Fexofenadine Hydrochloride

FEXOFENADINE HYDROCHLORIDE- fexofenadine hydrochloride tablet, film coated
Aphena Pharma Solutions — Tennessee, Inc.

1 INDICATIONS AND USAGE

1.1 Seasonal Allergic Rhinitis

Fexofenadine hydrochloride tablets are indicated for the relief of symptoms associated with seasonal allergic rhinitis in adults and children 2 years of age and older.

1.2 Chronic Idiopathic Urticaria

Fexofenadine hydrochloride tablets are indicated for treatment of uncomplicated skin manifestations of chronic idiopathic urticaria in adults and children 6 months of age and older.

2 DOSAGE AND ADMINISTRATION

2.1 Fexofenadine Hydrochloride Tablets USP

Seasonal Allergic Rhinitis and Chronic Idiopathic Urticaria

Adults and Children 12 Years and Older: The recommended dose of fexofenadine hydrochloride tablets USP are 60 mg twice daily or 180 mg once daily with water. A dose of 60 mg once daily is recommended as the starting dose in patients with decreased renal function [see Clinical Pharmacology (12.3) ].

Children 6 to 11 Years: The recommended dose of fexofenadine hydrochloride tablets USP are 30 mg twice daily with water. A dose of 30 mg once daily is recommended as the starting dose in pediatric patients with decreased renal function [see Clinical Pharmacology (12.3) ].

3 DOSAGE FORMS AND STRENGTHS

Fexofenadine hydrochloride tablets USP are available in 30 mg, 60 mg, and 180 mg strengths. Fexofenadine hydrochloride tablets USP are coated with a peach colored film coating. Tablets have the following unique shape and identifiers: 30 mg tablets are capsule-shaped and have “93” on one side and “7251” on the other; 60 mg tablets are round and have “93” on one side and “7252” on the other; and 180 mg tablets are round and have “93” on one side and “7253” on the other.

4 CONTRAINDICATIONS

Fexofenadine hydrochloride tablets are contraindicated in patients with known hypersensitivity to fexofenadine and any of the ingredients of fexofenadine hydrochloride tablets. Rare cases of hypersensitivity reactions with manifestations such as angioedema, chest tightness, dyspnea, flushing and systemic anaphylaxis have been reported.

6 ADVERSE REACTIONS

6.1 Clinical Studies Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

The safety data described below reflect exposure to fexofenadine hydrochloride in 5083 patients in trials for allergic rhinitis and chronic idiopathic urticaria. In these trials, 3010 patients 12 years of age and older with seasonal allergic rhinitis were exposed to fexofenadine hydrochloride at doses of 20 to 240 mg twice daily or 120 to 180 mg once daily. A total of 646 patients 6 to 11 years of age with seasonal allergic rhinitis were exposed to fexofenadine hydrochloride at doses of 15 to 60 mg twice daily. The duration of treatment in these trials was 2 weeks. A total of 534 patients 6 months to 5 years of age with allergic rhinitis were exposed to fexofenadine hydrochloride at doses of 15 to 30 mg twice daily. The duration of treatment in these trials ranged from 1 day to 2 weeks. There were 893 patients 12 years of age and older with chronic idiopathic urticaria exposed to fexofenadine hydrochloride at doses of 20 to 240 mg twice daily or 180 mg once daily. The duration of treatment in these trials was 4 weeks.

Seasonal Allergic Rhinitis

Adults and Adolescents: In placebo-controlled seasonal allergic rhinitis clinical trials in subjects 12 years of age and older, 2439 subjects received fexofenadine hydrochloride capsules at doses of 20 mg to 240 mg twice daily. All adverse reactions that were reported by greater than 1% of subjects who received the recommended daily dose of fexofenadine hydrochloride (60 mg capsules twice daily) are listed in Table 1.

In another placebo-controlled clinical study in the United States, 571 subjects aged 12 years and older received fexofenadine hydrochloride tablets at doses of 120 or 180 mg once daily. Table 1 also lists adverse reactions that were reported by greater than 2% of subjects treated with fexofenadine hydrochloride tablets at doses of 180 mg once daily.

The incidence of adverse reactions, including somnolence/fatigue, was not dose-related and was similar across subgroups defined by age, gender, and race.

Table 1: Adverse Reactions in Subjects Aged 12 Years and Older Reported in Placebo-Controlled Seasonal Allergic Rhinitis Clinical Trials in the United States
Twice-daily dosing with fexofenadine capsules at rates of greater than 1%
Adverse reaction Fexofenadine 60 mg Twice Daily (n = 680) Frequency Placebo Twice Daily (n = 674) Frequency
Dysmenorrhea 1.5% 0.3%
Once-daily dosing with fexofenadine hydrochloride tablets at rates of greater than 2%
Adverse reaction Fexofenadine 180 mg Once Daily (n = 283) Frequency Placebo (n = 293) Frequency
Headache 10.3% 7.2%
Back Pain 2.5% 1.4%

The frequency and magnitude of laboratory abnormalities were similar in fexofenadine hydrochloride- and placebo-treated subjects.

Pediatrics: Table 2 lists adverse reactions in subjects aged 6 years to 11 years of age which were reported by greater than 2% of subjects treated with fexofenadine hydrochloride tablets at a dose of 30 mg twice daily in placebo-controlled seasonal allergic rhinitis studies in the United States and Canada.

Table 2: Adverse Reactions Reported in Placebo-Controlled Seasonal Allergic Rhinitis Studies in Pediatric Subjects Aged 6 Years to 11 Years in the United States and Canada at Rates of Greater Than 2%
Adverse reaction Fexofenadine 30 mg Twice Daily (n = 209) Frequency Placebo (n = 229) Frequency
Cough 3.8% 1.3%
Upper Respiratory Tract Infection 2.9% 0.9%
Pyrexia 2.4% 0.9%
Otitis Media 2.4% 0.0%

Table 3 lists adverse reactions in subjects 6 months to 5 years of age which were reported by greater than 2% of subjects treated with fexofenadine hydrochloride in 3 open single- and multiple-dose pharmacokinetic studies and 3 placebo-controlled safety studies with fexofenadine hydrochloride capsule content (484 subjects) and suspension (50 subjects) at doses of 15 mg (108 subjects) and 30 mg (426 subjects) given twice a day.

Table 3: Adverse Reactions Reported in Placebo-Controlled Studies in Pediatric Subjects With Allergic Rhinitis Aged 6 Months to 5 Years of Age at Rates Greater Than 2%
Adverse reaction Fexofenadine 15 mg Twice Daily (n = 108) Frequency Fexofenadine 30 mg Twice Daily (n = 426) Frequency Fexofenadine Total Twice Daily (n = 534) Frequency Placebo (n = 430) Frequency
Vomiting 12.0% 4.2% 5.8% 8.6%
Diarrhea 3.7% 2.8% 3.0% 2.6%
Somnolence/Fatigue 2.8% 0.9% 1.3% 0.2%
Rhinorrhea 0.9% 2.1% 1.9% 0.9%

Chronic Idiopathic Urticaria

Adverse reactions reported by subjects 12 years of age and older in placebo-controlled chronic idiopathic urticaria studies were similar to those reported in placebo-controlled seasonal allergic rhinitis studies.

In placebo-controlled chronic idiopathic urticaria clinical trials, 726 subjects 12 years of age and older received fexofenadine hydrochloride tablets at doses of 20 to 240 mg twice daily. Table 4 lists adverse reactions in subjects aged 12 years and older which were reported by greater than 2% of subjects treated with fexofenadine hydrochloride 60 mg tablets twice daily in controlled clinical studies in the United States and Canada.

In a placebo-controlled clinical study in the United States, 167 subjects aged 12 years and older received fexofenadine hydrochloride 180 mg tablets. Table 4 also lists adverse reactions that were reported by greater than 2% of subjects treated with fexofenadine hydrochloride tablets at doses of 180 mg once daily.

Table 4: Adverse Reactions Reported in Subjects 12 Years of Age and Older in Placebo-Controlled Chronic Idiopathic Urticaria Studies
Twice-daily dosing with fexofenadine hydrochloride in studies in the United States and Canada at rates of greater than 2%
Adverse reaction Fexofenadine 60 mg Twice Daily (n = 191) Frequency Placebo (n = 183) Frequency
Dizziness 2.1% 1.1%
Back Pain 2.1% 1.1%
Stomach discomfort 2.1% 0.6%
Pain in extremity 2.1% 0.0%
Once-daily dosing with fexofenadine hydrochloride in a study in the United States at rates of greater than 2%
Adverse reaction Fexofenadine 180 mg Once Daily (n = 167) Frequency Placebo (n = 92) Frequency
Headache 4.8% 3.3%

The safety of fexofenadine hydrochloride in the treatment of chronic idiopathic urticaria in pediatric patients 6 months to 11 years of age is based on the safety profile of fexofenadine hydrochloride in adults and pediatric patients at doses equal to or higher than the recommended dose [see Use in Specific Populations (8.4) ].

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