Pamster and others Allergy "meds"

[Isabelle]

From University of Wisconsin Hospital and Clinics,directly from Lorna Goshman, RPh,CSPI, clinical pharmacist in the Center for Drug Policy and Clinical Economics, etc,etc,etc, etc.......and etc.
She writes: ..."Allegra and Zyrtec. Both are active metabolites of well-known parents drugs and both are advertised as to consumers as therapeutics advances in allergy treatment. The advertising is misleading. In fact, Allegra was developed to replace a more toxic parent, Seldane".

She explains just to get "virtual extensions of the parent drugs", but the problem is that the "new" med Allegra is 180mg higher. If at 60mg Seldane was questionable effective the higher dose of 180mg in Allegra "has been associated with QT prolongation and polymorphic ventricular tachicardia,the problem that caused withdrawal of Seldane from the market".

QT prolongation and ventricular tachicardia has been associated with sudden death among children.

Just google her name Lorna Goshman New Drugs for more information.

[matika]

OMG
:mad:

[Pamster]

Wow! THanks for posting this ISabelle! :eek: :mad:

[mrsdoubtfyre]

Allegra comes in several doses.

Allegra 30mg for younger patients or those who don't weigh much, immediate release.

Allegra 60mg is immediate release.

Allegra 180 is a once a day long acting med, in a sustained acting matrix.

To the best of my knowledge, fexofenadine does not prolong QT. Its parent terfenadine (Seldane) did only in combination with erythromycin and antifungal drugs. Terfenadine was taken off the market in USA, but some countries of Europe still sell it. What is alarming is that after 10 yrs RX it almost made it OTC here! WHEW.

Here is a link to the most recent list of drugs that have been reported:

http://www.torsades.org/medical-pros/drug-lists/list-01.cfm
Just click on 2 or 3 or 4 for the complete list.

You can also read more here:
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1767957
but it is pretty complex.

[Pamster]

Thanks Mrs.Doubtfyre. I appreciate the information you shared. I wonder if Allegra would be a good choice for him, the paradoxical reactions he's had have been to Singular and the other med I can't spell right, Hydroxyine HCL I think is the name...He has like no inhibitions and is aggressive and restless, still, I think the abilify isn't working so well anymore and I expect us to be on the med trial and error roller coaster again really soon...*sigh*

[mrsdoubtfyre]

is a neurotransmitter in the brain.

The first generation antihistamines are lipophilic --meaning they cross the blood brain barrier and get into that neurotransmitter system. This is why they have side effects and affect movement (they can be used in dystonias that arise from antipsychotic drug use).

The second generation antihistamines like Allegra and Claritin, do not cross and therefore do not affect brain function much. However, they are not really good at blocking allergy symptoms IMO.

Now Singulair...is not an antihistamine. It is a leukotriene B4 blocker. This is a inflammatory cytokine that begins the histamine release cycle in the body.
I have not met anyone who showed psychiatric signs/side effects from Singulair.
Distribution: Montelukast is more than 99% bound to plasma proteins. The steady-state volume of distribution of montelukast averages 8 to 11 L. Studies in rats with radiolabeled montelukast indicate minimal distribution across the blood-brain barrier. In addition, concentrations of radiolabeled material at 24 hours postdose were minimal in all other tissues.
from http://www.rxcarecanada.com/Singulair.asp?prodid=0&drug=Singulair

I am curious...what effects did Singulair have on your child?

I've been using it for 3 yrs now, and I find it far superior to Claritin (which I think is useless) or Allegra (which was moderate, but almost useless too).
Singulair also helps my ears which tend to get alot of fluid in them. I think it is great for this. It is also being used in larger doses to prevent certain types of cluster headache (but this is still off label and experimental).

[Pamster]

He was restless, agitated and aggressive, moreso then usual and it was only attributeable to the singular and that hydroxyine HCL. It is still going on too even though the drug is out of his system, the dr called it a paradoxial reaction, and sadly he's just going to have to go with allergies because we can't have this it's been unbearable. :(

[mrsdoubtfyre]

Hydroxyzine (Atarax) is one of the most potent and sedating of the
first generation antihistamines. I can understand a reaction like you describe
to it. It is even used as a tranquilizer some times.

The other (Singulair) is very puzzling. Allergies in general make kids rather "nuts" IMO.
My son used to get really difficult when his ears plugged up.

[Pamster]

I can't tell if it's just allergies bothering him or what but singular seems to make him hyper and the aggression and agitation seem to just be the way things are now after that Hydroxyine HCL and it had NO sedating effect on my son whatsoever. But he's days of feither med and still has trouble with aggression and agitation, I think his abilify isn't working anymore for him so we're going to be back on the roller coaster of trying and seeing what will work...*sigh* I am so not looking forward to this at all. :(

[tgrimes]

Pamster - just wondering if you ever try taking you son's new meds yourself for a couple of days to check for adverse reactions... that can help weed out some of the ones that will cause trouble.

[Isabelle]

abilify is a major tranquilizer, a atypical antipsychotic, with time loses effectiveness, sometimes interact with other drugs like anti allergies drugs which also block some neurotransmitters to increase sleepiness or restlessness (akathisia)
polypharmacy or taking more than 2 drugs cause many times a reaction, see if you can reduce his drugs to just one, the brain adjust better to one, best is to be drug-free if you can.

[Pamster]

Sadly I don't think we can go drug free he's just too aggressive Isabelle, we're waiting and hoping after puberty that he will be better able to cope with the world around him and no longer need drugs other then seizure meds should he still have seizures...He's not taking anything for allergies now, almost a week now. :) Things are better today, he's not being rambunctious or anything, but school is still going to be a problem, he's not doing well and hasn't for the past few weeks. :(

[mrsdoubtfyre]

like hydroxyzine or Benadryl, the larger the paradoxical reaction would be if there were going to be one.

There are non drug things you can do for allergy.
Grapeseed extract is one, quercetin another. These are antioxidants and do
work for some. Both are derived from food.

[Isabelle]

Sadly I don't think we can go drug free he's just too aggressive Isabelle, we're waiting and hoping after puberty that he will be better able to cope with the world around him and no longer need drugs other then seizure meds should he still have seizures...He's not taking anything for allergies now, almost a week now. :) Things are better today, he's not being rambunctious or anything, but school is still going to be a problem, he's not doing well and hasn't for the past few weeks. :(

<<<<<hugs, huge hugs>>>>>>