Onset-of-action for antihistamine and decongestant combinations during an outdoor challenge.

Abstract

BACKGROUND:

Medications containing a combination antihistamine-decongestant are commonly used for allergic rhinitis yet onset-of-action comparisons for symptom relief after a single dose have not been performed.

OBJECTIVE:

To determine the onset of symptom relief and efficacy of antihistamine-decongestant medications (acrivastine-pseudoephedrine and loratadine-pseudoephedrine) compared with placebo in an outdoor park.

METHODS:

This study was conducted during the spring of 1997 using a double-blind, placebo-controlled design. Patients completed baseline rhinitis symptom diaries from 7:30 to 9:30 AM. Subjects with qualifying symptom scores received one dose of either acrivastine-pseudoephedrine, loratadine-pseudoephedrine, or placebo at 10:00 AM. Symptom diaries were recorded for the next 4 hours.

RESULTS:

Of 593 patients randomized to treatment, 592 were included in efficacy analysis. Acrivastine-pseudoephedrine and loratadine-pseudoephedrine demonstrated a mean onset-of-action by 45 and 30 minutes respectively for total symptom and rhinitis symptom scores for the five sites. Onset-of-action for nasal congestion scores was 45 minutes for both medications. Sites having higher pollen exposure (>100 pollen grains over 6 hours) demonstrated a difference between the antihistamine combinations: acrivastine-pseudoephedrine had an onset of action at 45 minutes for total symptom and rhinitis symptom scores, and 15 minutes for nasal congestion scores whereas loratadine-pseudoephedrine had onset-of-action for nasal congestion score of 105 minutes but failed to reach significance at any timepoint for total symptom and rhinitis symptom scores.

CONCLUSIONS:

Both antihistamine-decongestant combinations demonstrate an onset-of-action within 60 minutes of administration but under conditions of higher pollen exposure, the acrivastine combination was more effective for total symptoms, rhinitis symptoms, and nasal congestion with an onset-of-action within 45 minutes for rhinitis symptoms and 15 minutes for congestion.

• Authors: J W Georgitis, E O Meltzer, M Kaliner, J Weiler, R Berkowitz
• Journal: Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology (Ann Allergy Asthma Immunol) Vol. 84 Issue 4 Pg. 451-9 (Apr 2000) ISSN: 1081-1206 [Print] United States
• PMID: 10795655 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Air Pollutants
• Allergens
• Anti-Allergic Agents
• Drug Combinations
• Histamine H1 Antagonists
• Nasal Decongestants
• Triprolidine
• Loratadine
• acrivastine
• Ephedrine

Topics

• Adult
• Air Pollutants (immunology)
• Allergens (immunology)
• Anti-Allergic Agents (therapeutic use)
• Double-Blind Method
• Drug Combinations
• Ephedrine (therapeutic use)
• Female
• Histamine H1 Antagonists (therapeutic use)
• Humans
• Loratadine (therapeutic use)
• Male
• Nasal Decongestants (therapeutic use)
• Pollen (immunology)
• Rhinitis, Allergic, Seasonal (drug therapy, etiology)
• Time Factors
• Triprolidine (analogs & derivatives, therapeutic use)