Second-Generation
Generic Antihistamines:
Safe, Effective, and Affordable
When determining which antihistamine to prescribe to your patients, often
drug efficacy and cost are principal considerations. Research indicates that
there is no clinically significant difference between antihistamines.1, 2
Safe and Effective
Consumer Reports1 conducted an analysis on second-generation
antihistamines Allegra® (fexofenadine), Clarinex® (desloratadine), Claritin®
(loratadine) and Zyrtec® (cetirizine). Results indicated:
n They do not differ consistently in effectiveness, safety or side effects profile.
n They all bring relief in one to three hours and continue to work for 12 to 24
hours in most people.
n All four of the newer antihistamines cause less sedation and drowsiness
than older antihistamines.
n None of the four can be said to be consistently less sedating than the others.
Affordable
n OTC loratadine is not covered under most prescription drug benefits.
However, in most cases, patient out-of-pocket cost for OTC loratadine is less
than one copayment amount for a generic antihistamine.
n OTC loratadine is a low-cost generic available without a prescription.
www.excellusbcbs.com
A nonprofit independent licensee of the BlueCross BlueShield Association
n Prescription fexofenadine (generic Allegra®) is available as a generic, but at
higher cost than OTC loratadine.
n Consumer Reports1 has designated OTC loratadine as a Best Buy in this category based on efficacy, safety, dosing, and cost.
Brand vs. Generic Antihistamines Average Cost Per Months
$100
$90
$80
$70
$60
$50
$40
$30
$20
$10
$0
$90
$90
$73
$55
$29
$3 - 11
Allegra
180mg
Clarinex
5mg
s
Zyrtec
10mg
fexofenadine
180mg
OTC
Claritin
10mg
OTC
loratadine
10mg
Average cost/month: 3/06 Medispan (average wholesale price for brands and
approximate discounted reimbursement rate for generic and OTC)
Continued on back.
Tips To Help Your Patients
For patients who need an antihistamine, consider:
n OTC loratadine 10mg – generic (various store brands)
n If OTC loratadine is not effective – fexofenadine (generic Allegra)
n Intranasal steroids for severe allergic rhinitis symptoms (with OTC
loratadine), if appropriate.
When converting existing users:3
Patient’s Daily Dose:
Consider Prescribing
Zyrtec 10 mg
OTC loratadine 10 mg or fexofenadine 180 mg
Allegra 180 mg
OTC loratadine 10 mg or fexofenadine 180 mg
Clarinex 5 mg
OTC loratadine 10 mg
If you have any questions about this information, please call the FLRx Drug
Information Service line at 1-877-777-2737 or email your questions to
[email protected].
References
1. Treating Allergies, Hay Fever, and Hives: The Antihistamines. Consumer Reports Best Buy DrugsTM.
www.CRBestBuyDrugs.org.
2. Chandler, C. Drug Class Review on Second Generation Antihistamines, Final Report, November, 2004.
(http://www.ohsu.edu/drugeffectiveness/reports. Drug Effectiveness Review Project - Oregon Health Science
University).
3. Micromedex
B-1920