Brand Names: Blexten

Routes: 10/20mg PO tab, 2.5mg/ml liquid (uncommon)

MoA: 2nd generation H1 receptor antagonist

Half-life: ~15 hours

Time to peak action: ~1h, rapid absorption

Doses:

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

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

Coverage: ON (ODB)

Age Group: ≥4 years old

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 (4%); headache (4%). For reference, drowisness/headache had a 2% incidence rate in placebo arm

Severe SEs: Torsades (very rare)

Monograph Links:

• Bilastine (2021 - 1)

Brand Names: Claritin, Alavert

Routes: oral tab/capsule, solution

MoA: 2nd generation H1 receptor antagonist

Half-life: 8.4 hours (half life of active metabolite desloratadine is 28h)

Doses:

• CSU, AR: 10mg OD to QID (>= 6y)
• CSU, AR: 10mg q48h (CrCl <30ml/min)
• CSU, AR: 5mg OD to QID (ages [2,6))

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

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

Age Group: [2, adults) with dosing adjustments

Pregnancy: Safe as per ACOG and firstexposure

Contraindications: Hypersensitivity

Common SEs: Fatigue, headache, dry mouth, drowsiness, nausea (~4-8%)

Severe SEs: Essentially none reported in monograph.

Monograph Links:

• Loratadine (2017 - 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 (≥12 years)
• AR: 1 spray (50mcg per spray) EN OD (3-11 years)
• CRS: 1-2 sprays (50mcg per spray) EN BID (≥12 years)

Coverage: ON (ODB)

Age Group: ≥3 years

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: oral 10 mg tab, liquid 1mg/ml

MoA: 2nd generation H1 receptor antagonist and platelet activating factor antagonist

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

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

Doses:

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

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

Coverage: ON (ODB)

Age Group: ≥2 years old

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: oral tab, liquid, ODT

MoA: Insert MoA

Half-life: ~X hours

Time to peak action: Optional to add this in

Doses:

• diseaseA: Zmg OD (adult)
• diseaseA: Zmg OD (adult, CrCl < 30)
• diseaseB: Zmg BID (pediatric (ages X-Y))

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

Contraindications: insert

Common SEs: insert

Severe SEs: insert

Monograph Links:

• Example (2025 - 1)