Ebastine

Ebastine

File:Ebastine.svg
Systematic (IUPAC) name
4-(4-benzhydryloxy-1-piperidyl)-1- (4-tert-butylphenyl)butan-1-one 220px
Clinical data
Routes of administration	Oral
Pharmacokinetic data
Protein binding	Greater than 95%
Metabolism	Hepatic (CYP3A4-mediated), to carebastine
Biological half-life	15 to 19 hours (carebastine)
Identifiers
CAS Number	90729-43-4
ATC code	R06AX22 (WHO)
PubChem	CID 3191
Chemical data
Formula	C32H39NO2
Molar mass	469.658 g/mol[[]]

Ebastine (trade names Kestine, Evastin, Ebastel, Aleva) is a non-sedating H₁ antihistamine.

It does not penetrate the blood-brain barrier and thus allows an effective block of the H₁ receptor in peripheral tissue without a central side effect, i.e not causing sedation or drowsiness.

The basic patent for ebastine in Europe is EP-B-134124. It is often provided in micronised form, due to poor water solubility.

Introduction

Ebastine is a second-generation H1 receptor antagonist that is indicated mainly for allergic rhinitis and chronic idiopathic urticaria. It is available in 10 and 20 mg tablets and in the new formulation of 10 and 20 mg Fast-Dissolving Tablets, as well as in pediatric syrup. It has a recommended flexible daily dose of 10 or 20 mg, depending on disease severity.

Ebastine is available in different formulations (tablets, Fast Dissolving Tablets and syrup) and commercialized under different brand names around the world, Ebastel, Ebastel FLAS, Kestine, KestineLIO, KestinLYO, EstivanLYO, Evastel Z, etc

Pharmacokinetic profile

Ebastine has a unique chemical structure that differs from other second generation antihistamines. After oral administration, ebastine undergoes extensive first-pass metabolism by hepatic cytochrome P450 3A4 into its active carboxylic acid metabolite, carebastine. This reaction has a conversion rate of 100%.

Efficacy

Data from over 8.000 patients in more than 40 clinical trials and studies suggest efficacy of ebastine in the treatment of intermitent allergic rhinitis, persistent allergic rhinitis and other indications.

Safety

Ebastine has shown overall safety and tolerability profile with no cognitive/psycomotor impairment, no sedation and cardiac safety. The incidence of most commonly reported adverse events was comparable between the ebastine and placebo groups, which confirms that ebastine has a favourable safety profile. It should not be used by pregnant women.

Ebastine Fast-Dissolving Tablets

The ebastine Fast-Dissolving Tablets are a unique innovation. The freeze-dried tablets dissolve quickly in the mouth and patients have a perception of faster onset of antihistamine activity than conventional tablets. They have shown pharmacokinetic bioequivalence to conventional formulations and a superior pharmacodynamic profile to other conventional antihistamines. Patients appreciate the new formulation for its convenience and perception of fast onset of action.

• 1. Peyri J, Vidal J, Marrón J et al.Ebastine in chronic urticaria: a double-blind placebo controlled study J Dermatol Treat 1991;2:51-3.

• 2. Gehanno P, Bremard-Oury C, Zeisser P. Comparison of ebastine to cetirizine in seasonal allergic rhinitis in adults. Annals of Allergy , Asthma and Immunol 1996;76 (6): 507-12.

• 3. Bousquet J, Gaudaño EM, Palama Carlos AG et al. A 12-week, placebo-controlled study of the efficacy and safety opf ebastine, 10 and 20 mg once daily, in the treatment of perennial allergic rhinitis. Allergy 1999;S4: S62-S68.

• 4. Tagawa M, Kano M, Okamura N, et al.Neuroimaging of histamine H1-receptor occupancy in human brain by positron emission tomography (PET): a comparative study of ebastine, a second-generation antihistamine, and (+)-clorphrniramine, a classical antihistamine.Br J Clin Pharmacl 2001;52:501-509.

• 5. Van Cauwenberge P, de Belder T, Sys L. A review of the second-generation antihistamine ebastine for the treatment of allergic disorders. Exp Rew Pharmacother 2004;5(8):1807-13.

• 6. Ratner P, Falqués M, Chuecos F et al. Meta-analysis of the efficacy of ebastine 20 mg compared to loratadine 10 mg and placebo in the symptomatic treatment of seasonal allergic rhinitis.Int Arch Allergy Immunol 2005;138:312-8.

• 7. Antonijoan RM, García- Gea C; Puntes Met al. A comparison of ebastine 10 mg fast-dissolving tablet with oral desloratadine and placebo in inhibiting the cutaneous reaction to histamine in healthy adults.Clin Drug Invest 2007;27(7):453-61.

• 8. Antonijoan R, García-Gea C, Puntes M et al.Comparison of inhibition of cutaneous histamine reaction of ebastine fast-dissolving tablet (20 mg) versus desloratadine capsules (5 mg): a randomized, double-blind, double-dummy, placebo-controlled, three period crossover study in healthy , nonatopic adults. Clin Ther 2007;29(5):814-22.

• 9. Salvà M, Carreño B, Pintos M et al. Phase I, single dose, open label, randomized, crossover bioequivalence studies of ebastine 10 mg and 20 mg regular tablets vs 10 and 20 mg fast-dissolving tablets in healthy male volunteers. J Invest Allergol Clin Immunol 2004;14(4) (Suppl 1): S5.

• 10. J Sastre. Ebastine in allergic rhinitis and chronic idiopathic urticaria. Allergy 2008;63( Suppl 89):1-20.

External links

Almirall.es *[1]

• "KESTINE Package Insert". South African Electronic Package Inserts. 1997-10-24. Retrieved 2007-04-01. 

es:Ebastina