Antihistamine effects and safety of fexofenadine: a systematic review and Meta-analysis of randomized controlled trials

Abstract

BackgroundAs a new generation antihistamine, fexofenadine has been widely used in allergic diseases. However, there is still a lack of collective evidence regarding the antihistamine effects and safety profiles of fexofenadine relative to other antihistamine drugs and placebo. Therefore, we aimed to systematically evaluate the antihistamine effects and safety of fexofenadine.MethodsAn electronic literature search of randomized controlled trials (RCTs) was performed using Embase, Cochrane and PubMed from establishment to January 1st, 2018. RCTs comparing the antihistamine effects or safety (adverse events, sedative effects, and cognitive/psychomotor function) of fexofenadine with either other antihistamines or placebo for healthy subjects and patients with allergy were selected.ResultsFifty-one studies of 14,551 participants met the inclusion criteria. When compared with the first-generation antihistamines, fexofenadine produced significantly lower adverse events frequency (OR = 0.446; 95% CI: 0.214 to 0.929, P = 0.031), significantly lower sedative effects frequency (OR = 0.265; 95% CI: 0.072 to 0.976, P = 0.046) and significantly less change of all cognitive/psychomotor function. When compared with the second-generation antihistamines, fexofenadine produced significantly marginal sedative effects (OR = 0.59; 95% CI, 0.38 to 0.93; P = 0.02) and significantly less change of most of the cognitive/psychomotor function. When compared with placebo, fexofenadine produced more significant antihistamine effects.ConclusionsFexofenadine has a positive antihistamine effect, which is probably no worse than the second-generation antihistamines. Fexofenadine probably has a favorable safety profile, which is more likely better than that of the first-generation antihistamines. There is lack of data to support that fexofenadine has a better overall safety profile compared to the second-generation antihistamines, however, some presently available evidence on sedative effects and certain aspects of cognitive/psychomotor function favors fexofenadine. Therefore, fexofenadine may be worthy of recommendation for safety related workers.

Screening of Prospective Plant Compounds as H1R and CL1R Inhibitors and Its Antiallergic Efficacy through Molecular Docking Approach

“…They could also prevent airway inflammation and hyperreactivity which is caused by allergens [14]. The known inhibitors of histamine-1 receptors are levocetirizine [15], desloratadine [16], and fexofenadine [17]. Cysteinyl leukotriene receptor-1 is the receptor of leukotriene.…”

How to use antihistamines

“…Compared with first-generation antihistamines, systematic reviews of randomized controlled trials have found newer antihistamines to be safer (e.g., 4% sedation v. 28%), 2 – 4 longer lasting (12–24 h v. 4–6 h dosing) and faster acting (50 v. 80 min). 1 The World Health Organization replaced chlorpheniramine with loratadine on its essential medicines list in 2013 for these reasons (see Table 1 and Appendix 1, available at www.cmaj.ca/lookup/doi/10.1503/cmaj.201959/tab-related-content for preferred antihistamines).…”

Development and Validation of Methods for Quantitative Determination of Active Pharmaceutical Substances in Nasal Spray

“…Как следует из полученных результатов, открываемость внесенных добавок фексофенадина гидрохлорида находилась в интервале от 95 до 105%, аммония глицирризината -от 85 до 106,25% при величине RSD не более ±3,74% и ±7,84% соответственно, что соответствует предъявляемым требованиям 8 [30].…”

“…Фексофенадин имеет благоприятный профиль лекарственной безопасности, превосходящий таковой у антигистаминных препаратов первого поколения. Отсутствие седативного эффекта позволяет использовать препарат различным группам населения, в том числе в рабочее время, так как не нарушается концентрация внимания, моторные и когнитивные функции [8][9][10][11][12].…”