Brand Names: Blexten

Routes: 10 or 20mg tab, 2.5mg/ml liq (uncommon)

MoA: 2nd gen H1 receptor antagonist

Half-life: ~15 hours

Time to peak action: ~1h, rapid absorption

Doses:

• CSU, AR:
  • 20mg PO OD to QID (ages ≥12)
  • 10mg PO OD to QID (ages 4-11)

Cost: ~$1.1 CAD / 20mg tab (ON)

Coverage: ON (ODB)

Age Group: ages ≥4

Pregnancy: Avoid (not enough data)

Contraindications: Hypersensitivity, QT prolongation or history of torsades

Common SEs: QT prolongation (at 100mg ODx4, max mean increase 6ms); drowsiness/headache ~4%[D], ~3%[P]; abdo pain 3%[D], 3%[P]

Severe SEs: Torsades (extremely rare; only 1 case reported in monograph post-market reactions)

Monograph Links:

• Bilastine (2021 - 1)

Brand Names: Reactine, Allacan

Routes: 20mg tab (Rx), 5 or 10mg tab (OTC)

MoA: 2nd gen H1 receptor antagonist

Half-life: ~8 hours

Time to peak action: ~1 hour

Doses:

• CSU, AR:
  • 10mg OD to QID (ages ≥12)
  • 5mg OD (ages ≥12; 'moderate hepatic or renal impairment')

Cost: ~$0.40 CAD / 10mg tab (ON)

Coverage: ON (ODB)

Age Group: ages ≥12

Pregnancy: Generally considered safe in pregnancy

Contraindications: CrCl <10ml/min,

Common SEs: For the 20mg OD: Drowsiness 24%[D], 8%[P]; fatigue 7%[D], 2.5%[P]; dry mouth 8%[D], 1.5%[P]

Severe SEs: <1% and rare: see monograph

Monograph Links:

• Cetirizine (2025 - 1)
• Cetirizine (2018 - 1)

Brand Names: Aerius, Clarinex

Routes: 5mg tab, 0.5mg/ml liq

MoA: 2nd gen H1 receptor antagonist

Half-life: ~27 hours

Time to peak action: Max serum conc in 3 hours

Doses:

• CSU, AR:
  • 5mg OD to QID (ages ≥12)
  • 2.5mg liq OD to QID (ages 6-11)
  • 1.25mg liq OD to QID (ages 2-5)

Coverage: ON (None on ODB)

Age Group: ≥12 tablet, ≥2 liq

Pregnancy: Avoid (limited data) for pregnancy and breast-feeding

Contraindications: Hypersensitivity

Common SEs: Tab: Fatigue 1.8%[D], 0.6%[P]; headache 4.5%[D], 4%[P], drowsiness 2%[D], 2%[P]. Liq: only 2/115 S/E reported (headache/rash).

Severe SEs: Extremely rarely: anaphylaxis, seizure, liver enzyme elevation

Monograph Links:

• Aerius (2019 - 1)
• Desloratadine (2018 - 1)
• Desloratadine (2023 - 1)

Brand Names: Allegra

Routes: 60 or 120mg tab

MoA: 2nd gen H1 receptor antagonist

Half-life: ~11-16 hours

Time to peak action: Rapid absorption, max serum conc at ~2.5h

Doses:

• CSU, AR:
  • 60mg BID
  • 120mg OD to QID (up to QID for CSU)
  • 60mg OD (CrCl<40)

Cost: ~$0.80 CAD / 120mg tab at Shoppers (2025) (ON)

Coverage: ON (None)

Age Group: ages ≥12

Pregnancy: Not recommended, due to lack of data

Contraindications: Hypersensitivity to drug or components

Common SEs: Drowsiness, nausea, fatigue 1%[D], 1%[P]; headache 3%[D], 3%[P]

Severe SEs: One case of CHF and atrial fibrillation, post-market

Monograph Links:

• Fexofenadine (2021 - 1)

Brand Names: Claritin, Alavert

Routes: 10mg tab (generic), 5mg tab, 1mg/ml liq

MoA: 2nd gen H1 receptor antagonist

Half-life: 7.8-11 hours (half life of active metabolite descarboethoxyloratadine is 17-24h)

Time to peak action: Rapid onset, ~1-2h

Doses:

• CSU, AR:
  • 10mg OD to QID (ages ≥6)
  • 5mg OD to QID (ages 2-6)
  • 5mg OD or 10mg q48h (>30kg; if severe liver impairment)
  • 5mg q48h (≤30kg; if severe liver impairment)

Cost: ~$0.6 CAD / 10mg tab (ON)

Coverage: ON (ODB)

Age Group: ages ≥2

Pregnancy: Safe as per ACOG and firstexposure

Contraindications: Hypersensitivity

Common SEs: Fatigue 4%[D], 4%[P]; headache 8%[D], 6%[D]; drowsiness 8%[D], 6%[P]

Severe SEs: Extremely rare and all post-market: anaphylaxis, hepatic dysfunction, palpitations

Monograph Links:

• Loratadine (2017 - 1)
• Claritin (2020 - 1)

Brand Names: Nasonex, Sinuva

Routes: nasal spray (50mcg)

MoA: Steroid, topical

Half-life: ~5.8 hours

Time to peak action: While monograph says ~12 hours, maximal effect requires 2-4 weeks of use

Doses:

• AR:
  • 1-4 sprays (50mcg per spray) EN OD (ages ≥12)
  • 1 spray (50mcg per spray) EN OD (ages 3-11)
• CRS:
  • 1-2 sprays (50mcg per spray) EN BID (ages ≥12)

Coverage: ON (ODB)

Age Group: ages ≥3

Pregnancy: Maybe OK, but no adequate or well-controlled studies in pregnant or nursing women

Contraindications: Hypersensitivity, acute bacterial sinus infection without antibiotics

Common SEs: For adults: headache 8%[D], 6%[P]; epistaxis 8%[D], 5%[P], pharyngitis 4%[D], 3%[P]. For 3-11, all comparable to placebo

Severe SEs: All very rare (<1%): liver enzyme elevation

Monograph Links:

• Mometasone-furoate (2021 - 1)

Brand Names: Rupall, Rupafin, Rupita

Routes: 10mg tab, 1mg/ml liq

MoA: 2nd gen H1 receptor antagonist, platelet activating factor antagonist

Half-life: ~6 hours, but some metabolites (ie. desloratadine) remain longer; effects last ~24h

Time to peak action: Rapid absorption; max blood concentration in 1 hr

Doses:

• CSU, AR:
  • 10mg tab OD to QID (ages ≥12)
  • 2.5mg liq OD to QID, (10-25kg, ages 2-11)
  • 5mg liq OD to QID, (>25kg, ages 2-11)

Cost: ~$0.99 CAD / 10mg tab (ON)

Coverage: ON (ODB)

Age Group: ages ≥2

Pregnancy: Avoid (not enough data)

Contraindications: Hypersensitivity, QT prolongation or history of Torsades

Common SEs: Drowsiness 3-9%[D], 2-5%[P]; headache 1-6%[D], 2-5%[P]; tiredness 1%[D], 1%[P]; QT-prolongation 1%[D], <1%[P]; dizziness 1%[D], 1%[P]; nausea 0-2%[D], 1-2%[P]

Severe SEs: All very rare (<1%): Torsades (only 1 event), liver enzyme elevation

Monograph Links:

• Rupatadine (2023 - 1)

Brand Names: brandnameA, brandnameB

Routes: Xmg tab; Xmg/ml liq

MoA: Insert MoA

Half-life: ~X hours

Time to peak action: Optional

Doses:

• diseaseA:
  • Zmg OD (ages 3-11)
  • Zmg OD (ages ≥12; CrCl < 30)
• diseaseB:
  • Zmg BID (ages ≥18; >25kg)

Cost: ~$X CAD / Ymg tab (ON); ~$X CAD / Ymg tab (BC)

Coverage: ON (enter details); BC (enter details)

Age Group: insert age group

Pregnancy: insert information, can link to data/links if need be

Contraindications: insert

Common SEs: insert

Severe SEs: insert

Monograph Links:

• Example (2025 - 1)