Histamine is a key mediator in the development of
allergy symptoms, and oral H(1)-antihistamines are among the most widely used treatments for symptomatic relief in conditions such as
allergic rhinitis and
chronic urticaria.
Ebastine is a
second-generation antihistamine which has been shown to be an effective treatment for both seasonal and
perennial allergic rhinitis. In controlled clinical trials in adult and adolescent patients with
allergic rhinitis,
ebastine 10 mg once-daily improved symptoms to a significantly greater extent than placebo and to a similar extent as
loratadine 10 mg and
cetirizine 10 mg (both once-daily), while
ebastine 20 mg proved to be more effective than these two comparator
antihistamines. In addition,
ebastine was significantly more effective than placebo at relieving the symptoms of
chronic idiopathic urticaria.
Ebastine provides efficacy throughout the 24-h dosing interval with once-daily administration and clinical benefit is seen from the first day of treatment. Small studies have found beneficial effects for
ebastine in patients with other disorders, including
cold urticaria,
dermographic urticaria, atopic
asthma, mosquito
bites and (in combination with
pseudoephedrine) the
common cold. In addition to the regular
ebastine tablet, a fast-dissolving
tablet (FDT) formulation, which disintegrates in the mouth without the aid of a drink, is also available. It has been shown to be bioequivalent to the regular
tablet, and to be significantly more effective than
desloratadine at reducing
histamine-induced cutaneous wheals. A number of patient surveys demonstrated that the majority of individuals who tried the fast-dissolving formulation reported it to be convenient for use, fast-acting and preferred it to their previous
antihistamine medication. Perhaps most importantly, a large proportion of patients indicated that they would prefer to use this new formulation in the future.
Ebastine has a rapid onset of action and it can be administered once-daily, with or without food. Dose modifications are not needed in elderly patients, or in those with renal or mild to moderate hepatic impairment.
Ebastine is generally well-tolerated, and clinical studies showed that at usual therapeutic doses of 10 and 20 mg once-daily, it had no clinically relevant adverse effects on cognitive function and psychomotor performance or on cardiovascular function. In conclusion,
ebastine is an effective and generally well-tolerated treatment for
allergic rhinitis and
chronic idiopathic urticaria. In addition to the regular
tablet formulation,
ebastine is available as a FDT, providing a treatment option that is particularly convenient for patients.