Allegra (Fexofenadine) for Runny Nose
Yes, Allegra (fexofenadine) is effective for treating runny nose (rhinorrhea) associated with allergic rhinitis, but has limited effectiveness for runny nose caused by non-allergic conditions. 1, 2
Effectiveness for Allergic Rhinitis Symptoms
- Fexofenadine is FDA-approved for relief of symptoms associated with seasonal allergic rhinitis, including rhinorrhea (runny nose), sneezing, and itchy nose/palate/throat 2
- Oral antihistamines like fexofenadine are generally effective in reducing rhinorrhea, sneezing, and itching associated with allergic rhinitis 1
- Fexofenadine has a rapid onset of action (within 2 hours) and long duration, making it suitable for once-daily administration 3
- Clinical trials have demonstrated that fexofenadine significantly reduces rhinorrhea compared to placebo in both adults and children with seasonal allergic rhinitis 4, 3
Advantages of Fexofenadine Over Other Antihistamines
- Fexofenadine is a second-generation antihistamine that does not cause sedation at recommended doses, unlike first-generation antihistamines 1
- Among second-generation antihistamines, fexofenadine, loratadine, and desloratadine do not cause sedation at recommended doses, while cetirizine may cause sedation 1
- Fexofenadine does not cross the blood-brain barrier and is free of sedative effects even at dosages up to 240 mg/day 3
- Unlike some other antihistamines, fexofenadine does not inhibit cardiac K+ channels and is not associated with QT interval prolongation 3
Limitations for Nasal Symptoms
- Oral antihistamines like fexofenadine have little objective effect on nasal congestion compared to their effect on rhinorrhea 1
- For patients with significant nasal congestion, combination therapy with a decongestant may be more effective 1
- Antihistamines have a limited role in treating non-allergic rhinitis syndromes 1
- Intranasal corticosteroids are typically more effective than oral antihistamines for controlling all nasal symptoms, including rhinorrhea 1
Dosing Considerations
- For adults and children 12 years and older: 60 mg twice daily or 180 mg once daily 3, 5
- For children 6-11 years: 30 mg twice daily has been shown to be effective and safe 6, 4
- Continuous treatment is more effective than intermittent use for seasonal or perennial allergic rhinitis 1
When Fexofenadine May Not Be Sufficient
- For patients with predominant nasal congestion, adding a decongestant may be beneficial 1
- For patients who remain symptomatic after treatment with fexofenadine, intranasal antihistamines like azelastine may provide additional relief 7
- For more severe allergic rhinitis, intranasal corticosteroids are typically the most effective medication class 1
- For non-allergic rhinitis with rhinorrhea, intranasal anticholinergics may be more effective than oral antihistamines 1
Safety Profile
- Fexofenadine has a safety profile similar to placebo in clinical trials 3
- The most common adverse event is headache, occurring at a similar rate to placebo 3
- Unlike first-generation antihistamines, fexofenadine does not cause significant performance impairment or anticholinergic effects 1
Remember that while Allegra is effective for runny nose caused by allergic triggers, it may not help with runny nose from other causes such as viral infections, vasomotor rhinitis, or gustatory rhinitis 1.