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Bilastine: a new H 1 ‐antihistamine with an optimal profile for updosing in urticaria
Author(s) -
Church M.K.,
Labeaga L.
Publication year - 2017
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.14305
Subject(s) - antihistamine , medicine , somnolence , guideline , sedation , dermatology , pharmacology , anesthesia , adverse effect , pathology
This review set out to examine published papers detailing the efficacy of bilastine in skin models and urticaria to assess whether it meets the optimal profile for updosing in urticaria, that is, strong clinical efficacy and freedom from unwanted side effects, particularly sedation. Bilastine is a highly effective H 1 ‐antihistamine even when used at the basic dose of 20 mg daily. Its facilitated uptake after oral dosage gives it a rapid onset and long duration of action. In both wheal and flare studies and in urticaria updosing fourfold showed increased effectiveness. With respect to somnolence, bilastine is a substrate for P‐glycoprotein, a membrane pump which prevents it crossing the blood–brain barrier. Consequently, bilastine is a practically ‘non‐sedating’ H 1 ‐antihistamine. In conclusion, the excellent profile of bilastine in both efficacy and safety make it the ideal H 1 ‐antihistamine for updosing the daily dose fourfold in difficult‐to‐treat urticaria as recommended by the EAACI/GA 2 LEN/EDF/WAO guideline for the management of urticaria.