

• Suspension: 15 mg or 2.5 ml (1/2 tsp) twice daily
• In case of impaired renal function: 15 mg or 2.5 ml (1/2 tsp) once daily

• Suspension: 30 mg or 5 ml (1 tsp) twice daily
• In case of impaired renal function: 30 mg or 5 ml (1 tsp) once daily

The dosage of fexofenadine varies based on the condition being treated and the patient's age. Typical dosages include:

• For adults and children 12 years and older: 60 mg twice daily or 180 mg once daily.
• For children aged 6 to 11 years: 30 mg twice daily.
• For children aged 2 to 5 years: 15 mg twice daily (as a liquid formulation).

Dosage adjustments may be required for patients with renal impairment.

Administration

Fexofenadine is administered orally, usually in the form of tablets, oral suspension, or dissolvable tablets. It should be taken with water and not with fruit juices such as orange or apple juice, as these can affect the drug’s absorption. Consistency in the timing of doses is important to maintain effective symptom control.

Side Effects

Common side effects of fexofenadine include:

• Headache
• Drowsiness (though less common than with first-generation antihistamines)
• Dizziness
• Dry mouth
• Nausea

Serious side effects are rare but may include:

• Severe allergic reactions, such as anaphylaxis
• Severe dizziness or fainting

Toxicity

Overdose of fexofenadine can lead to symptoms such as severe drowsiness, dry mouth, dizziness, and headache. In case of overdose, symptomatic treatment and supportive care should be provided. There is no specific antidote for fexofenadine overdose.

Precautions

Precautions include:

• Use with caution in patients with severe renal impairment, as the drug is primarily excreted through the kidneys.
• Monitor for signs of severe allergic reactions if there is a history of such conditions.
• Avoid concurrent use with other antihistamines or alcohol to reduce the risk of additive effects.

Interaction

Fexofenadine has minimal drug interactions due to its limited metabolism in the liver. However, interactions with the following may occur:

• Antacids containing aluminum or magnesium may decrease the absorption of fexofenadine. It is advised to separate the administration of these antacids from fexofenadine by at least 2 hours.
• Other medications affecting renal function or those that increase the risk of drowsiness should be used with caution.

Disease Interaction

Fexofenadine should be used with caution in individuals with:

• Severe renal impairment, as the drug's elimination may be reduced.
• Existing liver disease, though fexofenadine is minimally metabolized by the liver.

Drug Interaction

Significant drug interactions are minimal due to fexofenadine's limited metabolism. However, interactions with the following should be considered:

• Antacids containing aluminum or magnesium, which can reduce the absorption of fexofenadine.

Food Interactions

Fexofenadine absorption can be affected by fruit juices, particularly orange and apple juice, which may reduce the bioavailability of the drug. It is advisable to take fexofenadine with water to ensure optimal absorption and efficacy.

Pregnancy Use

Fexofenadine is classified as a Category C drug for pregnancy. There is limited data on its safety during pregnancy, so it should only be used if the potential benefits outweigh the risks. Pregnant women should consult their healthcare provider before using this medication.

Lactation Use

Fexofenadine is excreted into breast milk in small amounts. While significant adverse effects in breastfed infants are unlikely, it is recommended to use the medication with caution and consult a healthcare provider if breastfeeding.

Acute Overdose

Acute overdose of fexofenadine may result in symptoms such as severe drowsiness, headache, dizziness, and dry mouth. Immediate medical attention is required for appropriate management and supportive care. There is no specific antidote for fexofenadine overdose.

Contraindication

Fexofenadine is contraindicated in patients with a known hypersensitivity to fexofenadine or any component of the formulation. Caution should be exercised in patients with severe renal impairment.

Use Direction

Fexofenadine should be taken as prescribed by a healthcare provider. It is typically administered once or twice daily, depending on the specific formulation and dose. It should be taken with water and not with fruit juices that can affect absorption. Adhere to the prescribed dosage and frequency to ensure effective symptom control.

Storage Conditions

Store fexofenadine tablets or suspension at room temperature, away from moisture and direct sunlight. Keep the medication in its original container and out of reach of children. Follow any specific storage instructions provided by the manufacturer or pharmacist.

Volume of Distribution

Fexofenadine has a moderate volume of distribution, indicating that it distributes well into various tissues and body fluids. This helps ensure effective relief of allergy symptoms throughout the body.

Half Life

The half-life of fexofenadine is approximately 14.4 hours, which allows for once or twice-daily dosing. This prolonged half-life helps maintain therapeutic levels of the drug in the body over an extended period.

Clearance

Fexofenadine is primarily cleared from the body via the kidneys. The drug's clearance rate can be affected by renal function, and dose adjustments may be necessary for patients with significant renal impairment to avoid drug accumulation and potential toxicity.

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