Doustne leki przeciwhistaminowe II generacji: jakie? komu? – charakterystyka wybranych leków Artykuł przeglądowy
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Opublikowane:
mar 17, 2025
Słowa kluczowe:
leki przeciwhistaminowe drugiej generacji, desloratadyna, bilastyna, feksofenadyna, alergiczny nieżyt nosa, pokrzywka, dzieci, dorośli
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Abstrakt
W pracy o charakterze przeglądowym omówiono 3 często stosowane leki przeciwhistaminowe II generacji: bilastynę, desloratadynę i feksofenadynę. Przedstawiono wybrane elementy farmakokinetyki, postacie farmaceutyczne oraz wskazania kliniczne (alergiczne nieżyty nosa, pokrzywka) do stosowania tych leków. Bilastyna jest bezpiecznym lekiem dla pacjentów z wielochorobowością, w tym dla osób starszych. Nie powoduje sedacji i może być stosowana u chorych powyżej 6 r.ż. Desloratadyna jest bezpiecznym i skutecznym lekiem u dzieci już od 1. r.ż., może być przyjmowana niezależnie od posiłku, nie powoduje zmiany masy ciała. Feksofenadyna jest bezpiecznym lekiem także dla pacjentów z niewydolnością wątroby lub nerek, pozbawionym właściwości sedatywnych i może być stosowana nawet przez pilotów i osoby obsługujące maszyny. Dodatkowo ma działanie przeciwzapalne oraz nie wchodzi w interakcje z alkoholem i innymi lekami.
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Jak cytować
Panas-Hołowacz, K., & Emeryk, A. (2025). Doustne leki przeciwhistaminowe II generacji: jakie? komu? – charakterystyka wybranych leków. Alergoprofil, 21(1), 3-10. https://doi.org/10.24292/01.AP.211170325
Numer
Dział
THERAPY
Utwór dostępny jest na licencji Creative Commons Uznanie autorstwa – Użycie niekomercyjne 4.0 Międzynarodowe.
Copyright: © Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
Bibliografia
1. Emanuel MB. Histamine and the antiallergic antihistamines: a history of their discoveries. Clin Exp Allergy. 1999; Suppl 3: 1-11.
2. Chaudhari R, Gosavi S, Bornare P et al. An overview of antihistamines and their properties used for treatment of different diseases. Antiinflamm Antiallergy Agents Med Chem. 2023; 22: 220-9.
3. Simons FE, Simons KJ. Histamine and H1-antihistamines: celebrating a century of progress. J Allergy Clin Immunol. 2011; 128: 1139-50.
4. Simons FE, Simons KJ. H1 antihistamines: current status and future directions. World Allergy Organ J. 2008; 1: 145-55.
5. Brożek JL, Bousquet J, Agache I et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016 revision. J Allergy Clin Immunol. 2017; 140: 950-8.
6. Xiang YK, Fok JS, Podder I et al. An update on the use of antihistamines in managing chronic urticaria. Expert Opin Pharmacother. 2024; 25: 551-69.
7. Kuna P, Jurkiewicz D, Czarnecka-Operacz M et al. The role and choice criteria of antihistamines in allergy management – expert opinion. Adv Dermatol Allergol. 2016; 23: 397-410.
8. Fein MN, Fischer DA, O’Keefe AW et al. CSACI position statement: newer generation H1-antihistamines are safer than first-generation H1-antihistamines and should be the first-line antihistamines for the treatment of allergic rhinitis and urticaria. Allergy Asthma Clin Immunol. 2019; 15: 61.
9. Carr W, Berstein J, Lieberman P et al. A novel intranasal therapy of azelastine with fluticasone for the treatment of allergic rhinitis. J Allergy Clin Immunol. 2012; 129: 1282-9.
10. Patel P, Salapatek AM, Tantry SK. Effect of olopatadine-mometasone combination nasal spray on seasonal allergic rhinitis symptoms in an environmental exposure chamber study. Ann Allergy Asthma Immunol. 2019; 122: 160-6.
11. Samoliński B, Sybilski A, Raciborski F et al. Częstość występowania nieżytów nosa w polskiej populacji na podstawie badania Epidemiologia Chorób Alergicznych w Polsce (ECAP). Otolaryng Pol. 2009; 63: 324-30.
12. Samoliński B, Raciborski F, Tomaszewska A et al. Częstość występowania alergii w Polsce – program ECAP. Alergoprofil. 2008; 3; 26-8.
13. Samoliński B, Raciborski F, Lipiec A et al. Epidemiologia Chorób Alergicznych w Polsce (ECAP). Alergol Pol. 2014; 1: 10-8.
14. Wise SK, Damask C, Roland LT et al. International consensus statement on allergy and rhinology: Allergic rhinitis – 2023. Int Forum Allergy Rhinol. 2023; 13: 293-859.
15. Hellings PW, Scadding G, Bachert C et al. EUFOREA treatment algorithm for allergic rhinitis. Rhinology. 2020; 58: 618-22.
16. Scadding GK, Smith PK, Blaiss M et al. Allergic rhinitis in childhood and the new EUFOREA algorithm. Front Allergy. 2021; 2: 706589.
17. Do TT, Canty RA, Joshi SR et al. Current and future management of chronic spontaneous urticaria and chronic inducible urticaria Allergy Asthma Proc. 2023; 44: 3-14.
18. Schad CA, Skoner DP. Antihistamines in the pediatric population: achieving optimal outcomes when treating seasonal allergic rhinitis and chronic urticaria. Allergy Asthma Proc. 2008; 29: 7-13.
19. Bartuzi Z, Kaczmarski M, Czerwionka-Szaflarska M et al. Position Paper of Food Allergy Section the Polish Society of Allergology on the diagnosis and management of food allergies. Pol J Allerg. 2017; 4: 109-22.
20. Parisi GF, Licari A, Papale M et al. Antihistamines: ABC for the pediatricians. Pediatr Allergy Immunol. 2020; Suppl 24: 34-6.
21. Terada T, Kawata R. Diagnosis and treatment of local allergic rhinitis. Pathogens. 2022; 11: 80.
22. Iordache A, Boruga M, Mușat O et al. Relationship between allergic rhinitis and allergic conjunctivitis (allergic rhinoconjunctivitis) – review. Rom J Ophthalmol. 2022; 66: 8-12.
23. Knudgaard MH, Andreasen TH, Ravnborg N et al. Rhinitis prevalence and association with atopic dermatitis: A systematic review and meta-analysis. Ann Allergy Asthma Immunol. 2021; 127: 49-56.
24. Juel-Berg N, Darling P, Bolvig J et al. Intranasal corticosteroids compared with oral antihistamines in allergic rhinitis: A systematic review and meta-analysis. Am J Rhinol Allergy. 2017; 31: 19-28.
25. Li L, Liu R, Peng C et al. Pharmacogenomics for the efficacy and side effects of antihistamines. Exp Dermatol. 2022; 31: 993-1004.
26. Bousquet J, Toumi M, Sousa-Pinto B et al. The Allergic Rhinitis and Its Impact on Asthma (ARIA) approach of value-added medicines: as-needed treatment in allergic rhinitis. J Allergy Clin Immunol Pract. 2022; 10: 2878-88.
27. Smith SM, Gums JG. Fexofenadine: biochemical, pharmacokinetic and pharmacodynamic properties and its unique role in allergic disorders. Expert Opin Drug Metabol Toxicol. 2009; 5: 813-22.
28. Lee CA, Cook JA, Reyner EL et al. P-glycoprotein related drug interactions: Clinical importance and a consideration of disease states. Expert Opin Drug Metab Toxicol. 2010; 6: 603-19.
29. Charakterystyka produktu leczniczego. Telfast.
30. Charakterystyka produktu leczniczego. Telfexo 120 mg.
31. Charakterystyka produktu leczniczego. Telfexo 180 mg.
32. Charakterystyka produktu leczniczego. Bilaxten.
33. Bilastine FDA Approval Status.
34. Charakterystyka produktu leczniczego. Clatra 10 mg.
35. Charakterystyka produktu leczniczego. Clatra 20 mg.
36. Charakterystyka produktu leczniczego. Delortan.
37. Charakterystyka produktu leczniczego. Desloratadine Mylan.
38. Informacja dla pacjenta. Hitaxa 5 mg.
39. Charakterystyka produktu leczniczego. HITAXA 2,5 mg.
40. Kuna P, Bachert Z, Nowacki Z et al. Efficacy and safety of bilastine 20 mg compared with cetirizine 10 mg and, placebo for the symptomatic treatment of seasonal allergic rhinitis: a randomized, double-blind, parallel-group study. Clin Exp Allergy. 2009; 39: 1338-47.
41. Singh Randhawa A, Mohd Noor N, Md Daud MK et al. Efficacy and safety of bilastine in the treatment of allergic rhinitis: a systematic review and meta-analysis. Front Pharmacol. 2022; 12: 731201.
42. Jáuregui I, Ferrer M, Bartra J et al. Bilastine for the treatment of urticaria. Expert Opin Pharmacother. 2013; 14: 1537-44.
43. Demonte A, Guanti MB, Liberati S et al. Bilastine safety in drivers who need antihistamines: new evidence from high-speed simulator driving test on allergic patients. Eur Rev Med Pharmacol Sci. 2018; 22: 820-8.
44. Bousquet J, Ansótegui I, Establishing the place in therapy of bilastine in the treatment of allergic rhinitis according to ARIA: evidence review. Curr Med Res Opin. 2012; 28: 131-9.
45. Novák Z, Yáñez A, Kiss I et al. Safety and tolerability of bilastine 10 mg administered for 12 weeks in children with allergic diseases. Pediatr Allergy Immunol. 2016; 27: 493-8.
46. Monroe E, Finn A, Patel P et al. Efficacy and safety of desloratadine 5 mg once daily in the treatment of chronic idiopathic urticaria: A double-blind randomized, placebo-controlled trial. J Am Acad Dermatol. 2003; 48: 535-41.
47. Bachert C, van Cauwenberge P. Desloratadine treatment for intermittent and persistent allergic rhinitis: a review. Clin Ther. 2007; 29: 1795-802.
48. Staevska M, Popov TA, Kralimarkova T et al. The effectiveness of levocetirizine and desloratadine in up to 4 times conventional doses in difficult-to-treat urticaria. J Allergy Clin Immunol. 2010; 125: 676-82.
49. Wen Y, Tang Y, Li M et al. Efficiency and safety of desloratadine in combination with compound glycyrrhizinin the treatment of chronic urticaria: a meta-analysis and systematic review of randomised controlled trials. Pharm Biol. 2021; 59: 1274-83.
50. Berger WE. The safety and efficacy of desloratadine for the management of allergic disease. Drug Saf. 2005; 28: 1101-18.
51. Gupta S, Kantesaria B, Banfield C et al. Desloratadine dose selection in children aged 6 months to 2 years: comparison of population pharmacokinetics between children and adults. Br J Clin Pharmacol. 2007; 64: 174-84.
52. Cingi C, Oghan F, Eskiizmir G et al. Desloratadine-montelukast combination improves quality of life and decreases nasal obstruction in patients with perennial allergic rhinitis. Int Forum Allergy Rhinol. 2013; 3: 801-6.
53. Wikipedia. Fexofenadine.
54. Kawauchi H, Yanai K, Wang DY et al. Antihistamines for allergic rhinitis treatment from the viewpoint of nonsedative properties. Int J Mol Sci. 2019; 20: 213.
55. Ansotegui IJ, Bousquet J, Canonica GW et al. Why fexofenadine is considered as a truly non-sedating antihistamine with no brain penetration: a systematic review. Curr Med Res Opin. 2024; 40: 1297-309.
56. Hindmarch I, Shamsi Z, Stanley N et al. A double-blind, placebo- controlled investigation of the effects of fexofenadine, loratadine and promethazine on cognitive and psychomotor function. Br J Clin Pharmacol. 1999; 48: 200-6.
57. Bower EA, Moore JL, Moss M et al. The effects of single-dose fexofenadine, diphenhydramine, and placebo on cognitive performance in flight personel. Aviat Sp Environ Med. 2003; 74: 145-52.
58. Naclerio RM, Ansotegui IJ, Canonica GW et al. Twenty-five years: the fexofenadine clinical experience. World Allergy Organ J. 2024; 17: 100950.
59. Axelrod D, Bielory L. Fexofenadine hydrochloride in the treatment of allergic disease: a review. J Asthma Allergy. 2008; 1: 19-29.
2. Chaudhari R, Gosavi S, Bornare P et al. An overview of antihistamines and their properties used for treatment of different diseases. Antiinflamm Antiallergy Agents Med Chem. 2023; 22: 220-9.
3. Simons FE, Simons KJ. Histamine and H1-antihistamines: celebrating a century of progress. J Allergy Clin Immunol. 2011; 128: 1139-50.
4. Simons FE, Simons KJ. H1 antihistamines: current status and future directions. World Allergy Organ J. 2008; 1: 145-55.
5. Brożek JL, Bousquet J, Agache I et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016 revision. J Allergy Clin Immunol. 2017; 140: 950-8.
6. Xiang YK, Fok JS, Podder I et al. An update on the use of antihistamines in managing chronic urticaria. Expert Opin Pharmacother. 2024; 25: 551-69.
7. Kuna P, Jurkiewicz D, Czarnecka-Operacz M et al. The role and choice criteria of antihistamines in allergy management – expert opinion. Adv Dermatol Allergol. 2016; 23: 397-410.
8. Fein MN, Fischer DA, O’Keefe AW et al. CSACI position statement: newer generation H1-antihistamines are safer than first-generation H1-antihistamines and should be the first-line antihistamines for the treatment of allergic rhinitis and urticaria. Allergy Asthma Clin Immunol. 2019; 15: 61.
9. Carr W, Berstein J, Lieberman P et al. A novel intranasal therapy of azelastine with fluticasone for the treatment of allergic rhinitis. J Allergy Clin Immunol. 2012; 129: 1282-9.
10. Patel P, Salapatek AM, Tantry SK. Effect of olopatadine-mometasone combination nasal spray on seasonal allergic rhinitis symptoms in an environmental exposure chamber study. Ann Allergy Asthma Immunol. 2019; 122: 160-6.
11. Samoliński B, Sybilski A, Raciborski F et al. Częstość występowania nieżytów nosa w polskiej populacji na podstawie badania Epidemiologia Chorób Alergicznych w Polsce (ECAP). Otolaryng Pol. 2009; 63: 324-30.
12. Samoliński B, Raciborski F, Tomaszewska A et al. Częstość występowania alergii w Polsce – program ECAP. Alergoprofil. 2008; 3; 26-8.
13. Samoliński B, Raciborski F, Lipiec A et al. Epidemiologia Chorób Alergicznych w Polsce (ECAP). Alergol Pol. 2014; 1: 10-8.
14. Wise SK, Damask C, Roland LT et al. International consensus statement on allergy and rhinology: Allergic rhinitis – 2023. Int Forum Allergy Rhinol. 2023; 13: 293-859.
15. Hellings PW, Scadding G, Bachert C et al. EUFOREA treatment algorithm for allergic rhinitis. Rhinology. 2020; 58: 618-22.
16. Scadding GK, Smith PK, Blaiss M et al. Allergic rhinitis in childhood and the new EUFOREA algorithm. Front Allergy. 2021; 2: 706589.
17. Do TT, Canty RA, Joshi SR et al. Current and future management of chronic spontaneous urticaria and chronic inducible urticaria Allergy Asthma Proc. 2023; 44: 3-14.
18. Schad CA, Skoner DP. Antihistamines in the pediatric population: achieving optimal outcomes when treating seasonal allergic rhinitis and chronic urticaria. Allergy Asthma Proc. 2008; 29: 7-13.
19. Bartuzi Z, Kaczmarski M, Czerwionka-Szaflarska M et al. Position Paper of Food Allergy Section the Polish Society of Allergology on the diagnosis and management of food allergies. Pol J Allerg. 2017; 4: 109-22.
20. Parisi GF, Licari A, Papale M et al. Antihistamines: ABC for the pediatricians. Pediatr Allergy Immunol. 2020; Suppl 24: 34-6.
21. Terada T, Kawata R. Diagnosis and treatment of local allergic rhinitis. Pathogens. 2022; 11: 80.
22. Iordache A, Boruga M, Mușat O et al. Relationship between allergic rhinitis and allergic conjunctivitis (allergic rhinoconjunctivitis) – review. Rom J Ophthalmol. 2022; 66: 8-12.
23. Knudgaard MH, Andreasen TH, Ravnborg N et al. Rhinitis prevalence and association with atopic dermatitis: A systematic review and meta-analysis. Ann Allergy Asthma Immunol. 2021; 127: 49-56.
24. Juel-Berg N, Darling P, Bolvig J et al. Intranasal corticosteroids compared with oral antihistamines in allergic rhinitis: A systematic review and meta-analysis. Am J Rhinol Allergy. 2017; 31: 19-28.
25. Li L, Liu R, Peng C et al. Pharmacogenomics for the efficacy and side effects of antihistamines. Exp Dermatol. 2022; 31: 993-1004.
26. Bousquet J, Toumi M, Sousa-Pinto B et al. The Allergic Rhinitis and Its Impact on Asthma (ARIA) approach of value-added medicines: as-needed treatment in allergic rhinitis. J Allergy Clin Immunol Pract. 2022; 10: 2878-88.
27. Smith SM, Gums JG. Fexofenadine: biochemical, pharmacokinetic and pharmacodynamic properties and its unique role in allergic disorders. Expert Opin Drug Metabol Toxicol. 2009; 5: 813-22.
28. Lee CA, Cook JA, Reyner EL et al. P-glycoprotein related drug interactions: Clinical importance and a consideration of disease states. Expert Opin Drug Metab Toxicol. 2010; 6: 603-19.
29. Charakterystyka produktu leczniczego. Telfast.
30. Charakterystyka produktu leczniczego. Telfexo 120 mg.
31. Charakterystyka produktu leczniczego. Telfexo 180 mg.
32. Charakterystyka produktu leczniczego. Bilaxten.
33. Bilastine FDA Approval Status.
34. Charakterystyka produktu leczniczego. Clatra 10 mg.
35. Charakterystyka produktu leczniczego. Clatra 20 mg.
36. Charakterystyka produktu leczniczego. Delortan.
37. Charakterystyka produktu leczniczego. Desloratadine Mylan.
38. Informacja dla pacjenta. Hitaxa 5 mg.
39. Charakterystyka produktu leczniczego. HITAXA 2,5 mg.
40. Kuna P, Bachert Z, Nowacki Z et al. Efficacy and safety of bilastine 20 mg compared with cetirizine 10 mg and, placebo for the symptomatic treatment of seasonal allergic rhinitis: a randomized, double-blind, parallel-group study. Clin Exp Allergy. 2009; 39: 1338-47.
41. Singh Randhawa A, Mohd Noor N, Md Daud MK et al. Efficacy and safety of bilastine in the treatment of allergic rhinitis: a systematic review and meta-analysis. Front Pharmacol. 2022; 12: 731201.
42. Jáuregui I, Ferrer M, Bartra J et al. Bilastine for the treatment of urticaria. Expert Opin Pharmacother. 2013; 14: 1537-44.
43. Demonte A, Guanti MB, Liberati S et al. Bilastine safety in drivers who need antihistamines: new evidence from high-speed simulator driving test on allergic patients. Eur Rev Med Pharmacol Sci. 2018; 22: 820-8.
44. Bousquet J, Ansótegui I, Establishing the place in therapy of bilastine in the treatment of allergic rhinitis according to ARIA: evidence review. Curr Med Res Opin. 2012; 28: 131-9.
45. Novák Z, Yáñez A, Kiss I et al. Safety and tolerability of bilastine 10 mg administered for 12 weeks in children with allergic diseases. Pediatr Allergy Immunol. 2016; 27: 493-8.
46. Monroe E, Finn A, Patel P et al. Efficacy and safety of desloratadine 5 mg once daily in the treatment of chronic idiopathic urticaria: A double-blind randomized, placebo-controlled trial. J Am Acad Dermatol. 2003; 48: 535-41.
47. Bachert C, van Cauwenberge P. Desloratadine treatment for intermittent and persistent allergic rhinitis: a review. Clin Ther. 2007; 29: 1795-802.
48. Staevska M, Popov TA, Kralimarkova T et al. The effectiveness of levocetirizine and desloratadine in up to 4 times conventional doses in difficult-to-treat urticaria. J Allergy Clin Immunol. 2010; 125: 676-82.
49. Wen Y, Tang Y, Li M et al. Efficiency and safety of desloratadine in combination with compound glycyrrhizinin the treatment of chronic urticaria: a meta-analysis and systematic review of randomised controlled trials. Pharm Biol. 2021; 59: 1274-83.
50. Berger WE. The safety and efficacy of desloratadine for the management of allergic disease. Drug Saf. 2005; 28: 1101-18.
51. Gupta S, Kantesaria B, Banfield C et al. Desloratadine dose selection in children aged 6 months to 2 years: comparison of population pharmacokinetics between children and adults. Br J Clin Pharmacol. 2007; 64: 174-84.
52. Cingi C, Oghan F, Eskiizmir G et al. Desloratadine-montelukast combination improves quality of life and decreases nasal obstruction in patients with perennial allergic rhinitis. Int Forum Allergy Rhinol. 2013; 3: 801-6.
53. Wikipedia. Fexofenadine.
54. Kawauchi H, Yanai K, Wang DY et al. Antihistamines for allergic rhinitis treatment from the viewpoint of nonsedative properties. Int J Mol Sci. 2019; 20: 213.
55. Ansotegui IJ, Bousquet J, Canonica GW et al. Why fexofenadine is considered as a truly non-sedating antihistamine with no brain penetration: a systematic review. Curr Med Res Opin. 2024; 40: 1297-309.
56. Hindmarch I, Shamsi Z, Stanley N et al. A double-blind, placebo- controlled investigation of the effects of fexofenadine, loratadine and promethazine on cognitive and psychomotor function. Br J Clin Pharmacol. 1999; 48: 200-6.
57. Bower EA, Moore JL, Moss M et al. The effects of single-dose fexofenadine, diphenhydramine, and placebo on cognitive performance in flight personel. Aviat Sp Environ Med. 2003; 74: 145-52.
58. Naclerio RM, Ansotegui IJ, Canonica GW et al. Twenty-five years: the fexofenadine clinical experience. World Allergy Organ J. 2024; 17: 100950.
59. Axelrod D, Bielory L. Fexofenadine hydrochloride in the treatment of allergic disease: a review. J Asthma Allergy. 2008; 1: 19-29.