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

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

  Bilastine Cetirizine Desloratadine Fexofenadine Levocetirizine Loratadine Rupatadinea
Indicated for:
 Allergic rhino-conjunctivitis X X X
 Allergic rhinitis
Most frequently prescribed for allergic rhinitis Cetirizine
Most frequently prescribed for urticaria Cetirizine
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
Light sedation
Very occasional worsening (could be due to allergy to dye of pill)
Severe renal impairment
Light sedation
Interaction with ketoconazole, erythromycin, and statins
  1. Data based on United Kingdom SmPCs and/or clinician survey. In some APAC countries, only certain formulations of cetirizine are approved for allergic rhinoconjunctivitis
  2. OD once daily
  3. aRupatadine is not available in Malaysia and was only recently introduced into the Philippines and Thailand; hence, experience using this drug may be limited