acrivastine + pseudoephedrine hydrochloride: clinical use

Prescribing considerations

• Confirm that congestion accompanies allergic rhinitis and review all combination cold, allergy and decongestant products.
• The selected product is not recommended in children under 12 or older people.
• Use caution with moderate renal impairment or severe hepatic impairment.
• Assess urinary outflow symptoms, prostatic enlargement, thyroid disorders and occlusive vascular disease.
• Counsel about sedation, cardiovascular effects and the neurological warning symptoms associated with pseudoephedrine.

Contraindications and cautions

• Hypersensitivity to acrivastine, pseudoephedrine, triprolidine or an excipient
• Cardiovascular disease, including hypertension
• Beta-blocker treatment
• Other sympathomimetic decongestants
• Diabetes mellitus
• Phaeochromocytoma
• Closed-angle glaucoma
• Hyperthyroidism
• Severe acute or chronic kidney disease or renal failure
• Current monoamine oxidase inhibitor treatment or use within the preceding 14 days
• Significant renal impairment

Monitoring

• Check cardiovascular and renal suitability before supply or prescribing.
• Review persistent palpitations, raised blood pressure, urinary retention or marked CNS stimulation.
• Stop treatment and assess urgently for thunderclap headache, neurological or visual symptoms, ischaemic chest or abdominal symptoms, or severe skin reactions.

Clinical pharmacology

Acrivastine is a competitive H1-receptor antagonist with little anticholinergic activity and low central nervous system penetration. Pseudoephedrine is a direct and indirect sympathomimetic decongestant. Renal excretion is the principal elimination route for both components.

Formulation and product differences

• The selected formulation is an oral capsule containing lactose monohydrate and gelatin.
• It is essentially sodium-free but is unsuitable for people with certain rare hereditary disorders affecting galactose or lactose handling.
• The capsule shell contains titanium dioxide and Patent Blue V.