No

Antihistamine

Temporary relief of nasal congestion, decongest sinus openings, running nose, itching of nose or throat, and itchy, watery eyes due to hay fever or other upper respiratory allergies

B

MAO inhibitor therapy within 14 days of initiating therapy, severe hypertension, severe coronary artery disease, hypersensitivity to pseudoephedrine, acrivastine (or other alkylamine antihistamines), or any component, renal impairment (Cl_cr <48 mL/minute)

Use with caution in patients >60 years of age; use with caution in patients with high blood pressure, ischemic heart disease, diabetes, increased intraocular pressure, GI or GU obstruction, asthma, thyroid disease, or prostatic hypertrophy; not recommended for use in children

>10%: Central nervous system: Drowsiness, headache

1% to 10%:

Cardiovascular: Tachycardia, palpitations

Central nervous system: Nervousness, dizziness, insomnia, vertigo, lightheadedness, fatigue

Gastrointestinal: Nausea, vomiting, xerostomia, diarrhea

Genitourinary: Dysuria

Neuromuscular & skeletal: Weakness

Respiratory: Pharyngitis, cough increase

Miscellaneous: Diaphoresis

<1%: Dysmenorrhea, dyspepsia

Symptoms of overdose include trembling, tachycardia, stridor, loss of consciousness, and possible convulsions

There is no specific antidote for pseudoephedrine intoxication, and the bulk of the treatment is supportive. Hyperactivity and agitation usually respond to reduced sensory input, however, with extreme agitation haloperidol (2-5 mg I.M. for adults) may be required.

Hyperthermia is best treated with external cooling measures, or when severe or unresponsive, muscle paralysis with pancuronium may be needed. Hypertension is usually transient and generally does not require treatment unless severe. For diastolic blood pressure >110 mm Hg, a nitroprusside infusion should be initiated. Seizures usually respond to diazepam I.V. and/or phenytoin maintenance regimens.

Decreased effect of guanethidine, reserpine, methyldopa, and beta-blockers

Increased toxicity with MAO inhibitors (hypertensive crisis), sympathomimetics, CNS depressants, alcohol (sedation)

Refer to Pseudoephedrine monograph; acrivastine is an analogue of triprolidine and it is considered to be relatively less sedating than traditional antihistamines; believed to involve competitive blockade of H₁-receptor sites resulting in the inability of histamine to combine with its receptor sites and exert its usual effects on target cells

Onset of action: Within 30 minutes

Duration: 12 hours

Absorption: Not affected by food

Protein binding: 50%

Metabolism: Hepatic to an active metabolite

Half-life: 1.4-2.5 hours

Elimination: Renal (65% eliminated unchanged)

Adults: 1 capsule 3-4 times/day

Drowsiness is common; may produce anxiety and insomnia

Hypertensive crisis may result with MAOI; effects of CNS depressants may be lessened

Use with caution since pseudoephedrine is a sympathomimetic amine which could interact with epinephrine to cause a pressor response

Up to 10% of patients could experience tachycardia, palpitations, and dry mouth; use vasoconstrictor with caution

Take as directed; do not exceed recommended dose. Avoid use of other depressants, alcohol, or sleep-inducing medications unless approved by prescriber. You may experience drowsiness or dizziness (use caution when driving or engaging in hazardous activity until response to drug is known); or dry mouth, nausea or vomiting (frequent small meals, frequent mouth care, chewing gum, or sucking lozenges may help). Report persistent dizziness, sedation, or agitation; chest pain, rapid heartbeat, or palpitations; difficulty breathing or increased cough; changes in urinary pattern; muscle weakness; or lack of improvement or worsening or condition. Breast-feeding precautions: Do not breast-feed.

Capsule: Acrivastine 8 mg and pseudoephedrine hydrochloride 60 mg

Brogden RN and McTavish D, "Acrivastine: A Review of Its Pharmacological Properties and Therapeutic Efficacy in Allergic Rhinitis, Urticaria, and Related Disorders," Drugs, 1991, 41(6):927-40.

Levien TL and Baker DE, "Reviews of Acrivastine and Midotrine," Hosp Pharm, 1995, 30(3):229-35.