Ask the Pharmacist
by Ron & Marla Chapleau

March 27, 2017


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Q) My allergies are starting to kick in and Iíve never really found an effective remedy in the past for them. Is there anything new on the market?

A) As the season finally changes to Spring and the grass and trees return from their dormant state, allergies also begin to resume their aggravating ways.

 There have long been a bevy of decent options available without a prescription that suit the needs of the majority of Canadians but there has always been a select few of us that have found none of the current options either particularly effective or too challenging to take due to side effects.

The good news is that there are now two new options available for these people to try. Blexten (bilastine) and Rupall (ruatadine) are the first new antihistamines released onto the Canadian market in 15 years. While they are more similar than not to the already available antihistamines, there will be some patients who find that one of these is a better choice for their particular needs.

One difference from the other options, with the exception of Reactine (cetirizine) in the 20mg dosage form, is that these two drugs both require a prescription.

This can be either a positive or a negative depending on the patient. On the negative side, it does require the time needed to see your doctor and therefore makes the price of a small trial of the drug (say a week or two to see if it is effective/ well tolerated) more expensive than buying an over the counter remedy such as Claritin, Aerius, Reactine or their generics.

On the positive side, many drug plans do not cover the over the counter (OTC) antihistamines because they do not legally require a prescription for purchase and they may well cover the costs of these two new entries.

For those who require antihistamine therapy right through until the fall, or in fact take it year round due to dust/ mould/ urticaria issues, the costs of these pills can add up when it comes straight out of the bank account.

As an aside, for those who need antihistamines on a long term basis, buying large quantities of any of the members of this class of drugs (Reactine, Claritin, Allegra and Aerius) is frequently cheaper on prescription than it is just grabbing them off the shelf.

This is because at a certain price point, the markup plus the taxes you pay can well exceed the dispensing fee for a particular drug, often by a significant margin. Added to this is that the money you spend on prescription drugs can be tax deductible if the totals meet the allowed threshold.

 If youíre not sure which the cheapest option is, ask your pharmacy and Iím sure they will be happy to advise you as to what is in your best financial interest.

As for the new drugs, Blexten is a once daily non sedating antihistamine approved for use in the treatment of allergies and urticaria in those patients who are 12 and over. Effectiveness seems to be equivalent to its competitors but its incidence of side effects seems to be a shade better than most of the others.

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While they are all considered non-drowsy, they all have the possibility of making you feel sluggish. However, Blexten is one of the least likely to (Reactine, particularly at the 20mg dose is the most sedating with one in five complaining of this effect) showing that roughly only 4 out of 100 people feel sleepy while taking it.

The only two agents that rank better with this sluggish side effect are Aerius and Allegra.

Other side effects are comparable in nature and frequency to the other drugs and include dizziness, headache, upset stomach and dry mouth that occur rarely.

The other advantage for Blexten is that those patients who also have some degree of liver dysfunction can safely take this drug since this organ is not necessary for the body to eliminate the drug.

Downsides include that it must be taken on an empty stomach (which is less convenient), should not be taken by those with heart rhythm abnormalities and has more interactions with other drugs than most of the other members of this drug which will preclude its use for some of us.

Rupall is also a once daily non-sedating antihistamine (although itsí incidence of sedation is 8% which is higher than Blexten). It comes in both a liquid and tablet dosage form and has been approved in those 2 and older for the same conditions as Blexten. Effectiveness and side effects are virtually indistinguishable from the others. It too should be avoided by those with arrhythmias and has even more potential drug interactions than Blexten which will need to be monitored for by your health professionals.

 Grapefruit consumption is not recommended for either of these two drugs which is a unique prohibition amongst the antihistamines.

Summing up, neither Blexten nor Rupall can be considered massive breakthroughs in the treatment of seasonal allergies but they are likely to be of benefit to some of us who have failed to find an effective solution to our symptoms thus far.


For more information about this or any other health related questions, contact the pharmacists at Gordon Pharmasave, Your Health and Wellness Destination in Port Elgin and Kincardine

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Monday, March 27, 2017