Fexofenadine + Pseudoephedrine

Oral
Seasonal allergic rhinitis

CrCl (mL/min)	Dosage
<80	Each tab contains fexofenadine 60 mg and pseudoephedrine 120 mg: Initially, 1 tab once daily.

Severe HTN or coronary artery disease, narrow-angle glaucoma, urinary retention. Patient receiving MAOIs or w/in 14 days of MAOI therapy withdrawal.

Patient w/ CV disease (e.g. HTN, ischaemic heart disease), DM, thyroid dysfunction, increased intraocular pressure, prostatic hypertrophy or urinary obstruction, seizure disorder. Renal impairment. Pregnancy and lactation.

Palpitations, abdominal pain, indigestion, nausea, headache, insomnia, agitation, upper resp infection.

PO: C

Monitor CNS effects (e.g. stimulation or depression).

Increased plasma levels w/ ketoconazole or erythromycin. Increased CNS effect w/ other sympathomimetic amines. Increased ectopic pacemaker activity w/ digitalis. Decreased plasma levels w/ Al and Mg containing antacids. May reduce the effect of antihypertensive drugs which interfere w/ sympathetic activity (e.g. methyldopa, mecamylamine, reserpine).
Potentially Fatal: Enhanced hypertensive effect w/ MAOIs.

Reduced bioavailability and exposure w/ grapefruit, orange and apple juice.

Description:
Mechanism of Action: Fexofenadine is a selective peripheral H₁-receptor antagonist thus, inhibits antigen-induced bronchospasm and histamine release. Pseudoephedrine exerts decongestant effect on the nasal mucosa.
Pharmacokinetics:
Absorption: Fexofenadine: Rapidly absorbed from the GI tract. Time to peak plasma concentration: 2-3 hr. Pseudoephedrine: Readily absorbed from the GI tract.
Distribution: Fexofenadine: Plasma protein binding: Approx 60-70%. Pseudoephedrine: Enters breast milk (small amounts).
Metabolism: Fexofenadine: Hepatically (approx 5% of the total dose). Pseudoephedrine: Hepatically (<1% of the total dose).
Excretion: Fexofenadine: Via faeces (80%), urine (11%). Elimination half -life: Approx 14 hr. Pseudoephedrine: Via urine (55-75%, as unchanged drug). Elimination half-life: Approx 5-8 hr.

Source: National Center for Biotechnology Information. PubChem Database. Fexofenadine, CID=3348, https://pubchem.ncbi.nlm.nih.gov/compound/Fexofenadine (accessed on Jan. 20, 2020)

Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 7028, Pseudoephedrine. https://pubchem.ncbi.nlm.nih.gov/compound/Pseudoephedrine. Accessed June 28, 2022.

Store between 20-25°C.

Antihistamines & Antiallergics

R01BA02 - pseudoephedrine ; Belongs to the class of systemic sympathomimetic preparations used as nasal decongestants.
R06AX26 - fexofenadine ; Belongs to the class of other antihistamines for systemic use.

Allegra-D 24 Hour Tablet, Film Coated (Sanofi-Aventis U.S. LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 29/06/2015.

Anon. Fexofenadine and Pseudoephedrine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 29/06/2015.

Buckingham R (ed). Fexofenadine Hydrochloride. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 29/06/2015.

Buckingham R (ed). Pseudoephedrine. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 29/06/2015.