Allegra (Fexofenadine) Dosing Guidelines
The recommended dose of Allegra (fexofenadine) for adults and children 12 years and older is 60 mg twice daily or 180 mg once daily with water for seasonal allergic rhinitis and chronic idiopathic urticaria. 1
Adult and Adolescent Dosing (≥12 years)
Seasonal Allergic Rhinitis and Chronic Idiopathic Urticaria:
- 60 mg twice daily OR
- 180 mg once daily 1
Patients with Decreased Renal Function:
- Starting dose: 60 mg once daily 1
Pediatric Dosing (6-11 years)
Seasonal Allergic Rhinitis and Chronic Idiopathic Urticaria:
- 30 mg twice daily 1
Children with Decreased Renal Function:
- Starting dose: 30 mg once daily 1
Administration Considerations
- Take with water
- Can be taken with or without food
- Once-daily dosing (180 mg) has been shown to be as effective as twice-daily dosing (60 mg twice daily) and may improve patient compliance 2
- Morning dosing is typically used in clinical trials for once-daily regimens 2
Efficacy and Safety Profile
- Fexofenadine has a safety profile similar to placebo in clinical trials 3
- Both 120 mg and 180 mg once-daily doses are effective for seasonal allergic rhinitis, with the 180 mg dose showing a trend toward greater symptom relief 2
- Onset of action occurs within approximately 60 minutes after administration 4
- Unlike some other antihistamines, fexofenadine is truly non-sedating, showing no dose-related increase in sedation even at high doses 3
Quality of Life Impact
- Once-daily fexofenadine (120 mg or 180 mg) significantly improves patient-reported quality of life and reduces performance impairment in work and daily activities compared to placebo 5
Common Side Effects
- The incidence of adverse events with fexofenadine is similar to placebo (approximately 30%) 2
- Headache is the most commonly reported adverse event (8.9% vs 7.5% for placebo) 2
- Unlike some other antihistamines, fexofenadine does not cause significant drowsiness or fatigue 6
Clinical Pearls
- Fexofenadine does not impair driving or psychomotor performance 3
- No clinically significant drug interactions have been identified 3
- No dosage adjustment is needed based on age alone
- For patients who prefer once-daily dosing, the 180 mg formulation provides 24-hour symptom relief 6
Contraindications and Precautions
- Use with caution in patients with renal impairment (dose adjustment recommended)
- Safe for use in elderly patients without dosage adjustment based on age alone 3