Fexofenadine 180mg/5ml oral solution

P-glycoprotein is a critical efflux transporter that may significantly affect the pharmacokinetics of various drugs by influencing their absorption, distribution and elimination. While European and American regulatory guidelines provide lists of P-glycoprotein modulators, they lack specificity concerning in vivo studies and clear guidance on inducers, creating uncertainty in their clinical relevance. A systematic search on in vivo clinical studies involving healthy volunteers using fexofenadine, dabigatran and digoxin as P-glycoprotein substrates has been performed in accordance with the PRISMA guidelines. A total of 151 studies assessing the impact of P-glycoprotein modulators on the concentration-time profile of P-glycoprotein substrates were retrieved. Additionally, data on the P-glycoprotein modulators' effect on cytochrome P450 3A4 induction or inhibition were also collected. P-gp modulators were classified as potent, moderate, weak or non-interactors for P-glycoprotein, with or without cytochrome P450 3A4 impact, on the basis of the area under the concentration-time curve ratio. This classification was adapted from the Food and Drug Administration criteria for cytochrome interactions. This systematic review identified 49 area under the plasma concentration-time curve ratio values corresponding to P-glycoprotein inhibitors, 23 to P-glycoprotein inducers and 131 to non-interactors. Of these, only 32.5% and 41.1% were classified as weak to potent, respectively. Only 0.7% of inhibitors and no inducers were classified as potent. This suggests that most P-glycoprotein modulators have a limited impact on drug exposure. The potential for interaction increases when P-glycoprotein modulators also affect cytochrome P450 3A4, which is the case for 59.9% of P-glycoprotein modulators. However, some moderate P-glycoprotein modulators may have clinically significant effects depending on the therapeutic margin of the substrate and the clinical context.

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ObjectivesAllergic rhinitis (AR) can substantially compromise daily functioning and well-being, and many patients require more than a single agent to obtain satisfactory symptom control. This study examined whether adding montelukast to antihistamine could manage AR symptoms and quality-of-life outcomes effectively.MethodsA review was performed in PubMed, Embase, Medline, Scopus, the Cochrane Library, and Google Scholar to identify eligible studies reported through April 2025. Eligible studies compared combination therapy with montelukast plus antihistamine against antihistamine monotherapy and reported nasal symptoms or rhinoconjunctivitis quality of life questionnaire (RQLQ) scores. Treatment effects were further examined by antihistamine class.ResultsFifteen studies including 2,882 subjects were analyzed. Combination therapy significantly improved daytime nasal symptoms (standardized mean difference [SMD] [95% CI], 0.44 [0.21-0.67]), nighttime nasal symptoms (0.12 [0.01-0.23]), and RQLQ scores (0.14 [0.00-0.27]) versus monotherapy. Individual nasal or ocular symptoms, sneezing, nasal obstruction, and rhinorrhea improved significantly, while nasal itching and ocular symptoms did not. Combinations with desloratadine and levocetirizine showed greater benefits than those with loratadine or fexofenadine.ConclusionMontelukast-antihistamine combination therapy reduced overall symptoms and improved quality of life versus antihistamine monotherapy. The magnitude of benefit appears to vary depending on the specific antihistamine used, highlighting the possible value of individualized treatment strategies in the treatments of AR.

Abstract licence: CC BY-NC

IntroductionAllergic rhinitis (AR) is highly prevalent worldwide, often leading to substantial healthcare costs and diminished patient quality of life. Although guidelines frequently recommend intranasal corticosteroids, oral second-generation antihistamines remain commonly used in many low- and middle-income countries. We performed a cost-utility analysis of newer-generation oral H1 antihistamines for adults with intermittent AR in Colombia.Materials and methodsA 28-day decision-tree model compared multiple antihistamines' costs and quality-adjusted life years (QALYs). Inputs included clinical effectiveness and adverse-event probabilities from systematic reviews and network meta-analyses. All costs, expressed in 2024 US dollars (1 USD = 4,400 COP), were adjusted for inflation. Net monetary benefits (NMB) were calculated using willingness-to-pay thresholds for Colombia (US$ 5130). Probabilistic sensitivity analyses were conducted to assess uncertainty in key parameters.ResultsCetirizine 10 mg and fexofenadine 180 mg were the only undominated strategies, exhibiting higher NMB values than other antihistamines. Deterministic analysis showed that cetirizine had a lower total cost (22.15 USD) and an ICER of 349.62 USD per QALY gained. In contrast, fexofenadine provided a slight gain in effectiveness at a modest incremental cost. Probabilistic analysis confirmed fexofenadine as cost-effective option across a wide range of thresholds, with cetirizine remaining a strong contender at lower thresholds.ConclusionIn this cost-utility analysis of oral H1 antihistamines for adults with intermittent allergic rhinitis in Colombia, cetirizine 10 mg and fexofenadine 180 mg emerged as the cost-effective options, offering high net monetary benefits and remaining undominated in deterministic and probabilistic analyses.

Abstract licence: CC BY-NC-ND

Allergic rhinitis (AR) significantly impairs quality of life and often necessitates combination therapies for optimal symptom control. This study aimed to evaluate the efficacy of montelukast-antihistamine combination therapy in patients with AR by using a network meta-analysis. A comprehensive search was conducted using PubMed, Embase, MEDLINE, Scopus, the Cochrane Library, and Google Scholar up to April 2025. The treatment strategies included montelukast alone, antihistamine monotherapies (loratadine, desloratadine, levocetirizine, and fexofenadine), their respective combinations with montelukast, including bilastine. Outcomes included daytime and nighttime symptom scores, Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), and individual symptoms. Both pairwise and network meta-analyses were conducted. Thirty studies (4,486 patients) were included. Montelukast combinations with desloratadine (standardized mean difference [SMD] = -0.51), levocetirizine (SMD = -0.44), and loratadine (SMD = -0.31) significantly improved daytime nasal symptoms compared to montelukast alone. Only montelukast-levocetirizine improved nighttime symptoms (SMD = -0.21) and RQLQ (SMD = -0.48). The combinations with desloratadine or levocetirizine were superior for nasal obstruction, sneezing, and itching, while nasal discharge improved only with montelukast-levocetirizine. No treatment significantly improved eye symptoms. Surface under the cumulative ranking curve rankings generally favored combination therapies, though trends varied by outcome. Desloratadine monotherapy ranked highest for nasal itching. Although some comparisons require cautious interpretation, montelukast-based combination therapy demonstrated greater efficacy than monotherapy for multiple AR symptoms. These results highlight the importance of selecting therapeutic strategies based on the predominant symptom profile of individual patients.

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BackgroundGlobus, a non-painful sensation of a lump in the throat, affects nearly half of the population. Its etiology remains uncertain, and standardized treatment is lacking. Ban-Xia-Hou-Pu-Tang (BXHPT, ), a classical formula for "Plum Pit Qi" ( ), closely resembles globus in traditional Chinese medicine. This study investigated the traditional Chinese medicine constitution of patients with globus and evaluated the efficacy and safety of BXHPT combined with western therapy.MethodsA single-blinded, randomized, placebo-controlled trial was conducted in patients with globus pharyngeus. Participants received either fexofenadine, famotidine, and acetylcysteine plus BXHPT (group A) or plus placebo (group B) for 4 weeks. The Constitution in Chinese Medicine Questionnaire, Reflux Symptom Index (RSI), Glasgow Edinburgh Throat Scale (GETS), Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II), and Reflux Finding Score (RFS) were assessed. Hepatic and renal safety were monitored.ResultsNinety-two patients completed the trial. Both groups showed significant improvements in RFS, RSI, GETS, BAI, and BDI-II. Group A had greater RFS reduction at week 2 (8.03 ± 1.57 vs 10.12 ± 1.75; p ConclusionBXHPT combined with western therapy provided additional improvement in laryngoscopic findings without safety concerns, supporting its potential as an effective adjunctive treatment for globus sensation.

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This study evaluates the repurposed application of an expired non-sedating antihistamine drug (ENSAD), fexofenadine hydrochloride, as a high-performance "green" corrosion inhibitor for copper in 1.0 M HCl. Gravimetric results demonstrate a concentration-dependent inhibition efficiency reaching 96.4% at 120 ppm, with remarkable long-term stability (> 92.5% efficiency after 72 h). Adsorption behavior followed the Langmuir isotherm model, indicating the formation of a stable monolayer. The calculated Gibbs free energy (∆Goads =-33.8 kJ mol- 1) confirms a comprehensive physicochemical adsorption mechanism involving both electrostatic attraction and chemical coordination. Thermodynamic investigations revealed that the addition of ENSAD increased the activation energy from 30.36 to 53.89 kJ mol⁻¹, creating a substantial energy barrier against metallic dissolution. Electrochemical studies (PDP and EIS) confirmed ENSAD as a mixed-type inhibitor that significantly enhances charge transfer resistance (Rct). Quantum chemical parameters, including a low energy gap (ΔEg = 2.361 eV) and high softness (S = 0.424 eV- 1), corroborate the high reactivity and electron-donating capability of the molecule's heteroatoms (N, O) and π-systems. Surface characterization (SEM/EDX) visually and chemically confirmed the presence of a robust organic film. These findings position ENSAD as a technically viable, thermally stable, and sustainable alternative for corrosion protection in industrial acid cleaning and low-temperature desalination stages.

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