More than 6 decades have passed since
|
|
- Sharleen Gardner
- 6 years ago
- Views:
Transcription
1 THE CONCEPT OF THE THERAPEUTIC WINDOW IN THE CHOICE OF H 1 -RECEPTOR ANTAGONIST * Peter H. Howarth, DM, FRCP ABSTRACT Antihistamines have existed for more than 60 years. The first-generation antihistamines provided symptom relief from allergic rhinitis but were also associated with undesired side effects due to lack of receptor selectivity and central nervous system penetration. Since then, newer-generation antihistamines have been specifically developed to reduce the occurrence of side effects while still providing efficacy. Differences of cardiotoxicity and sedation still exist, however, among available antihistamines. The choice of available antihistamines, therefore, is best informed through evaluation of the therapeutic window of each medication ie, the dose range over which a drug is efficacious while being free from side effects. A broad therapeutic window conveys the most ideal characteristics. The therapeutic window provides considerably more information for clinical considerations than standard individual terms, such as potency, efficacy, or safety, combining these characteristics into an easily attainable understanding of the agent. This paper describes the importance of conscientious choices of antihistamines through the use of a therapeutic window based on recent research. Understanding the therapeutic windows of these agents will enable physicians to make informed treatment decisions based on the requirements of the patient and characteristics of the antihistamine. (Adv Stud Med. 2004;4(7A):S508-S512) *Based on a presentation given by Prof Howarth at the 2003 World Allergy Organization Congress. Reader in Medicine and Honorary Consultant Physician, Respiratory Cell and Molecular Biology, Southampton General Hospital, Southampton, United Kingdom. Address correspondence to: Peter H. Howarth, DM, FRCP, Respiratory Cell and Molecular Biology, Mail point 810, Southampton General Hospital, Tremona Road, Southampton, UK SO16 6YD. P.H.Howarth@soton.ac.uk. More than 6 decades have passed since the first antihistamines were developed and used to treat allergic disease. These initial H 1 -receptor antagonists, although effective in the treatment of urticaria and rhinitis, were shown to cause undesired side effects, such as sedation, due to central nervous system (CNS) penetration. They also were shown to cause a range of other effects due to lack of receptor specificity. In the late 1970s and early 1980s, second-generation antihistamines, such as terfenadine, cetirizine, and loratadine, were developed to improve receptor specificity and reduce the sedative properties. Additional antihistamines, such as fexofenadine, intranasal levocabastine, and intranasal azelastine, were also developed to further improve the safety profile. Other H 1 antihistamines have also been developed, including mizolastine, desloratadine, and levocetirizine. Despite the range of antihistamines available, sedation and cardiotoxicity remain as potential undesirable side effects of some presently prescribed drugs. Given the wide range of H 1 antihistamines, physicians must assess these deleterious effects as well as the efficacy of the specific therapy to make an educated choice regarding medication. This choice is best informed through evaluation of the therapeutic window for each medication. THERAPEUTIC WINDOW The therapeutic window of an H 1 -receptor antagonist is the dose range over which it is efficacious and also free from unwanted side effects (Figure 1). The positioning of the clinically recommended dose (range) within this window provides an easy understanding of the impact of the interactions that decrease or increase therapeutic bioavailability as well as the impact of dose adjustments on both safety and efficacy. The lower limit of the therapeutic window is set by the lowest clinically effective dose for the disease condition under considera- S508 Vol. 4 (7A) July 2004
2 tion. By contrast, the upper limit is set by the highest dose tolerated without adverse pharmacologic effect. The therapeutic window will differ between intranasal (topical) and oral (systemic) drug administration. The issues discussed in this paper will focus on those pertaining to oral H 1 -antihistamine administration. Within any given therapeutic window for H 1 antihistamines, a range of factors may influence the positioning of any dose, such as coadministration of food, concomitant drug therapy (eg, macrolide antibiotics), concurrent illness (eg, hepatic/renal disease), and pharmacologic interactions (eg, alcohol). For example, fexofenadine, which is licensed for the treatment of allergic rhinitis and urticaria, is an H 1 antihistamine with a very broad therapeutic window. It is clinically effective in a total daily dose as low as 40 mg, 1,2 which is one third of the clinically recommended dose. Moreover, it is free from adverse CNS effects when assessed objectively at 3 times the standard therapeutic dose (360 mg daily), 3 and it is free from subjective reporting of sedation at 690 mg twice daily, a dose almost 12 times the recommended daily dose. 1 By contrast, the H 1 antihistamine loratadine has a very narrow therapeutic window, with the clinically recommended dose of 10 mg appearing to be both the minimally effective dose and the maximum tolerated dose. 4,5 Whereas interactions or dose adjustments are highly unlikely to influence the efficacy or safety of fexofenadine, they are likely to have an effect with respect to loratadine. H 1 -ANTIHISTAMINE ACTIVITY The standard H 1 -antihistamine doses selected for clinical evaluation are assessed both in the acute challenge situation to provide information on time to onset of action, maximum inhibitory effect, and duration of action and in naturally occurring clinical disease, which has greater intrinsic variability and is less rigorously controlled than the challenge studies. These challenge and wild-disease studies identify the H 1 -receptor antagonistic activity of all currently available H 1 antihistamines compared with placebo. 6 This antagonistic activity, however, is least evident with loratadine, 7 as one might anticipate when understanding the positioning of the clinically recommended dose within the therapeutic window. The receptor antagonistic activity of different H 1 -receptor antagonists can be assessed by their suppression of histamine-induced wheal and flare, a commonly used biologic assay for demonstrating the onset and duration of peripheral H 1 -receptor blockade. 8,9 This pharmacodynamic evaluation model is easily reproduced, allows objective assessments to be made in both healthy volunteers and patients, and is useful as an addition to clinical studies. WHEAL AND FLARE Wheal and flare studies have been widely used to indicate in vivo differences in the potential efficacy of secondgeneration antihistamines Frossard et al recently compared the inhibition of histamine-induced wheal and flare by fexofenadine HCl 180 mg, loratadine 10 mg, and desloratadine 5 mg in a single-dose, randomized, parallelgroup, double-blind, placebo-controlled study of healthy individuals. 11 This study found that total inhibition of wheal, as defined by the time required to achieve 95% inhibition of wheal area, occurred between 3 and 3.5 hours following administration of fexofenadine. In contrast, total inhibition of wheal was not observed following treatment with either loratadine or desloratadine at the standard doses. These results are further corroborated in the study by Kaliner et al. 12 In this randomized, doubleblind, single-dose, placebo-controlled, cross- over study, it was observed that fexofenadine HCl 180 mg was significantly more effective than loratadine 10 mg (P <.001) or placebo (P <.05) at suppressing the flare response. Fexofenadine wheal suppression was also significant relative to that of loratadine (P <.05) or placebo (P <.05). In a similar study, Purohit et al compared the inhibition of histamine-induced wheal and flare by single therapeutic doses of fexofenadine HCl 180 mg and cetirizine 10 mg in a single-center, double-blind, randomized, 2-way crossover study. 13 The findings showed that fexofenadine Figure 1.Therapeutic Window *The dose range over which a treatment is both effective and free from unwanted side effects. Advanced Studies in Medicine S509
3 and cetirizine are comparable in their time to occurrence of 95% inhibition of the wheal and flare reaction to histamine. CLINICAL STUDIES Although the histamine-induced wheal and flare reaction is a useful clinical pharmacologic test to assess dose-response relations for an antihistamine, thereby providing an indication of its efficacy, data from clinical studies are necessary to properly evaluate new agents. All H 1 antihistamines have been shown in placebo-controlled studies to be clinically efficacious. 6 Studies comparing different H 1 antihistamines allow evaluation of both clinical efficacy and safety, and permit investigation of the comparability of their profiles. The efficacy and safety of once-daily fexofenadine 120 mg and 180 mg and cetirizine 10 mg in the treatment of seasonal allergic rhinitis (SAR) were compared in a multicenter, doubleblind, randomized, parallel-group, placebo-controlled, 14-day trial. 14 A total symptom score (TSS) was generated as the sum of scores for the following symptoms: sneezing, rhinorrhea, itchy nose/palate/throat, and itchy/watery/red eyes. The findings revealed no significant differences in treatment efficacy between fexofenadine at either dose or cetirizine; however, cetirizine was found to substantially induce fatigue and drowsiness, in contrast to the results obtained with fexofenadine. In a similar study, fexofenadine 180 mg and cetirizine 10 mg demonstrated statistically and clinically equivalent efficacy throughout the dosing period, based on TSS in patients with moderate-to-severe SAR. This study also assessed drowsiness using a visual analog scale (VAS) by which scores were calculated based on a range from 0 (wide awake) to 100 (extremely sleepy). Differences in VAS change from baseline between treatments were observed; patients receiving fexofenadine consistently reported less drowsiness than those receiving cetirizine. 15 In a multicenter, multinational, double-blind, parallel-group, randomized, placebo-controlled 2-week study, van Cauwenberge et al assessed the efficacy, safety, and impact on quality of life (QOL) of once-daily fexofenadine HCl 120 mg, loratadine 10 mg, or placebo in the treatment of SAR. 16 Fexofenadine and loratadine were significantly superior to placebo in reducing instantaneous TSS (P.0001 and P.005, respectively) and individual 24-hour reflective symptom scores for sneezing, rhinorrhea, itchy nose/palate/throat, and itchy/ watery/red eyes (P.005 and P <.05, respectively; Figure 2). In addition, fexofenadine was significantly superior to loratadine at improving nasal congestion and itchy/watery/red eyes (P.05). All treatment groups had significantly improved overall QOL from baseline (P <.0001); however, the improvement in the fexofenadine group was significantly greater compared with the loratadine (P.03) and placebo groups (P.005). This difference between fexofenadine and loratadine may be explained by their antagonist profile. Receptor antagonists may be neutral antagonists or inverse agonists. Neutral antagonists inhibit the action of the relevant agonist but have no other intrinsic activity. Inverse agonists, while inhibiting the action of the agonist, also have additional activity independent of this property through receptor binding. This binding alters the agonist-independent G-protein coupling of the receptor, which contributes to the basal level of cell activation. Inverse agonists will thus have a broader profile of effect than pure neutral antagonists. 17 Studies that we have undertaken with fexofenadine in vitro indicate that it acts as an inverse agonist in that it not only inhibits tumor necrosis factor alpha induced interleukin (IL)-8 release from epithelial cells, but also reduces the level of IL-8 in the supernatant to below the unstimulated value. The additional activity of fexofenadine over loratadine on QOL and in relieving nasal obstruction in the study by van Cauwenberge et al could be explained by its ability to act as an inverse agonist. 16 DRUG-DRUG INTERACTIONS The coadministration of other drugs or pharmacologically active agents may potentially modify the positioning of an H 1 antihistamine within the therapeutic window by, for example, interfering with absorption or metabolism. Such changes may either reduce clinical efficacy or increase the risk of side effects. These possible consequences became most apparent when drug interactions led to the appreciation that astemizole and terfenadine had potentially serious cardiac effects due to their inhibitory actions on the potassium rectifier currents within the myocardium. 18 Both astemizole and terfenadine undergo hepatic metabolism involving the cytochrome P450 isoenzymes. The coadministration of macrolide antibiotics, such as erythromycin, or antifungal agents, such as ketoconazole, which share the same P450 isozymes, led to the inhibition of their metabolism and a rise in their plasma levels. This interaction took these drugs out of their therapeutic window, with the potentially fatal, although very rare, consequence of the S510 Vol. 4 (7A) July 2004
4 Figure 2. Placebo-Controlled Comparison of Fexofenadine and Loratadine in Seasonal Allergic Rhinitis Adapted with permission from van Cauwenberge et al. Comparison of the efficacy, safety, and quality of life provided by fexofenadine hydrochloride 120 mg, loratadine 10 mg, and placebo administered once daily for the treatment of seasonal allergic rhinitis. Clin Exp Allergy. 2000;30(6): Blackwell Publishing. ventricular arrhythmia, torsade de pointes. H 1 antihistamines that do not undergo hepatic metabolism, such as fexofenadine and cetirizine, are thus free from these cytochrome P450 interactions. Interest has more recently focused on the relevance of pharmacologic interactions involving the superfamily of adenosine triphosphate-binding cassette proteins, such as P-glycoprotein (Pgp) and other carrier protein families, including the organic anion transporting peptide (OATP) family. 19 Pgp is an important transport protein regulating clearance of molecules that penetrate the blood-brain barrier. Substrates for this carrier protein are rapidly cleared from the CNS and thus are not available to act on central receptors. Fexofenadine is an excellent Pgp substrate; this property makes it a safe H 1 antihistamine regarding CNS sedative effects (see review by Prof Hindmarch for details of CNS effects of H 1 antihistamines). 20 Pgp is also involved in eliminating drugs across the gastrointestinal mucosa. At this site, ketoconazole and macrolide antibiotics are known to inhibit Pgp, reducing the gastrointestinal elimination of H 1 antihistamines that use this transport mechanism. For example, ketoconazole increases the plasma levels of desloratadine, and azithromycin increases the plasma levels of both desloratadine and fexofenadine. 21,22 By contrast, the OATP family helps facilitate the gastrointestinal absorption of certain H 1 antihistamines. This transport process is susceptible to inhibition by grapefruit juice. 23,24 Studies in a small number of healthy volunteers have reported a decrease in the plasma levels of fexofenadine when taken with large quantities (1.2 L) of double-strength grapefruit juice. 24 This reduction is, however, only about 30% and, due to the minimally effective dose being substantially lower than the effects of this reduction, there is no clinical consequence. Individuals would be unlikely to consume quantities of grapefruit juice large enough to effect this level of reduction. Consistent with the lack of clinical significance of this interaction, data from White et al demonstrated that fexofenadine significantly inhibits the histamine wheal and flare response within the skin when oral fexofenadine is coadministered with either grapefruit juice or orange juice. 25,26 Changes in the positioning of H 1 antihistamines within a narrow therapeutic window will, however, lead to clinical consequences. The significance of the 40% increase in plasma levels of desloratadine when coadministered with ketoconazole is undetermined, as much less is known about the therapeutic window of this antihistamine. It is appreciated, however, that increasing the dose of drugs that have a therapeutic dose at the top end of their therapeutic window, such as cetirizine and loratadine, can lead to central effects, such as sedation and cognitive impairment. 5 These effects could become an issue in situations in which patients overmedicate beyond the prescribed dose due to inadequate symptom control of either rhinitis or urticaria. GENETIC INFLUENCES Variations in the population and among different racial populations, in terms of the metabolism of antihistamines, may theoretically alter the position of a certain drug within its known therapeutic window. Little is known about how this variable influences either the efficacy or the side-effect profile of the currently available H 1 -receptor antagonists. Any impact of metabolic alterations will, as for the other considerations, be more relevant to those drugs with a narrow therapeutic window, those that are administered either at the lower or upper end of this range, and those for which small alterations can take them outside their therapeutic window. The product insert for desloratadine indicates that certain populations of patients are thought to be slow metabolizers of this agent. Approximately 7% of the general population and 20% of the black population have difficulty in converting desloratadine to its active metabolite, 3-hydroxydesloratadine, and may be more susceptible to dose-related adverse events. 27 Additional investigation of Advanced Studies in Medicine S511
5 this issue is warranted to understand differences in individual susceptibility within the population and to better inform physicians regarding choice of antihistamine. CONCLUSION The appreciation of the therapeutic window for any antihistamine and the positioning of the medication within this window allow an easy evaluation of the likely impact of any dose changes or interactions that will either decrease or increase the bioavailability of that medication. Ideally, an antihistamine should be positioned centrally within a broad therapeutic window. Under such circumstances, those influences that alter bioavailability are unlikely to have any clinical consequence, and the drug can be prescribed without concern. REFERENCES 1. Russell T, Stoltz M, Weir S. Pharmacokinetics, pharmacodynamics, and tolerance of single- and multiple-dose fexofenadine hydrochloride in healthy male volunteers. Clin Pharmacol Ther. 1998;64(6): Bronsky EA, Falliers CJ, Kaiser HB, Ahlbrandt R, Mason JM. Effectiveness and safety of fexofenadine, a new nonsedating H1-receptor antagonist, in the treatment of fall allergies. Allergy Asthma Proc. 1998;19(3): Hindmarch I, Shamsi Z, Kimber S. An evaluation of the effects of high-dose fexofenadine on the central nervous system: a double-blind, placebo-controlled study in healthy volunteers. Clin Exp Allergy. 2002;32(1): Hansen GR. Loratadine in the high performance aerospace environment. Aviat Space Environ Med. 1999;70(9): Hindmarch I, Shamsi Z. Antihistamines: models to assess sedative properties, assessment of sedation, safety and other sideeffects. Clin Exp Allergy. 1999;29(suppl 3): Howarth PH. H1-receptor antagonists in the rhinoconjunctivitis. In: Simons FER, ed. Histamine and H1-Receptor Antagonists in the Treatment of Allergic Disease. New York: Marcel Deker Inc; 2002: Meltzer EO, Malmstrom K, Lu S, et al. Concomitant montelukast and loratadine as treatment for seasonal allergic rhinitis: a randomized, placebo-controlled clinical trial. J Allergy Clin Immunol. 2000;105(5): Simons FE, McMillan JL, Simons KJ. A double-blind, singledose, crossover comparison of cetirizine, terfenadine, loratadine, astemizole, and chlorpheniramine versus placebo: suppressive effects on histamine-induced wheals and flares during 24 hours in normal subjects. J Allergy Clin Immunol. 1990;86(4, pt 1): Rivest J, Despontin K, Ghys L, Rihoux JP, Lachapelle JM. Pharmacological modulation by cetirizine and ebastine of the cutaneous reactivity to histamine. Dermatologica. 1991;183(3): Grant JA, Riethuisen JM, Moulaert B, DeVos C. A doubleblind, randomized, single-dose, crossover comparison of levocetirizine with ebastine, fexofenadine, loratadine, mizolastine, and placebo: suppression of histamine-induced whealand-flare response during 24 hours in healthy male subjects. Ann Allergy Asthma Immunol. 2002;88(2): Frossard N, Purohit A, Kovacs S, Vitow C, Georges G, Pauli G. Fexofenadine is superior to loratadine and desloratadine in onset of action of histamine-induced wheal and flare inhibition. Ann Allergy Asthma Immunol. 2003;90: Kaliner MA, White MV, Economides A, et al. Relative potency of fexofenadine HCl 180 mg, loratadine 10 mg, and placebo using a skin test model of wheal-and-flare suppression. Ann Allergy Asthma Immunol. 2003;90(6): Purohit A, Deslandes B, Pauli G, Frossard N. Fexofenadine and cetirizine have similar rapid onset of action and magnitude of effect as assessed by inhibition of histamine-induced wheal and flare. Ann Allergy Asthma Immunol. 2003; 90: Howarth PH, Stern MA, Roi L, Reynolds R, Bousquet J. Double-blind, placebo-controlled study comparing the efficacy and safety of fexofenadine hydrochloride (120 mg and 180 mg once daily) and cetirizine in seasonal allergic rhinitis. J Allergy Clin Immunol. 1999;104(5): Hampel F, Ratner P, Mansfield L, Meeves S, Liao Y, Georges G. Fexofenadine HCl 180 mg exhibits equivalent efficacy to cetirizine, 10 mg, with less drowsiness in patients with moderate-to-severe seasonal allergic rhinitis. Ann Allergy Asthma Immunol. 2003;91(4): van Cauwenberge P, Juniper E. Comparison of the efficacy, safety and quality of life provided by fexofenadine hydrochloride 120mg, loratadine 10mg and placebo administered once daily for the treatment of seasonal allergic rhinitis. Clin Exp Allergy. 2000;30(6): Leurs R, Church MK, Taglialatela M. H1-antihistamines: inverse agonism, anti-inflammatory actions and cardiac effects. Clin Exp Allergy. 2002;32(4): Hibbert J, Howarth PH. Antihistamines and cardiac arrhythmias. Prescribers J. 1994;34: Hansten PD, Levy RH. Role of P-glycoprotein and organic anion transporting polypeptides in drug absorption and distribution: focus on H1-receptor antagonists. Clin Drug Invest. 2001;21: Cvetkovic M, Leake B, Fromm MF, Wilkinson GR, Kim RB. OATP and P-glycoprotein transporters mediate the cellular uptake and excretion of fexofenadine. Drug Metab Dispos. 1999;27(8): Hwang KK, Correll M, Offord SJ. Evaluation of desloratadine for absorption drug-drug interactions with ketoconazole. J Allergy Clin Immunol. 2001;107: Gupta S, Banfield C, Kantesaria B, et al. Pharmacokinetic and safety profile of desloratadine and fexofenadine when coadministered with azithromycin: a randomized, placebo-controlled, parallel-group study. Clin Ther. 2001;23(3): Dresser GK, Bailey DG, Leake BF, et al. Fruit juices inhibit organic anion transporting polypeptide-mediated drug uptake to decrease the oral availability of fexofenadine. Clin Pharmacol Ther. 2002;71(1): Banfield C, Gupta S, Marino M, Affrime M. Grapefruit juice reduces the oral bioavailability of fexofenadine but not desloratadine. Clin Pharmacokinet. 2002;41(4): White MV, Kaliner MA, Rothrock S, et al. Effect of grapefruit juice on fexofenadine vs placebo in a skin wheal-andflare challenge model. Presented at: the 22nd European Academy of Allergology and Immunology Congress; June 7-10, 2003; Paris, France. 26. White MV, Kaliner MA, Rothrock S, et al. Effect of orange juice on fexofenadine vs placebo in a skin wheal-and-flare challenge model. Presented at: the 22nd European Academy of Allergology and Immunology Congress; June 7-10, 2003; Paris, France. 27. Clarinex [package insert]. Kenilworth, NJ: Schering Corporation; Available at: com/piclarinex.pdf. Accessed November 10, S512 Vol. 4 (7A) July 2004
Antihistamines are used as a first-line PROCEEDINGS THE VALUE OF A BROAD THERAPEUTIC INDEX FOR ANTIHISTAMINES * F. Estelle R. Simons, MD ABSTRACT
THE VALUE OF A BROAD THERAPEUTIC INDEX FOR ANTIHISTAMINES * F. Estelle R. Simons, MD ABSTRACT The therapeutic index of a histamine-1 (H 1 )- antihistamine is the benefit-to-risk ratio of the medication
More informationVOLUME 89, SEPTEMBER,
Efficacy of ebastine, cetirizine, and loratadine in histamine cutaneous challenges Juan Gispert, MD*; Rosa Antonijoan, PhD ; Manel Barbanoj, PhD ; Ignaci Gich, PhD ; Estrella Garcia, PhD*; Ramon Esbrí,
More informationEffects of acrivastine, loratadine and cetirizine on histamine-induced wheal and flare responses
Experimental dermatology Original article Effects of acrivastine, loratadine and cetirizine on histamine-induced wheal and flare responses D. Bayramgürler, N. Bilen, R. Apaydýn, L. Altıntaş,* G. Sal, Ş.
More informationPEDIATRIC PHARMACOTHERAPY
PEDIATRIC PHARMACOTHERAPY A Monthly Newsletter for Health Care Professionals from the Children s Medical Center at the University of Virginia Volume 7 Number 4 April 2001 A The second-generation (peripherally-selective)
More informationPOSTER PRESENTATIONS
POSTER PRESENTATIONS POSTER PRESENTATIONS The following are summaries of posters presented at the XXI Congress of the European Academy of Allergology and Clinical Immunology, Naples, Italy, June1-5, 2002.
More informationReview Article Bilastine: A New Nonsedating Oral H1 Antihistamine for Treatment of Allergic Rhinoconjunctivitis and Urticaria
BioMed Research International Volume 2013, Article ID 626837, 6 pages http://dx.doi.org/10.1155/2013/626837 Review Article : A New Nonsedating Oral H1 Antihistamine for Treatment of Allergic Rhinoconjunctivitis
More informationAntihistamines: a brief review
Antihistamines: a brief review Van Schoor J, MPharm Amayeza Info Centre Introduction The prevalence rates of allergic diseases such as allergic rhinitis and asthma appear to be increasing in many countries.
More informationDrug Class Review. Newer Antihistamines
Drug Class Review Newer Antihistamines Preliminary Scan Report #3 February 2015 Last Report: Update #2, May 2010 The purpose of reports is to make available information regarding the comparative clinical
More informationPharmacotherapy for Allergic Rhinitis
Pharmacotherapy for Allergic Rhinitis William Reisacher, MD FACS FAAOA Assistant Professor Weill Cornell Medical College The Impact of Allergic Rhinitis Allergic rhinitis affects approximately 50 million
More informationP Usharani, DNB, MD MUR Naidu, MD KLN Reddy, PhD * BPS Reddy, PhD * T Ramesh Kumar, MD
Randomized, Double-Blind, Crossover Comparison Between Two Levocetirizine Formulations on Histamine-Induced Cutaneous Response in Healthy Male Human Adult Volunteers P Usharani, DNB, MD MUR Naidu, MD KLN
More informationEfficacy of Levocetirizine Compared with Montelukast for the Treatment of Allergic Rhinitis
Human Journals Research Article July 2018 Vol.:10, Issue:1 All rights are reserved by Manju K Mathew et al. Efficacy of Levocetirizine Compared with Montelukast for the Treatment of Allergic Rhinitis Keywords:
More informationLevocetirizine dihydrochloride
INSERT TEXT UAP Levocetirizine dihydrochloride Allerzet 5 mg Tablet Antihistamine FORMULATION Each film-coated tablet contains: Levocetirizine dihydrochloride.. 5 mg PRODUCT DESCRIPTION Levocetirine 5
More informationSYNOPSIS. The study results and synopsis are supplied for informational purposes only.
SYNOPSIS INN : FEXOFENADINE Study number : PJPR0024 Study title : A double-blind, randomized, placebo-controlled, parallel study comparing the efficacy and safety of three dosage strengths of MDL 16,455A
More informationDrug Class Review Newer Antihistamines
Drug Class Review Newer Antihistamines Preliminary Scan Report 1 Update 3 November 2012 The purpose of reports is to make available information regarding the comparative clinical effectiveness and harms
More informationMontelukast: a better alternative than antihistaminics in allergic rhinitis
International Journal of Otorhinolaryngology and Head and Neck Surgery Kaur G et al. Int J Otorhinolaryngol Head Neck Surg. 017 Apr;():17- http://www.ijorl.com pissn -99 eissn -97 Original Research Article
More informationAllergic rhinitis is a frequent chronic disease that may. Persistent Allergic Rhinitis and the XPERT Study SYMPOSIUM REPORT SUPPLEMENT
SYMPOSIUM REPORT SUPPLEMENT Persistent Allergic Rhinitis and the XPERT Study Anthi Rogkakou, MD, Elisa Villa, MD, Valentina Garelli, MD, G. Walter Canonica, MD Abstract: Allergic rhinitis (AR) is a chronic
More informationbenzene acetic acid, 4-[1-hydroxy-4-[4-(hydroxy diphenylmethyl)-1- piperidinyl]butyl]-a,a-dimethyl-, hydrochloride
XERGIC Fexofenadine hydrochloride PRODUCT INFORMATION NAME OF THE MEDICINE Active ingredient: Chemical name: fexofenadine hydrochloride benzene acetic acid, 4-[1-hydroxy-4-[4-(hydroxy diphenylmethyl)-1-
More informationSEASONAL ALLERGIC RHINITIS NASAL SYMPTOMS AND QUALITY OF LIFE WITH OLOPATADINE/MOMETASONE COMBINATION NASAL SPRAY
SEASONAL ALLERGIC RHINITIS NASAL SYMPTOMS AND QUALITY OF LIFE WITH OLOPATADINE/MOMETASONE COMBINATION NASAL SPRAY GARY N. GROSS 1 ; GARY BERMAN 2 ; NIRAN J. AMAR 3 ; CYNTHIA F. CARACTA 4 ; SUDEESH K. TANTRY
More informationComposition: Each tablet contain. Levocetirizine. Each 5ml contains. Montelukast. Pharmacokinetic properties:
Composition: Each tablet contain Montelukast Levocetirizine 10mg 5mg Each 5ml contains Montelukast Levocetirizine 4mg 2.5mg Pharmacokinetic properties: Peak plasma concentrations of montelukast are achieved
More informationMTnL Tablet/ MTnL Kid Tablet Montelukast & Levocetirizine dihydrochloride
MTnL Tablet/ MTnL Kid Tablet Montelukast & Levocetirizine dihydrochloride COMPOSITION MTnL Tablets Each film-coated tablet contains: Montelukast sodium equivalent to montelukast Levocetirizine dihydrochloride
More informationantihistamines A del Cuvillo 1, J Mullol 2, J Bartra 3, I Dávila 4, I Jáuregui 5, J Montoro 6, J Sastre 7, AL Valero 3
Comparative pharmacology of the H 1 Comparative pharmacology of the H 1 A del Cuvillo 1, J Mullol 2, J Bartra 3, I Dávila 4, I Jáuregui 5, J Montoro 6, J Sastre 7, AL Valero 3 1 Clínica Dr. Lobatón, Cádiz,
More informationSUMMARY OF PRODUCT CHARACTERISTICS 2 QUALITATIVE AND QUANTITATIVE COMPOSITION
SUMMARY OF PRODUCT CHARACTERISTICS 1 NAME OF THE MEDICINAL PRODUCT Telfast 120 mg film-coated tablets. 2 QUALITATIVE AND QUANTITATIVE COMPOSITION Each tablet contains 120 mg of fexofenadine hydrochloride,
More informationSUMMARY OF PRODUCT CHARACTERISTICS
SUMMARY OF PRODUCT CHARACTERISTICS 1. NAME OF THE MEDICINAL PRODUCT Fexofenadine Cipla 120 mg film-coated tablets 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each film-coated tablet contains 120 mg fexofenadine
More informationPRINCIPAL MEDICATION OPTIONS FOR RHINITIS
SEE INDICATED SUMMARY STATEMENT (SS#) DISCUSSION FOR SUPPORTING DATA ALLERGIC RHINITIS (AR): SEASONAL (SAR) AND PERENNIAL (PAR) MONOTHERAPY ORAL Antihistamines, oral (H1 receptor antagonists) (SS# 61-64)
More informationDoes Desloratadine Alter the Serum Levels of Montelukast When Administered in a Fixed-Dose Combination?
The Laryngoscope VC 2013 The American Laryngological, Rhinological and Otological Society, Inc. Does Desloratadine Alter the Serum Levels of Montelukast When Administered in a Fixed-Dose Combination? Cemal
More informationARIA. At-A-Glance Pocket Reference 2007
ARIA_Glance_2007_8pg:ARIA_Glance_English 9/14/07 3:10 PM Page 1 ARIA At-A-Glance Pocket Reference 2007 1 st Edition NEW ARIA UPDATE BASED ON THE ALLERGIC RHINITIS AND ITS IMPACT ON ASTHMA WORKSHOP REPORT
More informationClinical Pharmacology Review for Primary Health Care Providers: I. Antihistamines
TCP 2014;22(1):13-18 http://dx.doi.org/10.12793/tcp.2014.22.1.13 Clinical Pharmacology Review for Primary Health Care Providers: I. Antihistamines Seunghoon Han* Department of Clinical Pharmacology and
More informationDrug Effectiveness Review Project Literature Scan Summary. Month/Year of Review: January 2015 Date of Last Review: January 2013
Drug Use Research & Management Program Oregon State University, 500 Summer Street NE, E35, Salem, Oregon 97301 1079 Phone 503 947 5220 Fax 503 947 1119 Copyright 2012 Oregon State University. All Rights
More informationNEW ZEALAND DATA SHEET
NEW ZEALAND DATA SHEET 1. PRODUCT NAME Telfast 6 11 years 30mg film coated tablets # Telfast 60mg film coated tablets Telfast 120mg film coated tablets Telfast 180mg film coated tablets Telfast Oral Liquid,
More informationEbastine in allergic rhinitis and chronic idiopathic urticaria
Allergy 2008: 63 (Suppl. 89): 1 20 Ó 2008 The Author Journal compilation Ó 2008 Blackwell Munksgaard ALLERGY Review article Ebastine in allergic rhinitis and chronic idiopathic urticaria Histamine is a
More informationBilastine in allergic rhinoconjunctivitis and urticaria
Allergy REVIEW ARTICLE C. Bachert 1, P. Kuna 2 & T. Zuberbier 3 1 Department of Otorhinolaryngology, University Hospital Ghent, Ghent, Belgium; 2 Division of Internal Medicine, Asthma and Allergy, Berlicki
More informationEverant.in/index.php/jmpr. Journal of Medical Practice and Review
Everant.in/index.php/jmpr Journal of Medical Practice and Review Real world Efficacy and Tolerance of Bepotastine, a new 2 nd generation antihistamine, in Pruritis and other symptoms associated with cutaneous
More informationDrug Class Review Newer Antihistamines
Drug Class Review Newer Antihistamines Final Report Update 2 May 2010 The purpose of reports is to make available information regarding the comparative clinical effectiveness and harms of different drugs.
More informationBody weight more than 30kg : 10ml (10mg) of the syrup once daily.
1. Name of the medicinal product Clarityn Allergy 1mg/ml Syrup 2. Qualitative and quantitative composition Each ml of syrup contains 1mg loratadine. Excipients with known effect. The quantity of sucrose
More informationF/P F/P VAS. 2 fexofenadine pseudoefedrine F/P F/P F/P. dust mite HDM 17. fexofenadine pseudoefedrine F/P F/P
JJIAO 35 1 : 1 6, 2017 原 著 / 1 1 2 1 1 3 1 2 3 NPO 2 fexofenadine pseudoefedrine F/P F/P 17 12 5 28.6 F/P F/P VAS F/P 8 30 90 8 2 6 8 F/P F/P, fexofenadine/pseudoephedrine; VAS, visual analogue scale 2
More informationThe management of chronic urticaria in primary care for adults and children
The management of chronic urticaria in primary care for adults and children September Version 2.0 This supersedes version 1.0 Review due in September 2019 Document location DOCUMENT CONTROL Copies of this
More informationEvaluation of Efficacy and Sedative Profiles of H1 Antihistamines by Large-Scale Surveillance Using the Visual Analogue Scale (VAS)
Allergology International. ;57:57-63 DOI:.33allergolint.O-7-55 ORIGINAL ARTICLE Evaluation of Efficacy and Sedative Profiles of H Antihistamines by Large-Scale Surveillance Using the Visual Analogue Scale
More informationClinical Policy: Antihistamines Reference Number: CP.HNMC.18 Effective Date: Last Review Date: Line of Business: Medicaid Medi-Cal
Clinical Policy: Reference Number: CP.HNMC.18 Effective Date: 11.16.16 Last Review Date: 11.17 Line of Business: Medicaid Medi-Cal Revision Log See Important Reminder at the end of this policy for important
More informationSUMMARY OF PRODUCT CHARACTERISTICS 2 QUALITATIVE AND QUANTITATIVE COMPOSITION
SUMMARY OF PRODUCT CHARACTERISTICS 1 NAME OF THE MEDICINAL PRODUCT Fexofenadine hydrochloride 180 mg film-coated tablets 2 QUALITATIVE AND QUANTITATIVE COMPOSITION Each film coated tablet contains 180mg
More informationFexofenadine apollo
Fexofenadine apollo +9191 46 950 950 Fexofenadine apollo +9191 46 950 950 Fexofenadine CAS Number : 83799-24-0 Molecular Weight : 501.65 g/mol Molecular Formula : C32H39NO4 Systematic (IUPAC) : 2-(4-{1-hydroxy-4-[4-
More informationAllergic Rhinitis. Abstract Allergic rhinitis is defined as an immunologic response moderated by IgE and is. Continuing Education Column
Allergic Rhinitis Hun Jong Dhong, M.D. Department of Otorhinolaryngology Head and Neck Surgery Sungkyunkwan University School of Medicine, Samsung Medical Center E mail : hjdhong@smc.samsung.co.kr Abstract
More informationSUMMARY OF PRODUCT CHARACTERISTICS
MUTUAL RECOGNITION PROCEDURE Page 1 of 5 SUMMARY OF PRODUCT CHARACTERISTICS 1. NAME OF THE MEDICINAL PRODUCT, syrup 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each ml of syrup contains 1 mg loratadine.
More informationANTIHISTAMINES ARE widely used to treat allergic. Desloratadine Shows No Effect on Performance During 6 h at 8,000 ft Simulated Cabin Altitude
RESEARCH ARTICLE Desloratadine Shows No Effect on Performance During 6 h at 8,000 ft Simulated Cabin Altitude Pierre J. L. Valk, Dominique B. Van Roon, Ries M. Simons, and Ger Rikken VALK PJL, VAN ROON
More informationAllergy and inflammation
and inflammation 1 Allergic population hyper-producers of IgE consistently increasing western societies: ~20% of general population 2 Allergic population 3 Allergic triggers 4 Allergic triggers abnormal
More informationClinical Medicine Reviews in Therapeutics. A Review of Rupatadine in the Treatment of Seasonal Allergic Rhinitis. R. Borici-Mazi.
Clinical Medicine Reviews in Therapeutics ExpERT REviEw A Review of Rupatadine in the Treatment of Seasonal Allergic Rhinitis R. Borici-Mazi Medicine and pediatrics, Division of Allergy and immunology,
More informationOpinion 8 January 2014
The legally binding text is the original French version TRANSPARENCY COMMITTEE Opinion 8 January 2014 WYSTAMM 1 mg/ml, oral solution 120 ml vial with syringe for oral administration (CIP: 34009 222 560
More informationFirst do no harm: Managing antihistamine impairment in patients with allergic rhinitis
First do no harm: Managing antihistamine impairment in patients with allergic rhinitis The Antihistamine Impairment Roundtable: Thomas B. Casale, MD, a Michael S. Blaiss, MD, b Erwin Gelfand, MD, c Timothy
More informationCompared with older compounds of this class of drugs, the newer, secondgeneration
Comparison of ebastine to cetirizine in seasonal allergic rhinitis in adults Pierre Gehanno, MD*; Clothilde Bremard-Oury, MD ; and Philippe Zeisser, MD Background: Second-generation histamine H 1 -receptor
More informationPRODUCT MONOGRAPH. ALLEGRA 12 Hour. (fexofenadine hydrochloride, Manufacturer s standard) 60 mg Tablets. ALLEGRA 24 Hour
PRODUCT MONOGRAPH ALLEGRA 12 Hour (fexofenadine hydrochloride, Manufacturer s standard) 60 mg Tablets ALLEGRA 24 Hour (fexofenadine hydrochloride, Manufacturer s standard) 120 mg Tablets Histamine H 1
More informationDefense Technical Information Center Compilation Part Notice
UNCLASSIFIED Defense Technical Information Center Compilation Part Notice ADPO 11043 TITLE: Hr-Antihistamines and Aircrew DISTRIBUTION: Approved for public release, distribution unlimited This paper is
More informationUCLA Nutrition Bytes. Title. Permalink. Journal ISSN. Author. Publication Date. Grapefruit Juice and Some Oral Drugs: A Bitter Combination
UCLA Nutrition Bytes Title Grapefruit Juice and Some Oral Drugs: A Bitter Combination Permalink https://escholarship.org/uc/item/7cn8p8k9 Journal Nutrition Bytes, 5(1) ISSN 1548-4327 Author Vu, Minh Chau
More informationAllergic rhinitis, in addition to having
Primary principles relevant to the clinical management of allergic rhinitis include (1) avoidance of allergens and triggering factors, (2) use of appropriate pharmacotherapy, (3) evaluation regarding need
More informationIdeal Sedative Agent. Pharmacokinetics. Benzodiazepines. Pharmacodynamics 11/11/2013
Ideal Sedative Agent Pharmacology of Benzodiazepines Used for Conscious Sedation in Dentistry Peter Walker Anxiolysis Analgesic No effect on CVS No effect on respiratory system Not metabolised Easy and
More informationIdeal Sedative Agent. Benzodiazepines 11/12/2013. Pharmacology of Benzodiazepines Used for Conscious Sedation in Dentistry.
Pharmacology of Benzodiazepines Used for Conscious Sedation in Dentistry Peter Walker Ideal Sedative Agent Anxiolysis Analgesic No effect on CVS No effect on respiratory system Not metabolised Easy and
More informationSeasonal Allergic Rhinoconjunctivitis
Seasonal Allergic Rhinoconjunctivitis Allergic rhinoconjunctivitis is a common condition. Most patients can achieve good symptom control through allergen avoidance and pharmacotherapy with non-sedating
More informationDrug Interactions Keeping it all Straight. Peter Lin MD CCFP Director Primary Care Initiatives Canadian Heart Research Centre
Drug Interactions Keeping it all Straight Peter Lin MD CCFP Director Primary Care Initiatives Canadian Heart Research Centre Copyright 2017 by Sea Courses Inc. All rights reserved. No part of this document
More informationPRODUCT INFORMATION TELFAST. Chemical Structure Fexofenadine HCl is an equimolar mixture of two enantiomers. structure:
NAME OF THE MEDICINE Non-proprietary Name Fexofenadine (as hydrochloride). PRODUCT INFORMATION TELFAST Chemical Structure Fexofenadine HCl is an equimolar mixture of two enantiomers. structure: It has
More informationEFFICACY AND SAFETY OF OLOPATADINE/MOMETASONE COMBINATION NASAL SPRAY FOR THE TREATMENT OF SEASONAL ALLERGIC RHINITIS
EFFICACY AND SAFETY OF OLOPATADINE/MOMETASONE COMBINATION NASAL SPRAY FOR THE TREATMENT OF SEASONAL ALLERGIC RHINITIS PAUL H. RATNER 1 ; FRANK HAMPEL 2 ; AURORA BREAZNA 3 ; CYNTHIA F. CARACTA 3 ; SUDEESH
More informationDiphenhydramine (Benadryl) Adam Nasir Corrigan Horton
Diphenhydramine (Benadryl) Adam Nasir Corrigan Horton Main Points Diphenhydramine acts as an inverse agonist at its molecular target of action, the H 1 - Histamine receptors Early stages of hypersensitivity
More informationSafety and efficacy of mometasone furoate aqueous nasal spray in children with allergic rhinitis: Results of recent clinical trials
Safety and efficacy of mometasone furoate aqueous nasal spray in children with allergic rhinitis: Results of recent clinical trials Javier Dibildox, MD San Luis Potosí, Mexico Intranasal mometasone furoate
More informationAzelastine nasal spray: the treatment of choice for allergic rhinitis
PRESS RELEASE Azelastine nasal spray: the treatment of choice for allergic rhinitis An astonishing one quarter of the planet s population suffers from allergic rhinitis, living with the aggravating symptoms
More informationScottish Medicines Consortium
Scottish Medicines Consortium montelukast 10mg tablets (Singulair ) No. (185/05) Merck, Sharp & Dohme Ltd (MSD) New indication: for asthmatic patients in whom montelukast is indicated in asthma, montelukast
More informationCME INFORMATION. December 16, 2002 THE AMERICAN JOURNAL OF MEDICINE Volume 113 (9A) 55S
CME SECTION Sponsored by the University of Medicine & Dentistry of New Jersey (UMDNJ), UMDNJ New Jersey Medical School, Department of Medicine, Division of Allergy and Immunology, and the UMDNJ Center
More informationTREATING ALLERGIC RHINITIS
TREATING ALLERGIC RHINITIS Prof. Dr. Jean-Baptiste Watelet, MD Department of Otorhinolaryngology Ghent University Hospital Ghent, Belgium Allergic rhinitis (AR) is a nasal disease with the presence of
More informationLatest advances in the management of childhood allergic rhinitis
Latest advances in the management of childhood allergic rhinitis Jason Y K Chan Assistant Professor Department of Otorhinolaryngology, Head & Neck Surgery The Chinese University of Hong Kong Disclosures
More informationDOSAGE FORMS AND STRENGTHS CLARINEX Tablets - 5 mg (3) CLARINEX Oral Solution - 0.
HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use CLARINEX safely and effectively. See full prescribing information for CLARINEX. CLARINEX (desloratadine)
More informationAn Update on Allergic Rhinitis. Mike Levin Division of Asthma and Allergy Department of Paediatrics University of Cape Town Red Cross Hospital
An Update on Allergic Rhinitis Mike Levin Division of Asthma and Allergy Department of Paediatrics University of Cape Town Red Cross Hospital Allergic Rhinitis Common condition with increasing prevalence
More informationEli O. Meltzer, MD, a John M. Weiler, MD, b and Michael D. Widlitz, MD c
Comparative outdoor study of the efficacy, onset and duration of action, and safety of cetirizine, Ioratadine, and placebo for seasonal allergic rhinitis Eli O. Meltzer, MD, a John M. Weiler, MD, b and
More informationPhototherapy in Allergic Rhinitis
Phototherapy in Allergic Rhinitis Rhinology Chair KSU KAUH Ibrahim AlAwadh 18\1\2017 MBBS, SB & KSUF Resident, ORL-H&N Background: Endonasal phototherapy can relieve the symptoms of allergic rhinitis
More informationAllergy and Immunology Review Corner: Chapter 87 of Middleton s Allergy Principles and Practice, 7 th Edition, edited by N. Franklin Adkinson, et al.
Allergy and Immunology Review Corner: Chapter 87 of Middleton s Allergy Principles and Practice, 7 th Edition, edited by N. Franklin Adkinson, et al. Chapter 87: Histamine and H-1 Anti-Histamines Prepared
More informationScottish Medicines Consortium
Scottish Medicines Consortium fluticasone furoate, 27.5 micrograms /actuation nasal (Avamys ) No. (544/09) GlaxoSmithKline 06 March 2009 The Scottish Medicines Consortium (SMC) has completed its assessment
More informationRandy Russell Assistant Director, Regulatory Affairs Alcon Research, Ltd South Freeway, R3-54 Fort Worth, TX
DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service Food and Drug Administration Silver Spring, MD 20993 Randy Russell Assistant Director, Regulatory Affairs 6201 South Freeway, R3-54 Fort Worth,
More informationPackage Insert. Clistin Dry. 24 hours.
Package Insert Clistin Dry Product Summary 1. Name of the medicinal product Clistin Dry 2. Qualitative and quantitative composition Dextromethorphan Hbr 10 mg Chlorpheniramine Maleate 2 mg Phenylephrine
More informationPharmacotherapy for Allergic Rhinitis
Disclosures: Pharmacotherapy for Allergic Rhinitis None John H. Krouse, MD, PhD, MBA Professor and Chairman Department of Otolaryngology-HNS Temple University School of Medicine Learning Objectives Describe
More informationIASIAN PACIFIC JOURNAL OF ALLERGY AND IMMUNOLOGY (2001) 19:
IASIAN PACIFIC JOURNAL OF ALLERGY AND IMMUNOLOGY (2001) 19: 171-175 A Double-Blind, Placebo-Controlled, and Randomized Study of Loratadine (Clarityne) Syrup for the Treatment of Allergic Rhinitis in Children
More informationBritish Journal of Clinical Pharmacology
et al. et al. British Journal of Clinical Pharmacology DOI:10.1111/j.1365-2125.2004.02072.x Effects of single or combined histamine H 1 -receptor and leukotriene CysLT 1 -receptor antagonism on nasal adenosine
More informationLIVOSTIN Eye Drops and Nasal Spray
LIVOSTIN Eye Drops and Nasal Spray PRODUCT INFORMATION NAME OF DRUG Levocabastine hydrochloride DESCRIPTION Levocabastine, (-)-[3S-[1(cis), 3 alpha, 4 beta]]-1-[4-cyano-4-(4-fluorophenyl) cyclohexyl]-3-
More informationLevocetirizine improves quality of life and reduces costs in long-term management of persistent allergic rhinitis
Levocetirizine improves quality of life and reduces costs in long-term management of persistent allergic rhinitis Claus Bachert, MD, PhD, a Jean Bousquet, MD, PhD, b G. Walter Canonica, MD, c Stephen R.
More informationClinical comparison of histamine H -receptor antagonist drugs
Clinical comparison of histamine H -receptor antagonist drugs Lawrence M. Du Buske, MD Fitchburg, Mass. Nearly 40 million Americans have symptoms of upper respiratory alleigies, making antihistamines among
More informationConcomitant montelukast and loratadine as treatment for seasonal allergic rhinitis: A randomized, placebo-controlled clinical trial
Concomitant montelukast and loratadine as treatment for seasonal allergic rhinitis: A randomized, placebo-controlled clinical trial Eli O. Meltzer, MD, a Kerstin Malmstrom, PhD, b Susan Lu, PharmD, b Bruce
More informationCoverage Criteria: Express Scripts, Inc. monograph dated 03/03/2010
BENEFIT DESCRIPTION AND LIMITATIONS OF COVERAGE ITEM: PRODUCT LINES: COVERED UNDER: DESCRIPTION: CPT/HCPCS Code: Company Supplying: Setting: Xolair (omalizumab) Commercial HMO/PPO/CDHP HMO/PPO/CDHP: Rx
More informationIntroduction. T. Kosoglou, M. Sal, J. M. Lim, V. K. Batra, M. N. Cayen & M. B. Affrime
Evaluation of the pharmacokinetics and electrocardiographic pharmacodynamics of loratadine with concomitant administration of ketoconazole or cimetidine T. Kosoglou, M. Sal, J. M. Lim, V. K. Batra, M.
More informationEFFICACY AND SAFETY OF OLOPATADINE/MOMETASONE COMBINATION NASAL SPRAY FOR THE TREATMENT OF SEASONAL ALLERGIC RHINITIS
EFFICACY AND SAFETY OF OLOPATADINE/MOMETASONE COMBINATION NASAL SPRAY FOR THE TREATMENT OF SEASONAL ALLERGIC RHINITIS GARY GROSS 1 ; FRANK HAMPEL 2 ; AURORA BREAZNA 3 ; CYNTHIA F. CARACTA 3 ; SUDEESH K.
More informationResearch Institute. Disclosures: Drs Danzig, Yao, and Staudinger are employees of Schering-Plough
A placebo-controlled study of the nasal decongestant effect of phenylephrine and pseudoephedrine in the Vienna Challenge Chamber Friedrich Horak, MD* ; Petra Zieglmayer, MD*; René Zieglmayer, DI ; and
More informationTrust the Original to help you turn it off.
Trust the Original to help you turn it off. Trust the Original to help you turn it off. Trust the Original to help you turn it off. Trust the Original to help you turn it off. Trust the Original to help
More informationDesloratadine is a second-generation, nonsedating H1-
SYMPOSIUM REPORT SUPPLEMENT Review of Desloratadine Data Using the ARIA Guidelines Elisa Villa, Anthi Rogkakou, Valentina Garelli, and G. Walter Canonica Key Words: seasonal allergy rhinitis, persistent
More informationDiagnosis and Treatment of Respiratory Illness in Children and Adults Guideline
Member Groups Requesting Changes: Lakeview Clinic Marshfield Clinic Mayo Clinic South Lake Pediatrics Response Report for Review and Comment January 2013 Diagnosis and Treatment of Respiratory Illness
More informationPRODUCT INFORMATION ZYRTEC LEVOCABASTINE Eye Drops and Nasal Spray
PRODUCT INFORMATION ZYRTEC LEVOCABASTINE Eye Drops and Nasal Spray NAME OF MEDICINE Levocabastine hydrochloride DESCRIPTION Levocabastine, (-)-[3S-[1(cis), 3 alpha, 4 beta]]-1-[4-cyano-4-(4-fluorophenyl)
More informationPage 1 of 9. Revised: 09/2012 FULL PRESCRIBING INFORMATION: CONTENTS *
HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use XYZAL safely and effectively. See full prescribing information for XYZAL. XYZAL (levocetirizine dihydrochloride)
More informationResearch Article. Assessment of patient satisfaction with ebastine fast-dissolving tablets in patients suffering from allergic rhinitis
Research Article Assessment of patient satisfaction with ebastine fast-dissolving tablets in patients suffering from allergic rhinitis Objective: The aim of this study was to assess patient satisfaction
More informationWhen choosing an antiepileptic ... PRESENTATION... Pharmacokinetics of the New Antiepileptic Drugs. Based on a presentation by Barry E.
... PRESENTATION... Pharmacokinetics of the New Antiepileptic Drugs Based on a presentation by Barry E. Gidal, PharmD Presentation Summary A physician s choice of an antiepileptic drug (AED) usually depends
More informationMonocast Description Indications
Monocast Tablet Description The active ingredient of Monocast tablet is Montelukast Sodium INN. Montelukast is a selective and orally active leukotriene receptor antagonist that inhibits the cysteinyl
More informationTDM. Measurement techniques used to determine cyclosporine level include:
TDM Lecture 15: Cyclosporine. Cyclosporine is a cyclic polypeptide medication with immunosuppressant effect. It has the ability to block the production of interleukin-2 and other cytokines by T-lymphocytes.
More informationMedicine Review. Medicine / Trade name Azelastine and fluticasone / Dymista Manufacturer
East & South East England Specialist Pharmacy Services East of England, London, South Central & South East Coast East Anglia Medicines Information Service Medicine Review Medicine / Trade name Azelastine
More informationTreating Allergies, Hay Fever, and Hives
The Antihistamines: Treating Allergies, Hay Fever, and Hives Comparing Effectiveness, Safety, and Price Our Recommendations This report evaluates seven newer or second-generation antihistamine medications
More informationStudy No.: Title: Rationale: Phase: Study Period: Study Design: Centres: Indication: Treatment: Objectives: Primary Outcome/Efficacy Variable:
The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product.
More informationNEW ZEALAND DATA SHEET. 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each tablet contains 10 mg cetirizine hydrochloride.
NEW ZEALAND DATA SHEET 1. PRODUCT NAME Zista, 10 mg, tablets 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each tablet contains 10 mg cetirizine hydrochloride. Excipient with known effect: lactose monohydrate
More informationANNEX I SUMMARY OF PRODUCT CHARACTERISTICS
ANNEX I SUMMARY OF PRODUCT CHARACTERISTICS 1 1. NAME OF THE MEDICINAL PRODUCT Aerius 5 mg film-coated tablets 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each tablet contains 5 mg desloratadine. For a
More informationA. Definition. B. Epidemiology. C. Classification. i. Pharmacokinetic DIs. ii. Pharmacodynamic DIs. D. Recognition. E. Prevention
DRUG OUTLINE A. Definition B. Epidemiology Dr Ruwan Parakramawansha MBBS, MD, MRCP(UK),MRCPE, DMT(UK) (2013/09/05) C. Classification i. Pharmacokinetic DIs ii. Pharmacodynamic DIs D. Recognition E. Prevention
More information