From the FDA Drug Label
Directions • shake bottle well before use • measure only with dosing cup provided • do not use dosing cup with other products • dose as follows or as directed by doctor adults and children 12 years of age and over 10 mL every 12 hours, not to exceed 20 mL in 24 hours children 6 to under 12 years of age 5 mL every 12 hours, not to exceed 10 mL in 24 hours children 4 to under 6 years of age 2.5 mL every 12 hours, not to exceed 5 mL in 24 hours children under 4 years of age do not use The maximum dose for Blexten is:
- 20 mL in 24 hours for adults and children 12 years of age and over 1
- 10 mL in 24 hours for children 6 to under 12 years of age 1
- 5 mL in 24 hours for children 4 to under 6 years of age 1
From the Research
The maximum recommended dose of Blexten (bilastine) is 20 mg once daily, but it can be safely used at doses of up to fourfold higher than standard dosage (80 mg once daily) as a second-line treatment option for urticaria, as specified in international guidelines. This antihistamine medication is typically used to treat allergic rhinoconjunctivitis and urticaria in adults and children weighing 20 kg or more. The standard 20 mg daily dose should not be exceeded without consulting a healthcare provider, as higher doses have not been shown to provide additional clinical benefit and may increase the risk of side effects 2. Blexten should be taken on an empty stomach, at least one hour before or two hours after a meal, as food can decrease its absorption and effectiveness. The medication works by blocking histamine H1 receptors, preventing the allergic response without causing significant sedation due to its limited ability to cross the blood-brain barrier. Patients with severe renal impairment should use caution with this medication. If symptoms persist despite taking the maximum dose, patients should consult their healthcare provider rather than increasing the dose beyond recommendations.
Some key points to consider when using Blexten include:
- The medication is generally well tolerated, even at supratherapeutic doses, and has a low potential for drug-drug interactions 2.
- Bilastine has demonstrated similar efficacy to cetirizine and desloratadine in patients with seasonal allergic rhinitis, and a potentially longer duration of action than fexofenadine in patients with asymptomatic seasonal allergic rhinitis 2.
- The medication has also shown significant efficacy and safety in the long-term treatment of perennial allergic rhinitis, and can be safely used at doses of up to fourfold higher than standard dosage (80 mg once daily) as a second-line treatment option for urticaria 2.
- More recent studies have confirmed the safety and efficacy of bilastine in children with allergic rhinoconjunctivitis or urticaria, with a recommended dose of 10 mg/day for children aged 6 to <12 years 3.
Overall, Blexten is a suitable option for the treatment of patients with allergic rhinoconjunctivitis or urticaria, and can be used at doses of up to 80 mg once daily as a second-line treatment option for urticaria, as specified in international guidelines. However, patients should always consult their healthcare provider before exceeding the standard recommended dose of 20 mg once daily.