Source:http://www4.wiwiss.fu-berlin.de/dailymed/resource/drugs/1300
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Fexofenadine Hydrochloride (Tablet, Film Coated)
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dailymed-instance:dosage |
Seasonal Allergic Rhinitis:<br/>Adults and Children 12 Years and Older: The recommended
dose of Fexofenadine Hydrochloride Tablets is 60 mg twice daily, or
180 mg once daily with water. A dose of 60 mg once daily is recommended
as the starting dose in patients with decreased renal function .<br/>Children 6 to 11 Years: The recommended
dose of Fexofenadine Hydrochloride Tablets is 30 mg twice daily with
water. A dose of 30 mg once daily is recommended as the starting dose
in pediatric patients with decreased renal function .<br/>Chronic Idiopathic Urticaria:<br/>Adults and Children 12 Years and Older: The recommended
dose of Fexofenadine Hydrochloride Tablets is 60 mg twice daily or
180 mg once daily with water. A dose of 60 mg once daily is recommended
as the starting dose in patients with decreased renal function .<br/>Children 6 to 11 Years: The recommended
dose of Fexofenadine Hydrochloride Tablets is 30 mg twice daily with
water. A dose of 30 mg once daily is recommended as the starting dose
in pediatric patients with decreased renal function .
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dailymed-instance:descripti... |
Fexofenadine hydrochloride
is a histamine H-receptor antagonist with the chemical
name (��)-4-[1 hydroxy-4-[4-(hydroxydiphenylmethyl)-1-piperidinyl]-butyl]-��,��-dimethyl
benzeneacetic acid hydrochloride. It has the following chemical structure The molecular
weight is 538.13 and the empirical
formula is CHNO���HCl. Fexofenadine hydrochloride is
a white to off-white crystalline powder. It is freely soluble in methanol
and ethanol, slightly soluble in chloroform and water, and insoluble
in hexane. Fexofenadine hydrochloride is a racemate and exists as
a zwitterion in aqueous media at physiological pH. Fexofenadine hydrochloride is formulated as a tablet for oral administration.
Each tablet contains 30, 60, or 180 mg fexofenadine hydrochloride
(depending on the dosage strength) and the following excipients: croscarmellose
sodium, magnesium stearate, microcrystalline cellulose, and pregelatinized
starch. The aqueous tablet film coating is made from hypromellose,
iron oxide blends, polyethylene glycol, povidone, silicone dioxide,
and titanium dioxide.
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Mechanism of Action: Fexofenadine hydrochloride,
the major active metabolite of terfenadine, is an antihistamine with
selective peripheral H-receptor antagonist activity. Both
enantiomers of fexofenadine hydrochloride displayed approximately
equipotent antihistaminic effects. Fexofenadine hydrochloride inhibited
antigen-induced bronchospasm in sensitized guinea pigs and histamine
release from peritoneal mast cells in rats. The clinical significanceof these findings is unknown. In laboratory animals, no anticholinergic
or alpha-adrenergic blocking effects were observed. Moreover,
no sedative or other central nervous system effects were observed.
Radiolabeled tissue distribution studies in rats indicated that fexofenadine
does not cross the blood-brain barrier.<br/>Pharmacokinetics: The pharmacokinetics
of fexofenadine hydrochloride in subjects with seasonal allergic rhinitis
and subjects with chronic urticaria were similar to those in healthy
volunteers.<br/>Absorption: Fexofenadine
hydrochloride was rapidly absorbed following oral administration of
a single dose of two 60 mg capsules to healthy male volunteers with
a mean time to maximum plasma concentration occurring at 2.6 hours
post-dose. After administration of a single 60 mg capsule to healthy
volunteers, the mean maximum plasma concentration was 131 ng/mL. Following
single dose oral administrations of either the 60 and 180 mg tablet
to healthy adult male volunteers, mean maximum plasma concentrations
were 142 and 494 ng/mL, respectively. The tablet formulations are
bioequivalent to the capsule when administered at equal doses. Fexofenadine
hydrochloride pharmacokinetics are linear for oral doses up to a total
daily dose of 240 mg (120 mg twice daily). The administration of the
60 mg capsule contents mixed with applesauce did not have a significant
effect on the pharmacokinetics of fexofenadine in adults. Co-administration
of 180 mg fexofenadine hydrochloride tablet with a high fat meal decreased
the AUC and Cmax of fexofenadine by 21 and 20% respectively.<br/>Distribution: Fexofenadine
hydrochloride is 60% to 70% bound to plasma proteins, primarily albumin
and��-acid glycoprotein.<br/>Metabolism: Approximately
5% of the total dose of fexofenadine hydrochloride was eliminated
by hepatic metabolism.<br/>Elimination: The mean
elimination half-life of fexofenadine was 14.4 hours following administration
of 60mg, twice daily, in healthy volunteers. Human mass balance studies documented a recovery of approximately
80% and 11% of the [C] fexofenadine hydrochloride dose
in the feces and urine, respectively. Because the absolute bioavailability
of fexofenadine hydrochloride has not been established, it is unknown
if the fecal component represents primarily unabsorbed drug or the
result of biliary excretion.<br/>Special Populations: Pharmacokinetics
in special populations (for renal, hepatic impairment, and age), obtained
after a single dose of 80 mg fexofenadine hydrochloride, were compared
to those from healthy volunteers in a separate study of similar design.<br/>Pharmacodynamics:<br/>Wheal and Flare: Human histamine
skin wheal and flare studies following single and twice daily doses
of 20 and 40 mg fexofenadine hydrochloride demonstrated that the drug
exhibits an antihistamine effect by 1 hour, achieves maximum effect
at 2 to 3 hours, and an effect is still seen at 12 hours. There was
no evidence of tolerance to these effects after 28 days of dosing.
The clinical significance of these observations is unknown. Histamine skin
wheal and flare studies in 7 to 12 year old subjects showed that following
a single dose of 30 or 60 mg, antihistamine effect was observed at
1 hour and reached a maximum by 3 hours. Greater than 49% inhibition
of wheal area, and 74% inhibition of flare area were maintained for
8 hours following the 30 and 60 mg dose.<br/>Effects on QT: In dogs
(30 mg/kg/orally twice daily for 5 days) and rabbits (10 mg/kg,
intravenously over 1 hour), fexofenadine hydrochloride did not prolong
QT. In dogs, the plasma fexofenadine concentration was
approximately 9 times the therapeutic plasma concentrations in adults
receiving the maximum recommended human daily oral dose of 180 mg.
In rabbits, the plasma fexofenadine concentration was approximately
20 times the therapeutic plasma concentration in adults receiving
the maximum recommended human daily oral dose of 180 mg. No effect
was observed on calcium channel current, delayed Kchannel
current, or action potential duration in guinea pig myocytes, Nacurrent in rat neonatal myocytes, or on the delayed rectifier
Kchannel cloned from human heart at concentrations up
to 1��10M of fexofenadine. No statistically significant increase in mean QTinterval
compared to placebo was observed in 714 subjects with seasonal allergic
rhinitis given fexofenadine hydrochloride capsules in doses of
60 to 240 mg twice daily for 2 weeks. Pediatric subjects from 2 placebo-
controlled trials (n=855) treated with up to 60 mg fexofenadine hydrochloride
twice daily demonstrated no significant treatment- or dose-related
increases in QT. In addition, no statistically significant
increase in mean QTinterval compared to placebo was observed
in 40 healthy volunteers given fexofenadine hydrochloride as an oral
solution at doses up to 400 mg twice daily for 6 days, or in 230 healthy
volunteers given fexofenadine hydrochloride 240 mg once daily for
1 year. In subjects with chronic idiopathic urticaria, there were
no clinically relevant differences for any ECG intervals, including
QT, between those treated with fexofenadine hydrochloride
180 mg once daily (n = 163) and those treated with placebo (n = 91)
for 4 weeks.
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Fexofenadine Hydrochloride
Tablets are contraindicated in patients with known hypersensitivity
to any of its ingredients.
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dailymed-instance:supply |
Fexofenadine Hydrochloride
Tablets 30 mg are available in HDPE bottles of 100 (NDC 66993-106-02)
with a polypropylene screw cap containing a pulp/wax liner with heat-sealed
foil inner seal. Fexofenadine
Hydrochloride Tablets 60 mg are available in HDPE bottles of 100 (NDC
66993-107-02) with a polypropylene screw cap containing a pulp/wax
liner with heat-sealed foil inner seal and HDPE bottles of 500 (NDC
66993-104-04) with a polypropylene screw cap containing a pulp/wax
liner with heat-sealed foil inner seal. Fexofenadine Hydrochloride Tablets 180 mg are available in HDPE bottles
of 100 (NDC 66993-109-02) with a polypropylene screw cap containing
a pulp/wax liner with heat-sealed foil inner seal and HDPE bottles
of 500 (NDC 66993-109-04) with a polypropylene screw cap containing
a pulp/wax liner with heat-sealed foil inner seal. Fexofenadine Hydrochloride Tablets are coated with a peach colored
film coating. Tablets have the following unique identifiers: 30 mg
tablets have 03 on one side, 60 mg tablets have 06 on one side, and
180 mg tablets have 018 on one side. Store Fexofenadine Hydrochloride Tablets at controlled room temperature
20���25��C (68���77��F). (See USP Controlled Room
Temperature). Fexofenadine Hydrochloride Tablets should be protected
from excessive moisture.
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dailymed-ingredient:croscarmellose_sodium,
dailymed-ingredient:hypromellose,
dailymed-ingredient:iron_oxide_blends,
dailymed-ingredient:magnesium_stearate,
dailymed-ingredient:microcrystalline_cellulose,
dailymed-ingredient:polyethylene_glycol,
dailymed-ingredient:povidine,
dailymed-ingredient:pregelatinized_starch,
dailymed-ingredient:silicone_dioxide,
dailymed-ingredient:titanium_dioxide
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dailymed-instance:precautio... |
Information for Patients: Patients taking
Fexofenadine Hydrochloride Tablets should receive the following information: Fexofenadine Hydrochloride
Tablets are prescribed for the relief of symptoms of seasonal allergic
rhinitis or for the relief of symptoms of chronic idiopathic urticaria
(hives). Patients should be instructed to take Fexofenadine Hydrochloride
Tablets only as prescribed. Do not exceed the recommended dose. If
any untoward effects occur while taking Fexofenadine Hydrochloride
Tablets, discontinue use and consult the doctor. The product should not be used by patients who are hypersensitive
to it or to any of its ingredients. Patients should be told that this product should be used in pregnancy
or lactation only if the potential benefit justifies the potential
risk to the fetus or nursing infant. Patients should be advised to take the tablet with water. Patients
should also be advised to store the medication in a tightly closed
container in a cool, dry place, away from children.<br/>Drug Interaction with Erythromycin and Ketoconazole: Fexofenadine has
been shown to exhibit minimal (ca. 5%) metabolism. However, co-administration
of fexofenadine hydrochloride with either ketoconazole or erythromycin
led to increased plasma concentrations of fexofenadine. Fexofenadine
had no effect on the pharmacokinetics of either erythromycin or ketoconazole.
In 2 separate studies, fexofenadine hydrochloride 120 mg twice daily
(240 mg total daily dose) was co-administered with either erythromycin
500 mg every 8 hours or ketoconazole 400 mg once daily under steady-state
conditions to healthy volunteers (n=24, each study). No differences
in adverse events or QTinterval were observed when subjects
were administered fexofenadine hydrochloride alone or in combination
with either erythromycin or ketoconazole. The findings of these studies
are summarized in the following table: The changes in
plasma levels were within the range of plasma levels achieved in adequate
and well-controlled clinical trials. The mechanism of these interactions has been evaluated in in vitro, in situ, and in vivo animal models. These studies
indicate that ketoconazole or erythromycin co-administration enhances
fexofenadine gastrointestinal absorption. This observed increase in
the bioavailability of fexofenadine may be due to transport-related
effects, such as p-glycoprotein. In vivo animal studies also suggest that in addition to enhancing absorption,
ketoconazole decreases fexofenadine gastrointestinal secretion, while
erythromycin may also decrease biliary excretion.<br/>Drug Interactions with Antacids: Administration of
120 mg of fexofenadine hydrochloride (2��60 mg capsule) within
15 minutes of an aluminum and magnesium containing antacid (Maalox) decreased fexofenadine AUC by 41% and Cmax by 43%.
Fexofenadine hydrochloride should not be taken closely in time with
aluminum and magnesium containing antacids.<br/>Interactions with Fruit Juices: Fruit juices such
as grapefruit, orange and apple may reduce the bioavailability and
exposure of fexofenadine. This is based on the results from 3 clinical
studies using histamine induced skin wheals and flares coupled with
population pharmacokinetic analysis. The size of wheal and flare were
significantly larger when fexofenadine hydrochloride was administered
with either grapefruit or orange juices compared to water. Based on
the literature reports, the same effects may be extrapolated to other
fruit juices such as apple juice. The clinical significance of these
observations is unknown. In addition, based on the population pharmacokinetics
analysis of the combined data from grapefruit and orange juices studies
with the data from a bioequivalence study, the bioavailability of
fexofenadine was reduced by 36%. Therefore, to maximize the effects
of fexofenadine, it is recommended that Fexofenadine hydrochloride
should be taken with water (see Dosage and Administration).<br/>CARCINOGENESIS, MUTAGENESIS, IMPAIRMENT OF FERTILITY: The carcinogenic
potential and reproductive toxicity of fexofenadine hydrochloride
were assessed using terfenadine studies with adequate fexofenadine
hydrochloride exposure (based on plasma area-under-the-concentration
vs. time [AUC] values). No evidence of carcinogenicity was observed
in an 18-month study in mice and in a 24-month study in rats at oral
doses up to 150 mg/kg of terfenadine (which led to fexofenadine exposures
that were approximately 3 and 5 times the exposure from the maximum
recommended human daily oral dose of fexofenadine hydrochloride in
adults [180 mg] and children [60 mg] respectively . In in vitro (Bacterial Reverse
Mutation, CHO/HGPRT Forward Mutation, and Rat Lymphocyte Chromosomal
Aberration assays) and in vivo (Mouse Bone Marrow Micronucleus assay) tests, fexofenadine hydrochloride
revealed no evidence of mutagenicity. In rat dietary fertility studies, dose-related reductions in implants
and increases in postimplantation losses were observed at an oral
dose of 150 mg/kg of terfenadine (which led to fexofenadine hydrochloride
exposures that were approximately 3 times the exposure of the maximum
recommended human daily oral dose of 180 mg fexofenadine hydrochloride).
In mice, fexofenadine hydrochloride produced no effect on male or
female fertility at average dietary doses up to 4438 mg/kg (approximately
10 times the maximum recommended human daily oral dose offexofenadine
hydrochloride 180 mg based on comparison of AUCs).<br/>PREGNANCY:<br/>Teratogenic Effects: Category C. There was no evidence of teratogenicity in rats or rabbits at oral
doses of terfenadine up to 300 mg/kg (which led to fexofenadine exposures
that were approximately 3 and 30 times, respectively, the exposure
from the maximum recommended human daily oral dose of fexofenadine
hydrochloride of 180 mg based on comparison of AUCs). In mice, no adverse effects and no teratogenic effects during gestation
were observed with fexofenadine at dietary doses up to 3730 mg/kg
(approximately 15 times the maximum recommended human daily oral dose
of fexofenadine hydrochloride 180 mg based on comparison of AUCs). There are no
adequate and well controlled studies in pregnant women. Fexofenadine
should be used during pregnancy only if the potential benefit justifies
the potential risk to the fetus.<br/>Nonteratogenic Effects: Dose-related
decreases in pup weight gain and survival were observed in rats exposed
to an oral dose of 150 mg/kg of terfenadine (approximately 3 times
the maximum recommended human daily oral dose of fexofenadine hydrochloride
of 180 mg in adults based on comparison of fexofenadine hydrochloride
AUCs).<br/>NURSING MOTHERS: It is not known
if fexofenadine is excreted in human milk. There are no adequate and
well-controlled studies in women during lactation. Because many drugs
are excreted in human milk, caution should be exercised when fexofenadine
hydrochloride is administered to a nursing woman.<br/>PEDIATRIC USE: The recommended
dose in patients 6 to 11 years of age is based on cross-study comparison
of the pharmacokinetics of fexofenadine hydrochloride in adults and
pediatric subjects and on the safety profile of fexofenadine hydrochloride
in both adult and pediatric subjects at doses equal to or higher than
the recommended doses. The safety of fexofenadine hydrochloride tablets at a dose of 30
mg twice daily has been demonstrated in 438 pediatric subjects 6 to
11 years of age in two placebo-controlled 2-week seasonal allergic
rhinitis trials. The safety of fexofenadine hydrochloride for the
treatment of chronic idiopathic urticaria in subjects 6 to 11 years
of age is based on cross-study comparison of the pharmacokinetics
of fexofenadine hydrochloride in adult and pediatric subjects and
on the safety profile of fexofenadine in both adult and pediatric
subjects at doses equal to or higher than the recommended dose. The effectiveness of
fexofenadine hydrochloride for the treatment of seasonal allergic
rhinitis in subjects 6 to 11 years of age was demonstrated in
1 trial (n=411) in which fexofenadine hydrochloride tablets 30 mg
twice daily significantly reduced total symptom scores compared to
placebo, along with extrapolation of demonstrated efficacy in subjects
aged 12 years and above, and the pharmacokinetic comparisons in adults
and children. The effectiveness of fexofenadine hydrochloride for
the treatment of chronic idiopathic urticaria in patients 6 to 11
years of age is based on an extrapolation of the demonstrated efficacyof fexofenadine hydrochloride in adults with this condition and the
likelihood that the disease course, pathophysiology and the drug's
effect are substantially similar in children to that of adult patients. Three clinical safety
studies comparing 15 mg twice daily (n=85) and 30 mg twice daily (n=330)
of an experimental formulation of fexofenadine to placebo (n=430)
have been conducted in pediatric subjects aged 6 months to 5 years. In
general, fexofenadine hydrochloride was well tolerated in these studies.
No unexpected adverse events were seen given the known safety profile
of fexofenadine and likely adverse reactions for this patient population. The safety
and effectiveness of fexofenadine hydrochloride in pediatric patients
under 6 years of age have not been established.<br/>GERIATRIC USE: Clinical studies
of fexofenadine hydrochloride tablets and capsules did not include
sufficient numbers of subjects aged 65 years and over to determine
whether this population responds differently from younger subjects.
Other reported clinical experience has not identified differences
in responses between the geriatric and younger subjects. This drug
is known to be substantially excreted by the kidney, and the risk
of toxic reactions to this drug may be greater in patients with impaired
renal function. Because elderly patients are more likely to have decreased
renal function, care should be taken in dose selection, and it may
be useful to monitor renal function. .
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Reports of fexofenadine
hydrochloride overdose have been infrequent and contain limited information.
However, dizziness, drowsiness, and dry mouth have been reported.
Single doses of fexofenadine hydrochloride up to 800 mg (6 healthy
volunteers at this dose level), and doses up to 690 mg twice daily
for 1 month (3 healthy volunteers at this dose level) or 240mg once
daily for 1 year (234 healthy volunteers at this dose level) were
administered without the development of clinically significant adverse
events as compared to placebo. In the event of overdose, consider standard measures to remove any
unabsorbed drug. Symptomatic and supportive treatment is recommended.
Following administration of terfenadine, hemodialysis did not effectively
remove fexofenadine, the major active metabolite of terfenadine, from
blood (up to 1.7% removed). No deaths occurred at oral doses of fexofenadine hydrochloride up
to 5000 mg/kg in mice (110 times the maximum recommended human daily
oral dose in adults and 200 times the maximum recommended human daily
oral dose in children based on mg/m) and up to 5000 mg/kg
in rats (230 times the maximum recommended human daily oral dose in
adults and 400 times the maximum recommended human daily oral dose
in children based on mg/m). Additionally, no clinical
signs of toxicity or gross pathological findings were observed. In
dogs, no evidence of toxicity was observed at oral doses up to 2000
mg/kg (300 times the maximum recommended human daily oral dose in
adults and 530 times the maximum recommended human daily oral dose
in children based on mg/m).
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dailymed-instance:genericMe... |
Fexofenadine Hydrochloride
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dailymed-instance:fullName |
Fexofenadine Hydrochloride (Tablet, Film Coated)
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dailymed-instance:adverseRe... |
Seasonal Allergic Rhinitis:<br/>Adults: In placebo-controlled
seasonal allergic rhinitis clinical trials in subjects 12 years of
age and older, which included 2461 subjects receiving fexofenadine
hydrochloride capsules at doses of 20 mg to 240 mg twice daily, adverse
events were similar in fexofenadine hydrochloride- and placebo-treated
subjects. All adverse events that were reported by greater than 1%
of subjects who received the recommended daily doseof fexofenadine
hydrochloride (60 mg capsules twice daily), and that were more common
with fexofenadine hydrochloride than placebo, are listed in Table
1. In a placebo-controlled clinical study in the United States, which
included 570 subjects aged 12 years and older receiving fexofenadine
hydrochloride tablets at doses of 120 or 180 mg once daily, adverse
events were similar in fexofenadine hydrochloride- and placebo-treated
subjects. Table 1 also lists adverse experiences that werereported
by greater than 2% of subjects treated with fexofenadine hydrochloride
tablets at doses of 180 mg once daily and that were more common with
fexofenadine hydrochloride than placebo. The incidence of adverse events, including drowsiness, was not dose-related
and was similar across subgroups defined by age, gender, and race. The frequency
and magnitude of laboratory abnormalities were similar in fexofenadine
hydrochloride- and placebo-treated subjects.<br/>Pediatrics: Table 2
lists adverse experiences in subjects aged 6 to 11 years of age which
were reported by greater than 2% of subjects treated with fexofenadine
hydrochloride tablets at a dose of 30 mg twice daily in placebo-controlled
seasonal allergic rhinitis studies in the United States and Canada
that were more common with fexofenadine hydrochloride than placebo. Three
clinical safety studies in 845 children aged 6 months to 5 years comparing
15 mg twice daily (n=85) and 30 mg twice daily (n=330) of an
experimental formulation of fexofenadine to placebo (n=430) have been
conducted. In general, fexofenadine hydrochloride was well tolerated
in these studies. No unexpected adverse events were seen given the
known safety profile of fexofenadine and likely adverse reactions
for this patient population.<br/>Chronic Idiopathic Urticaria: Adverse events reported
by subjects 12 years of age and older in placebo-controlled chronic
idiopathic urticaria studies were similar to those reported in placebo-controlled
seasonal allergic rhinitis studies. In placebo-controlled chronic
idiopathic urticaria clinical trials, which included 726 subjects
12 years of age and older receiving fexofenadine hydrochloride tablets
at doses of 20 to 240 mg twice daily, adverse events were similar
in fexofenadine hydrochloride- and placebo-treated patients. Table
3 lists adverse experiences in subjects aged 12 years and older which
were reported by greater than 2% of subjects treated with fexofenadine
hydrochloride 60 mg tablets twice daily in controlled clinical studies
in the United States and Canada and that were more common with fexofenadine
hydrochloride than placebo. In a placebo-controlled clinical study in the United States, which
included 167 subjects aged 12 years and older receiving fexofenadine
hydrochloride 180 mg tablets, adverse events were similar in fexofenadine
hydrochloride- and placebo-treated subjects. Table 3 also lists adverse
experiences that were reported by greater than 2% of subjects treated
with fexofenadine hydrochloride tablets at doses of 180 mg once daily
and that were more common with fexofenadine hydrochloride than placebo. The safety of fexofenadine
hydrochloride in the treatment of chronic idiopathic urticaria in
pediatric patients 6 to 11 years of age is based on the safety profile
of fexofenadine hydrochloride in adults and adolescent patients at
doses equal to or higher than the recommended dose (see Pediatric Use). Events that have
been reported during controlled clinical trials involving seasonal
allergic rhinitis and chronic idiopathic urticaria subjects with incidences
less than 1% and similar to placebo and have been rarely reported
during postmarketing surveillance include: insomnia, nervousness,
and sleep disorders or paroniria. In rare cases, rash, urticaria,
pruritus and hypersensitivity reactions with manifestations such as
angioedema, chest tightness, dyspnea, flushing and systemic anaphylaxis
have been reported.
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dailymed-instance:indicatio... |
Seasonal Allergic Rhinitis: Fexofenadine Hydrochloride
Tablets are indicated for the relief of symptoms associated with seasonal
allergic rhinitis in adults and children 6 years of age and older.
Symptoms treated effectively were sneezing, rhinorrhea, itchy nose/palate/throat,
itchy/watery/red eyes.<br/>Chronic Idiopathic Urticaria: Fexofenadine Hydrochloride
Tablets are indicated for treatment of uncomplicated skin manifestations
of chronic idiopathic urticaria in adults and children 6 years of
age and older. It significantly reduces pruritus and the number of
wheals.
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dailymed-instance:name |
Fexofenadine Hydrochloride
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