Can a patient switch from Allegra D (fexofenadine and pseudoephedrine) to Allegra (fexofenadine) for allergy management?

Switching from Allegra D to Allegra for Allergy Management

Yes, a patient can safely switch from Allegra D (fexofenadine with pseudoephedrine) to Allegra (fexofenadine alone) for allergy management without any concerns. 1, 2

Understanding the Difference Between Products

• Allegra D contains two active ingredients: fexofenadine (an antihistamine) and pseudoephedrine (a decongestant) 3
• Regular Allegra contains only fexofenadine, which treats allergy symptoms like sneezing, rhinorrhea, itchy nose/palate/throat, and itchy/watery/red eyes 2
• Pseudoephedrine in Allegra D specifically targets nasal congestion, which fexofenadine alone has limited effect on 4

Benefits of Switching to Allegra (Fexofenadine Only)

• Fexofenadine is a second-generation antihistamine that does not cause sedation at recommended doses and has minimal side effects compared to placebo 1, 2
• Eliminating pseudoephedrine removes potential side effects such as insomnia, irritability, palpitations, and elevated blood pressure that can occur with decongestants 1
• Fexofenadine is particularly beneficial for elderly patients with cardiovascular issues due to its favorable safety profile and lack of cardiovascular concerns 5

When to Consider Switching

• Switch to Allegra alone when nasal congestion is no longer a predominant symptom 1, 4
• Consider switching if experiencing side effects from the pseudoephedrine component of Allegra D, such as insomnia or elevated blood pressure 1
• Patients with controlled hypertension or cardiovascular issues may benefit from switching to fexofenadine alone 5

Important Considerations When Switching

• No tapering or waiting period is required when switching from Allegra D to Allegra - the change can be made immediately 2, 6
• The fexofenadine component remains the same, so allergy symptom control for sneezing, itching, and rhinorrhea will continue 2, 6
• Be aware that nasal congestion may worsen after switching, as you're removing the decongestant component 4

Dosing Recommendations

• Standard dosing for Allegra (fexofenadine) is 60 mg twice daily or 180 mg once daily for adults with seasonal allergic rhinitis 2, 6
• For chronic idiopathic urticaria, the recommended dose is 180 mg once daily 2
• Take Allegra with water, and avoid taking it with fruit juices like grapefruit, orange, or apple, as they can reduce bioavailability 2

Potential Pitfalls to Avoid

• Do not take Allegra close in time with aluminum and magnesium-containing antacids, as they can decrease fexofenadine absorption by up to 41% 2
• Be aware of potential drug interactions with erythromycin or ketoconazole, which can increase plasma concentrations of fexofenadine 2
• If nasal congestion becomes problematic after switching to Allegra alone, discuss with your healthcare provider about possibly adding a different decongestant or using an intranasal corticosteroid 1

Alternative Options for Nasal Congestion

• If nasal congestion persists after switching to Allegra alone, intranasal corticosteroids are typically the most effective medication for controlling all symptoms of allergic rhinitis, including congestion 1
• Short-term use of topical decongestants (no more than 3 days) can help with acute nasal congestion, but prolonged use risks rhinitis medicamentosa (rebound congestion) 1
• Nasal saline irrigation can provide some relief for nasal symptoms without medication-related side effects 1