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Review
. 2024 Jan 18:13:2023-9-5.
doi: 10.7573/dic.2023-9-5. eCollection 2024.

How to handle off-label prescriptions of rupatadine, a second-generation antihistamine and PAF antagonist: a review

Iñaki Izquierdo  1 , Laia Casas  2 , Susana Cabrera  3 , Alberto Fernandez  3
Affiliations
Review

How to handle off-label prescriptions of rupatadine, a second-generation antihistamine and PAF antagonist: a review

Iñaki Izquierdo et al. Drugs Context. .

Abstract

The off-label use of second-generation antihistamines, used outside of the formal indications authorized by regulatory authorities, in different age groups, doses or in special populations, is very common for many allergic, autoimmune and dermatological diseases. The off-label use of rupatadine (a second-generation antihistamine with PAF antagonist activity) in these conditions is reviewed here, including in combination with immunotherapy in the treatment of food allergy or allergic rhinitis, at high doses in chronic urticaria, and with prescriptions of less common but challenging conditions such as skin pruritus or mast cell activation disorders like mastocytosis. Rupatadine use is reviewed herein to confirm if its off-label management is supported by well-designed clinical trials or by published real-world cases. This review will contribute to increasing compliance and achieving better results in clinical practice. Off-label use of rupatadine should be left to the discretion of the prescribing healthcare professional after careful clinical evaluation.

Keywords: allergic rhinitis; antihistamine; chronic spontaneous urticaria; mast cell activation disorders; off-label use; platelet-activating factor; pruritus; rupatadine.

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Conflict of interest statement

Disclosure and potential conflicts of interest: II and LC are employees of BIOHORM S.L. SC and AF are employees of NOUCOR HEALTH S.A. The authors declare no other conflicts of interest. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2023/12/dic.2023-9-5-COI.pdf

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