Rupatadine

Rupatadine
ATC Code R06AX28
Formula C26H26ClN3
Molar Mass (g·mol−1) 415,97
Physical State solid
Melting Point (°C) 58–61
CAS Number 158876-82-5
PUB Number 133017
Drugbank ID DB11614

Basics

Rupatadine is an active substance from the group of H1-antihistamines(selective histamine H1 receptor antagonist) and an inhibitor (antagonist) of platelet-activating factor (PAF) used for the symptomatic treatment of hay fever (allergic rhinitis).

Indications and use

Rupatadine is a second-generation H1-antihistamine and chemically belongs to azines. It is used for symptomatic relief of the nasal and non-nasal symptoms of seasonal allergic rhinitis and perennial allergic rhinitis in patients 2 years of age and older. In addition, it is also used for the symptomatic relief of chronic spontaneous urticaria.

Usually, rupatadine is used in the form of tablets when used for adults and as a juice when used for children. Standard dosages are 10 mg in tablets and 1 mg/ml in oral solution.

Rupatadine is dispensed only against a doctor's prescription.

History

The initial synthesis, preclinical and clinical development of rupatadine was carried out by GRUPO J. URIACH, S.L, a Spanish pharmaceutical company. It was launched in Spain in 2003 under the brand name Rupafin.

Pharmacology

Pharmacology and mechanism of action

Rupatadine is a drug with a dual mechanism of action. On the one hand, rupatadine blocks H1-receptors, preventing histamine from binding to them, and on the other hand, it inhibits the platelet activating receptor (PAF). In an allergic reaction, mast cells degranulate and release histamine and other substances. Histamine acts on H1-receptors and causes symptoms such as nasal congestion, rhinitis, itching and swelling. PAF is formed from phospholipids that are cleaved by phospholipase A2. It causes blood vessels to become more permeable, contributing to nasal discharge and nasal congestion. By blocking both the H1-receptor and the PAF receptor, rupatidine prevents these mediators from exerting their effects, thereby reducing the severity of allergic symptoms.

Pharmacokinetics

Rupatidine is rapidly absorbed and reaches maximum plasma concentration after approximately one hour. Administration with a high-fat meal may increase absorption. Rupatidine is 99% bound to plasma proteins in the blood. Rupatadine is metabolized by oxidation mediated primarily by CYP3A4 in the liver. CYP2C9, CYP2C19, and CYP2D6 are also involved to a lesser extent. The half-life in adults is approximately 6 hours. In children, this can be significantly longer at 10 -15 hours.

Drug Interactions

Interactions may occur, especially when taken concomitantly with substances that inhibit or induce the CYP3A4 enzyme. These include:

  • Ketoconazole, Voriconazole
  • Grapefruit juice
  • erythromycin and related substances
  • Drugs from the statin group

Toxicity

Contraindications

If allergy to rupatadine is known, its use is strictly contraindicated.

Side effects

Since Rupatadine is a second-generation antihistamine, it does not actually have a soporific (sedative) effect. However, there are cases in which the occurrence of drowsiness has been reported as a side effect. However, controlled studies have shown that there is no difference here compared to a placebo administered.

Other possible side effects are:

  • Headache
  • Fatigue
  • Dry mouth
  • Nausea
  • abdominal pain
  • Vomiting
  • Gastrointestinal discomfort
  • muscle and joint pain
  • fever
  • Weight gain
  • Cough
  • Nosebleeds

Pregnancy and breastfeeding

Before taking during pregnancy or breastfeeding, a physician should be contacted, if possible, who will weigh the risk-benefit ratio.

Markus Falkenstätter

Markus Falkenstätter
Author

Markus Falkenstätter ist Autor zu pharmazeutischen Themen in der Medizin-Redaktion von Medikamio. Er befindet sich im letzten Semester seines Pharmaziestudiums an der Universität Wien und liebt das wissenschaftliche Arbeiten im Bereich der Naturwissenschaften.

Mag. pharm Stefanie Lehenauer

Mag. pharm Stefanie Lehenauer
Lector

Stefanie Lehenauer ist seit 2020 freie Autorin bei Medikamio und studierte Pharmazie an der Universität Wien. Sie arbeitet als Apothekerin in Wien und ihre Leidenschaft sind pflanzliche Arzneimittel und deren Wirkung.

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The contents shown do not replace the original package insert of the medicinal product, especially with regard to dosage and effect of the individual products. We cannot assume any liability for the correctness of the data, as the data was partly converted automatically. A doctor should always be consulted for diagnoses and other health questions. Further information on this topic can be found here.