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Table 1 Safety profile of representative second generation H1 antihistamines indicated for urticaria in children.

From: The safety and tolerability profile of bilastine for chronic urticaria in children

 

Bilastine

Cetirizine

Desloratadine

Fexofenadine

Levocetirizine

Loratadine

Rupatadine

Properties

 Paediatric indication

Yes

Yes

Yes

Yes

Yes

Yes

Yes

 T1/2 (h)

14.5, any age

10, in adults

6.1–7.1, in children over 4 years

5.5, in children under 4 years

27, any age

11–15, any age

7.9, in adults

In children 6–11 years 24% shorter than in adults

8.4, any age

5.9 in adults

15.9, in children 2–5 years

12.3, in children 6–11 years

 Dosage adjustment in impaired kidney function

No

In moderate to severe

In severe impairment

No

In moderate to severe

No

Not recommended in renal impairment

 Dosage adjustment in impaired hepatic function

No

If concomitant renal dysfunction

Not mentioned

No

If concomitant renal dysfunction

In severe disease

Not recommended in hepatic impairment

 Interaction with food

Yes, give on empty stomacha

No

No

Not mentioned

No

No

With grapefruit

 Clinically relevant drug interactions

No

No

No

Yes, antacids

No available data

Potential (with inhibitors of CYP3A4 and CYP2D6)

Yes, with CYP3A4 inhibitors

 Lack of sedative potential

Yes (caution, drowsiness)

Yes (in adult, check drug response when intending to drive)

Yes (caution, drowsiness)

Yes (impairment is unlikely)

Yes (in adult, check drug response when intending to drive)

Yes (caution, drowsiness)

Yes (caution, drowsiness)

 Contraindications (except hypersensitivity)

None

Severe renal impairment

None

None

Severe renal impairment

None

None

  1. aPharmacokinetic interaction of bilastine with food does not imply a significant reduction of its peripheral antihistaminic efficacy [43]