1.1. Adults
Maximum recommended daily dosages for available non-sedating antihistamines are summarized in Tables 1 and 2. Dosages identified in Texas Medicaid patient profiles exceeding these recommendations will be reviewed.
| Drug Name | Dosage Form/Strength | Treatment Indication | Maximum Recommended Dosage |
|---|---|---|---|
| azelastine (Astepro, Astepro Allergy, generics) | **0.15% nasal solution – 205.5 mcg/spray | seasonal or perennial allergic rhinitis | 2 sprays per nostril twice daily |
| azelastine (generics) | 0.1% nasal solution – 137 mcg/spray | perennial allergic rhinitis | 2 sprays per nostril twice daily |
| azelastine (Astepro, generics) | seasonal allergic rhinitis | 2 sprays per nostril twice daily | |
| azelastine (generics) | vasomotor rhinitis | 2 sprays per nostril twice daily | |
| cetirizine (Zyrtec, generics) | **tablets, chewable tablets – 5 mg, 10 mg **orally disintegrating tablets - 10 mg **liquid filled capsule – 10 mg **solution – 1 mg/mL syrup – 1 mg/ mL | perennial or seasonal allergic rhinitis | 10 mg once daily |
| cetirizine (Zyrtec, generics) | **liquid filled capsule – 10 mg **solution – 1 mg/mL syrup – 1 mg/mL **tablets, chewable tablets – 5 mg, 10 mg | chronic idiopathic urticaria | 10 mg once daily |
| desloratadine (Clarinex, generics) | tablets – 5 mg rapidly disintegrating tablets - 2.5 mg, 5 mg | chronic idiopathic urticaria | 5 mg once daily |
| desloratadine (Clarinex, generics) | perennial or seasonal allergic rhinitis | 5 mg once daily | |
| fexofenadine (Allegra, generics, Allegra ODT) | **tablets – 30 mg, 60 mg, 180 mg **orally disintegrating tablets - 30 mg **suspension – 30 mg/5 mL | allergic rhinitis | 60 mg twice daily; 180 mg once daily (tablets only) |
| fexofenadine (Allegra, generics, Allegra ODT) | chronic idiopathic urticaria | 60 mg twice daily or 180 mg once daily | |
| levocetirizine (Xyzal, generics) | **tablet – 5 mg **oral solution – 2.5 mg/5 mL | allergic rhinitis | 5 mg once daily in evening |
| levocetirizine (Xyzal, generics) | chronic idiopathic urticaria | 5 mg once daily in evening | |
| loratadine (Claritin, Alavert, Claritin Children’s, Claritin RediTabs, generics) | **tablets – 10 mg **chewable tablets (Claritin Children’s) – 5 mg **rapidly disintegrating tablets (Claritin RediTabs, Alavert) 10 mg **liquid-gel capsule – 10 mg **solution – 5 mg/5 mL | perennial or seasonal allergic rhinitis | 10 mg once daily |
| loratadine (Claritin, Alavert, Claritin Children’s, Claritin RediTabs, generics) | chronic idiopathic urticaria | 10 mg once daily | |
| olopatadine (Patanase, generics) | 0.6% nasal solution | seasonal allergic rhinitis | 2 sprays per nostril twice daily |
Legend:
- **now over-the-counter
- ODT = orally disintegrating tablet
| Drug Name | Dosage Form/Strength | Treatment Indication | Maximum Recommended Dosage |
|---|---|---|---|
| azelastine/fluticasone (Dymista, generics) | nasal suspension – 137 mcg/ 50 mcg per actuation | seasonal allergic rhinitis | 1 spray per nostril twice daily |
| **cetirizine/ pseudoephedrine (Zyrtec-D, generics) | 12-hour tablets (cetirizine 5 mg/ pseudoephedrine 120 mg/ tablet) | perennial or seasonal allergic rhinitis | 1 tablet twice daily |
| **fexofenadine/ pseudoephedrine (Allegra-D, generics) | 12-hour tablets (fexofenadine 60 mg/ pseudoephedrine 120 mg/ tablet) | seasonal allergic rhinitis | 1 tablet twice daily |
| **fexofenadine/ pseudoephedrine (Allegra-D, generics) | 24-hour tablets (fexofenadine 180 mg/ pseudoephedrine 240 mg/ tablet) | seasonal allergic rhinitis | 1 tablet once daily |
| desloratadine/ pseudoephedrine (Clarinex-D 12 hour, generics) | 12-hour tablets (2.5 mg desloratadine/ 120 mg pseudoephedrine/ tablet | seasonal allergic rhinitis | 1 tablet twice daily |
| **loratadine/ pseudoephedrine (Claritin D 12 Hour, Alavert-D, generics) | 12-hour tablets (loratadine 5 mg/ pseudoephedrine 120 mg/ tablet) | seasonal allergic rhinitis | 1 tablet twice daily |
| **loratadine/pseudoephedrine extended-release (Claritin D 24 Hour, generics) | 24-hour tablets (loratadine 10 mg/pseudoephedrine 240 mg/tablet) | seasonal allergic rhinitis | 1 tablet once daily |
Legend:
- **now over-the-counter