Your guide to fexofenadine - an antihistamine for allergies and hay fever

What is fexofenadine?

Fexofenadine is an antihistamine that helps to reduce symptoms caused by seasonal allergies and hay fever. The active substance it contains is fexofenadine hydrochloride. It’s known as a non-sedating, or non-drowsy antihistamine that studies have shown to be less likely than other allergy treatments to cause sleepiness and fatigue.

What is fexofenadine used for?

Fexofenadine is used to treat a range of conditions that cause our bodies to react to usually harmless substances (allergens). When exposed to allergens, the immune system can trigger an overreaction, leading to symptoms like itching, sneezing, watery eyes, and a runny nose.

Fexofenadine is licensed to treat the symptoms of hay fever (seasonal allergic rhinitis) and hives (chronic idiopathic urticaria). In some cases, a clinician may recommend it to alleviate the symptoms of:

• Eczema

• Conjunctivitis

• Insect bites and stings that have caused an allergic reaction

• Some food allergies

How to take fexofenadine?

The typical recommended dose of fexofenadine for adults and children over the age of 12 is one 120mg tablet taken once daily with water. If you're using fexofenadine for a period of time, the NHS recommends trying to take it around the same time each day. If you do miss a dose, have the tablet as soon as you remember unless it’s nearly time for your next dose. It’s important not to double up on your dose if you do miss one.

Fexofenadine is only available on prescription for children under the age of 12, in a lower strength of 30mg. Chat to your GP if you need advice about allergy treatments for a child.

Is fexofenadine right for me?

Clinical trials have demonstrated the effectiveness of fexofenadine in treating a range of conditions that trigger allergy-like symptoms such as:

• Itching

• Runny nose

• Sneezing

• Watery, irritated eyes

It can be a preferred option with patients due to its non-drowsy properties, meaning a smaller likelihood of it negatively impacting daily activities and routines. It may not be suitable for everyone, and you should discuss with a pharmacist before taking it if you:

• Have liver or kidney issues

• Have an existing, or historical heart condition

• Live with epilepsy, or another condition that increases your risk of fitting or seizure

• Are allergic to any other medicines

Advice from our pharmacist…

Pharmacy2U Patient Safety Manager and clinical pharmacist Duncan Reid says,

“Finding an effective treatment for allergy and hay fever symptoms is dependent on the person. Everyone is unique, and certain medicines will work better for some people than others depending on a range of factors.

You may need to try two or three different treatments to find the one that works best for you. If you experience side effects with one type of medicine, talk to your pharmacist and consider trying another. It may be that the side effects can be managed if the treatment is helping your allergy symptoms.”

What else to consider when taking fexofenadine

• It’s best to avoid apple, grapefruit, and orange juice when taking fexofenadine, as these may increase your chances of developing side effects

• Ibuprofen and paracetamol can be safely taken alongside fexofenadine for pain relief

• Although fexofenadine is non-drowsy, the NHS recommends avoiding alcohol consumption when taking it as this could make you feel sleepy

• Using fexofenadine whilst pregnant is advised against as there is little information available about its safety for use in pregnancy

• Talk to your pharmacist or GP before using fexofenadine if you’re breastfeeding

What about serious side effects?

Serious side effects are rare, but as with any medicine, be alert for any signs of serious allergic reaction (anaphylaxis) when you first use fexofenadine. Seek immediate medical attention if you experience:

• Swelling of the lips, tongue, mouth, or throat

• A tightness in the throat

• Difficulty breathing

• Confusion, dizziness, or significant drowsiness

• Fainting

• A skin rash develops that is swollen, itchy, blistered, or peeling

Managing common side effects

When you first use fexofenadine, you may notice mild nausea, sleepiness, headaches, a dry mouth, or some dizziness. These side effects are common (affect more than 1 in 100 people) but will often subside after a short time. If you want help managing these, speak to your pharmacist for advice. Avoiding rich or spicy foods may help prevent feeling sick, and drinking plenty of fluids should help prevent headaches. Paracetamol or ibuprofen can help relieve pain brought on by headaches, and sucking on a sugar-free sweet or chewing gum can help alleviate a dry mouth.

How does fexofenadine compare to other antihistamines?

This comparison table gives a summary of the key features of fexofenadine compared with other allergy and hay fever treatments including cetirizine, loratadine, and chlorphenamine.

Key findings from various sources indicate that fexofenadine is the least likely of the four antihistamines examined to cause drowsiness. It can effectively relieve allergy symptoms for up to 24 hours, getting to work up to 1 hour after taking. Fexofenadine is deemed safe for long-term use and has been found to interact with fewer medicines than cetirizine and chlorpheniramine. Remember to always read the patient information leaflet when taking a new medicine. You can find more information and advice on how to manage allergies and hay fever in our Health Hub.

Comparison table sources

*Antihistamines may be used beyond the stated duration with clinical supervision

1. https://www.drugs.com/tips/fexofenadine-patient-tips

2. https://www.medbroadcast.com/drug/getdrug/allergy-remedy

3. Cetirizine: Brand names: Allacan, Benadryl Allergy, Piriteze Allergy, Zirtek Allergy – https://www.nhs.uk/medicines/cetirizine/

4. Chlorpheniramine (Piriton). Other brand names: Allerief, Hayleve, Pollenase – https://www.nhs.uk/medicines/chlorphenamine-including-piriton/

5. Frank Hampel, Paul Ratner, Lyndon Mansfield, Suzanne Meeves, Yuning Liao, George Georges: Fexofenadine hydrochloride, 180mg, exhibits equivalent efficacy to cetirizine, 10mg, with less drowsiness in patients with moderate-to-severe seasonal allergic rhinitis; Ann Allergy Asthma Immunol. 2003 Oct;91 (4): 354-61.

6. https://www.nhs.uk/conditions/antihistamines/

7. Robert A. Nathan, Jolene Mason, David I. Bernstein, William C. Howland III, Harold B. Kaiser, Eli O. Meltzer & Nathan Segall: Long-term Tolerability of Fexofenadine in Healthy Volunteers; Clinical Drug Investigation volume 18, pages 317-328 (1999).

8. Drug Interaction Checker. Free online tool available at https://www.drugs.com/drug-interactions/. Check completed 27/03/2024.

Details about the qualitative research

On behalf of Dr. Reddy’s, Ipsos carried out 60-minute one-to-one qualitative interviews, via video calls, with a sample of 28 of allergy sufferers aged 18 or more in the UK. Most of the sample were dissatisfied with their current allergy treatment. The fieldwork was carried out by trained qualitative moderators between 12^th and 27^th July 2023 in accordance with the MRS Code of Conduct. Participants were screened by Ipsos approved recruiters through free finding to provide a cross section of allergy sufferers in terms of hay fever, pet hair allergy, skin allergies or dust allergy in the last 3 months.

Ipsos was responsible for the study design, sample design, recruitment, discussion guide design, moderation, interpretation and reporting. Dr.Reddy’s is responsible for the correct use of the research, having analysed the report provided by Ipsos.

Qualitative research was considered to be the most appropriate methodological approach to support and explore in more depth the range of views of allergy sufferers. Qualitative research is designed to be illustrative in nature and tells us what people think and why they hold these views. However, qualitative research is reflective of the views of those selected to take part in the research rather than being statistically representative of any population and does not look to produce statistics. This needs to be taken into account when interpreting the research findings. In addition, it is important to bear in mind that qualitative research deals with perceptions rather than facts (though perceptions are facts to those that hold them).