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Medication
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Dosing
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Information
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Cetirizine (Zyrtec)
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6 months to 2 years: 2.5 mg daily
2 to 5 years: 2.5 to 5 mg daily
>5 years: 5 to 10 mg daily
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Second generation antihistamine used to treat seasonal and perennial allergic rhinitis, and chronic urticaria. Onset of action is 15 - 30 minutes.
Common Side Effects: Dry mouth, sedation at higher than recommended doses.
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Fexofenadine (Allegra)
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<10.5 kg: 15 mg twice per day
>10.5 kg: 30 mg twice per day OR
6 mos to 2 years: 15 mg twice a day (urticaria)
2 to 11 years: 30 mg twice per day
>12 years: 60 mg twice per day or 180 mg daily
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Second generation antihistamine used to treat allergic rhinitis and chronic urticaria. Onset of action is 15 - 30 minutes.
Common Side Effects: Dry mouth, sedation at higher than recommended doses.
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Levocetirizine (Xyzal)
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6 months to 5 years: 1.25 mg daily
6 to 11 years: 2.5 mg daily
>12 years: 2.5 to 5 mg daily
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Second generation antihistamine used to treat seasonal and perennial allergic rhinitis, and chronic urticaria. Onset of action is 15 - 30 minutes.
Common Side Effects: Dry mouth, sedation at higher than recommended doses.
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Loratadine (Claritin)
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2 to 6 years: 5 mg daily
>6 years: 5 mg twice daily or 10 mg daily
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Second generation antihistamine used to treat allergic rhinitis and chronic urticaria. Onset of action is 15 - 30 minutes.
Common Side Effects: Dry mouth, sedation at higher than recommended doses.
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Azelastine (Astelin)
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≥6 months to <6 years: 0.1% solution: 1 spray per nostril twice daily
6 to <12 years: 0.1% or 0.15% solution: 1 spray per nostril twice daily
≥12 years and Adolescents: 0.15% solution: 2 sprays per nostril twice daily
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Intranasal antihistamine that blocks H1 receptors. Onset of action is 15 minutes.
Common side effects: Bitter after taste, epistaxis, headaches, nasal irritation, sedation
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Fluticasone propionate (Flonase)
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2 to 11 years: Intranasal: Initial: 1 spray per nostril once daily
≥12 years: Intranasal: Initial: 2 sprays per nostril once daily
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Intranasal corticosteroid that decreases the influx of inflammatory cells and inhibit the release of cytokines. Onset of action is <30 min.
Common Side Effects: bitter aftertaste, burning, epistaxis, headache, nasal dryness, throat irritation.
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Montelukast (Singulair)
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12 - 23 mos of age: 4 mg oral granules (+asthma)
2-5 years: 4 mg oral tablet or granules
6-14 years: 5 mg
15 years +: 10 mg
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Leukotriene receptor antagonist that block leukotriene receptors. Onset of action is 2 hours.
Common Side Effects: elevated levels of ALT, AST, and bilirubin.
*Potential aggression, behavioral issues, suicidal ideation
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