Indications

Rupatadine is indicated for the symptomatic treatment of Seasonal & Perennial Allergic Rhinitis and Urticaria.

Pharmacology

Rupatadine is a long-acting, non-sedative antagonist of histamine H1 receptors. It also antagonizes the platelet-activating factor (PAF). Both histamine and PAF cause bronchoconstriction which leads to an increase in vascular permeability and acts as a mediator in the inflammatory process. With the dual mode of action, Rupatadine shows a better therapeutic effect than an isolated antihistamine. Rupatadine possesses other anti-allergic properties such as the inhibition of the degranulation of mast cells induced by immunological and non-immunological stimuli and inhibition of the release of cytokines, particularly of the tumor necrosis factor-alpha (TNF α) in human mastocytes and monocytes.

Dosage & Administration

Adults and adolescents (over 12 years): The recommended dose is 10 mg once a day. Rupatadine may be taken with or without food.

Children aged 2 to 11 years:

• For children weighing 25 kg or more: 1 teaspoonful (5 ml) of the oral solution once daily with or without food.
• For children weighing equal or more than 10 kg to less than 25 kg: 1/2 teaspoonful (2.5 ml) oral solution once daily with or without food.

Interaction

With medicine: The concomitant administration of Rupatadine 20 mg and ketoconazole or erythromycin increases systemic exposure. Rupatadine should be used with caution when it is administered concomitantly with these drug substances and other inhibitors of the isozyme CYP3A4. Rupatadine should be used with caution when it is co-administered with statins, CNS depressants or alcohol.

With food: Grapefruit and Grapefruit juice should not be taken simultaneously with Rupatadine.

Contraindications

Hypersensitivity to Rupatadine or to any of the excipients.

Side Effects

Common: Asthenia, dizziness, drowsiness. Uncommon: Appetite increased, arthralgia, back pain, concentration impaired, constipation, cough, diarrhea, dry throat, epistaxis, fever, gastrointestinal discomfort, increased risk of infection, irritability, malaise, myalgia, nasal dryness, nausea, oropharyngeal pain, rash, thirst, vomiting, weight increased. Rare: Palpitations, tachycardia.

Pregnancy & Lactation

There is no clinical data available on the exposure of Rupatadine during pregnancy. Pregnant women should therefore not use Rupatadine unless the potential benefit outweighs the potential risk for the infant. No information is available, on whether Rupatadine is excreted in the mother’s milk. Therefore, it should not be used during lactation, unless the potential benefits for the mother justify the potential risk to the infant.

Precautions & Warnings

Rupatadine should be used with caution in patients with known prolongation of the QT interval, patients with uncorrected hypokalemia, and patients with ongoing proarrhythmic conditions, such as clinically significant bradycardia or acute myocardial ischemia. Rupatadine should be used with caution in elderly patients (65 years and older). As there is no clinical experience in patients with impaired kidney or liver function, the use of Rupatadine 10 mg tablets is at present not recommended in these patients.

Therapeutic Class

Non-sedating antihistamines

Storage Conditions

Store in a cool & dry place below 30°C, and protect from light & moisture. Keep out of reach of children.

Pharmaceutical Name

Ziska Pharmaceuticals Ltd.