Ebastine: what is this anti-allergy drug?

What is ebastine?

Ebastine is a anti-allergic molecule that exerts an action aimed at blocking histamine H1 receptors. The commercial specialties that contain it are: Kestin®, Kestinlyo® and their generics.

What are the indications for ebastine?

Ebastine is used to treat the manifestations of allergic rhinitis which are characterized in particular by sneezing and inflammation of the nasal mucosa. It can be seasonal (called hay fever) or perennial if present throughout the year. Ebastine is also indicated for the symptomatic treatment of hives caused by an allergenit resorbs skin patches and relieves itching.

What recommendations in case of allergy?

Whatever the type of allergy (seasonal, perennial, food), allergen avoidance measures should be implemented soon after diagnosis. For the seasonal pollen allergiesthere are several recommendations:

• rinse your hair at the end of the day
• ventilate your home early in the morning and late at night, but do not sleep with the window open
• do not dry clothes outside
• avoid mowing the lawn or gardening without protection (mask, glasses)
• avoid contact with an irritant or allergenic (tobacco, chemicals, cedars, etc.)
• do not roll the window open when traveling by car
• avoiding walks and outdoor physical activity

If the allergen is present in the house (animal hair, dust mites), regular airing and cleaning of the room are essential. In case of dust mite allergy, regular washing of sheets (twice a month at 60°C), the removal of textile materials (carpet, rug) and the use of a slats are advised. Similarly, acaricidal products can be used several times a year to treat surfaces in addition to these measures. Note that the effectiveness of air purifying filters and protective mattress and pillow covers has not been demonstrated. In case of allergic rhinitis, abundant nose washes and frequent are strongly recommended as a supplement. Faced with the ineffectiveness of eviction and prevention measures, drug treatment (such as ebastine) should be initiated to effectively combat the symptoms of allergy. In an emergency context, the occurrence of anaphylactic shock (or allergic shock) must lead injecting a dose of adrenaline. This severe allergic reaction can be caused by food (peanut, cow’s milk), medication, a bite (black widow spider, tick), insect bite or other allergens. A patient at risk should always have his treatment with him in a first aid kit.

Can I get ebastine without a prescription?

Whatever its pharmaceutical form (film-coated tablet or oral lyophilisate), ebastine is only available on presentation of a prescription.

What are the side effects of ebastine?

The main side effect is the occurrence of headache. Ebastine is frequently responsible for a dry mouth and drowsiness. Note that this does not prohibit the driving of a vehicle or the use of a machine if the prescribed doses are respected. Other effects like a increased appetite and weight gain can manifest. More rarely severe allergic reactions, heart palpitations, digestive disorders (abdominal pain, nausea and vomiting) and liver damage have been reported.

Ebastine is contraindicated in children under 12

What contraindications?

Ebastine is contraindicated in allergic patients to any of the components of the drug and in children under 12 years old. More specifically, the drug in the form of oral lyophilisate is to be avoided in case of phenylketonuria (hereditary genetic disease) due to the presence of aspartame. In this case, only ebastine in tablets can be prescribed. On the other hand, ebastine tablets contain lactose, their administration is therefore prohibited in patients with:

• galactose intolerance
• lactase deficiency (enzyme to digest milk)
• a defect in the absorption of galactose or glucose

Vigilance is required in patients with potassium deficiency, prolongation of the QT interval (visible on the electrocardiogram) or in those taking a drug that increases this interval. Ebastine is not contraindicated in pregnant or breastfeeding women, but should be avoided lack of available data.

Sources:
– Public drug database
– Allergic rhinitis, Vidal recommendations, 12/15/2022
– Pollen allergies: what to do, Ministry of Health, 07/12/22