Rupatadine 14-Aug-2017
lDRUG ACTIONRupatadine is a second generation non-
sedating antihistamine.
lINDICATIONS AND DOSE
Symptomatic relief of allergic rhinitis and urticaria
▶BY MOUTH
▶Child 12–17 years: 10 mg once dailylCAUTIONSHistory of QT-interval prolongation.
predisposition to arrhythmia.uncorrected hypokalaemia
lINTERACTIONS→Appendix 1 : antihistamines, non-
sedating
lSIDE-EFFECTS
▶Common or very commonAsthenia.dizziness.drowsiness.
dry mouth.headache
▶UncommonAppetite increased.arthralgia.back pain.
concentration impaired.constipation.cough.diarrhoea.
dry throat.epistaxis.fever.gastrointestinal discomfort.
increased risk of infection.irritability.malaise.myalgia.
nasal dryness.nausea.oropharyngeal pain.rash.thirst.
vomiting.weight increased
▶Rare or very rarePalpitations.tachycardia
SIDE-EFFECTS, FURTHER INFORMATIONNon-sedating
antihistamines such as rupatadine cause less sedation and
psychomotor impairment than the older antihistamines,
but can still occur; sedation is generally minimal. This is
because non-sedating antihistamines penetrate the blood
brain barrier to a much lesser extent.lPREGNANCYMost manufacturers of antihistamines advise
avoiding their use during pregnancy; however, there is no
evidence of teratogenicity.
lBREAST FEEDINGMost antihistamines are present in
breast milk in varying amounts; although not known to be
harmful, most manufacturers advise avoiding their use in
mothers who are breast-feeding.
lHEPATIC IMPAIRMENTManufacturer advises avoid—no
information available.
lRENAL IMPAIRMENTManufacturer advises avoid—no
information available.
lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Tablet
▶Rupatadine (Non-proprietary)
Rupatadine (as Rupatadine fumarate) 10 mgRupatadine 10 mg
tablets| 30 tabletP£ 30. 00 DT = £ 30. 00
ANTIHISTAMINES›SEDATING
Alimemazine tartrate
(Trimeprazine tartrate)
lINDICATIONS AND DOSE
Urticaria|Pruritus
▶BY MOUTH
▶Child 6 months–1 year (specialist use
only): 250 micrograms/kg 3 – 4 times a day (max. per
dose 2. 5 mg)
▶Child 2–4 years: 2. 5 mg 3 – 4 times a day
▶Child 5–11 years: 5 mg 3 – 4 times a day
▶Child 12–17 years: 10 mg 2 – 3 times a day, in severe cases
up to maximum daily dose has been used; maximum
100 mg per day
Premedication to anaesthesia
▶BY MOUTH
▶Child 2–6 years:Up to 2 mg/kg, to be given 1 – 2 hours
before operationlUNLICENSED USENot licensed for use in children under
2 years.
lCONTRA-INDICATIONSChildren under 2 years except on
specialist advice (safety of such use has not been
established).epilepsy.hepatic dysfunction.history of
narrow angle glaucoma.hypothyroidism.myasthenia
gravis.neonate (due to significant antimuscarinic activity)
.Parkinson’s disease.phaeochromocytoma.renal
dysfunction
lCAUTIONSCardiovascular diseases (due to tachycardia-
inducing and hypotensive effects of phenothiazines).
exposure to sunlight should be avoided during treatment
with high doses.pyloroduodenal obstruction.urinary
retention.volume depleted patients who are more
susceptible to orthostatic hypotension
lINTERACTIONS→Appendix 1 : antihistamines, sedating
lSIDE-EFFECTSAgitation.agranulocytosis.amenorrhoea.
atrioventricular block.autonomic dysfunction.bile
thrombus.consciousness impaired.drug fever.dry mouth
.eosinophilia.erectile dysfunction.eye disorder.
galactorrhoea.gynaecomastia.hepatic disorders.
hyperprolactinaemia.hyperthermia.hypotension.
insomnia.leucopenia (on prolonged high dose).
movement disorders.muscle rigidity.nasal congestion.
neuroleptic malignant syndrome.pallor.parkinsonism.
photosensitivity reaction.postural hypotension (more
common in volume depletion).QT interval prolongation.
respiratory depression.seizure.skin reactions.tardive
dyskinesia (more common after long term high doses).
tremor.ventricularfibrillation (increased risk with
hypokalamia and cardiac disease).ventricular tachycardia
(increased risk with hypokalamia and cardiac disease)
SIDE-EFFECTS, FURTHER INFORMATIONDrowsiness may
diminish after a few days.
Patients on high dosage may develop photosensitivity
and should avoid exposure to direct sunlight.
Children are more susceptible to side-effects.
lPREGNANCYMost manufacturers of antihistamines advise
avoiding their use during pregnancy; however, there is no
evidence of teratogenicity. Use in the latter part of the
third trimester may cause adverse effects in neonates such
as irritability, paradoxical excitability, and tremor.
lBREAST FEEDINGMost antihistamines are present in
breast milk in varying amounts; although not known to be
harmful, most manufacturers advise avoiding their use in
mothers who are breast-feeding.
lHEPATIC IMPAIRMENTAvoid in severe liver disease—
increased risk of coma.
lRENAL IMPAIRMENTAvoid.
lPATIENT AND CARER ADVICE
Driving and skilled tasksDrowsiness may affect
performance of skilled tasks (e.g. cycling or driving);
sedating effects enhanced by alcohol.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: oral solution
Oral solution
CAUTIONARY AND ADVISORY LABELS 2
▶Alimemazine tartrate (Non-proprietary)
Alimemazine tartrate 1.5 mg per 1 mlAlimemazine 7. 5 mg/ 5 ml oral
solution| 100 mlP£ 179. 55 DT = £ 179. 55
Alimemazine tartrate 6 mg per 1 mlAlimemazine 30 mg/ 5 ml oral
solution| 100 mlP£ 243. 51 DT = £ 243. 51
Tablet
CAUTIONARY AND ADVISORY LABELS 2
▶Alimemazine tartrate (Non-proprietary)
Alimemazine tartrate 10 mgAlimemazine 10 mg tablets|
28 tabletP£ 112. 85 DT = £ 112. 85BNFC 2018 – 2019 Allergic conditions 177
Respiratory system3