Drug reference

Rupatadine

Second-generation H1 antihistamine with PAF antagonism · Antiallergic

Also known as Rupatadine fumarate

START

10 mg PO once daily

TYPICAL MAX

10 mg/day

STOP IF

Severe hypersensitivity (rare)

WATCH

Sedation (mild); QT-prolonging co-meds in at-risk patients

CDSCO approvedSchedule HATC R06AX28

Dose laddermg/d

Renal dose adjustmenteGFR mL/min/1.73m²

KDIGO 2024 + manufacturer label

Pharmacokineticsplasma · t hours

ONSET: 30min · absorption
PEAK: 45min · Tmax
t½: 6h · t½
DURATION: 1d · once-daily

EXCRETION

Mainly faecal; minor renal

route + CYP

INTERACTIONS

—

none in our sources

PREGNANCY

Limited data; use only if benefit outweighs risk.

FDA category + note

Mechanism

Selective peripheral H1-receptor antagonist with concurrent platelet-activating factor (PAF) receptor blockade — provides anti-allergic and anti-inflammatory effects; minimal CNS sedation at therapeutic doses.

Indications

Seasonal / perennial allergic rhinitis (≥2 y)Chronic urticaria (≥2 y)

Dosing

Adult: 10 mg PO once daily.
Pediatric: ≥2 y: 2.5 mg/day (10–24 kg); 5 mg/day (25–49 kg); 10 mg/day (≥50 kg) — once daily.
Renal adjustment: Limited data in significant impairment; caution.
Hepatic adjustment: Limited data in significant impairment; caution.
Geriatric: No specific adjustment; rare sedation.
Max dose: 10 mg/day

Pharmacokinetics

Onset

~30 min (symptom relief)

Peak effect

~45 min (Tmax)

Duration

~24 h

Half-life

~6 h (active metabolites longer)

Bioavailability

Well absorbed orally

Protein binding

~98%

Metabolism

Hepatic CYP3A4 (desloratadine is an active metabolite)

Excretion

Mainly faecal; minor renal

Contraindications

Hypersensitivity
Caution: QT prolongation risk factors (less than older antihistamines)

Side effects

Common

HeadacheSomnolence (mild)FatigueDry mouthNausea

Serious

QT prolongation (theoretical, not seen at therapeutic doses)
Severe hypersensitivity

Pregnancy & lactation

Pregnancy

Limited data; use only if benefit outweighs risk.

Lactation

Limited data; caution.

Drug interactions

Qt Prolonging Drugs

Moderate

Database

Additive QT effect (theoretical)

Caution in at-risk patients