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Allegra (fexofenadine hydrochloride) is a second-generation, non-sedating H1-receptor antagonist indicated for the symptomatic relief of seasonal allergic rhinitis (hay fever), perennial allergic rhinitis, and chronic idiopathic urticaria in adults and children aged 12 years and older. It works by selectively and competitively blocking peripheral H1 histamine receptors on effector cells in the skin, nasal mucosa, and conjunctivae, preventing the actions of histamine, including vasodilation, increased vascular permeability, pruritus, and sensory nerve stimulation. Unlike first-generation antihistamines, fexofenadine does not readily cross the blood-brain barrier due to its substrate activity for the P-glycoprotein efflux transporter, resulting in minimal central nervous system penetration and a significantly reduced risk of sedation, psychomotor impairment, and anticholinergic side effects. It has no clinically relevant affinity for muscarinic, alpha-adrenergic, or serotonergic receptors.
Usual adult dose: For seasonal allergic rhinitis: 120 mg once daily. For perennial allergic rhinitis: 120 mg once daily. For chronic idiopathic urticaria: 180 mg once daily. The tablets should be taken with a full glass of water before a meal, as the bioavailability of fexofenadine is significantly reduced when taken with food, particularly high-fat meals or fruit juices such as grapefruit, orange, and apple juice, which can reduce absorption by up to 40% to 60%. The recommended dosing interval is 24 hours. In elderly patients and those with renal impairment, no routine dose adjustment is required unless renal function is severely impaired (creatinine clearance below 30 mL/min), in which case the dose should be reduced to 120 mg once daily for urticaria or 60 mg once daily for allergic rhinitis. Fexofenadine is not recommended for children under 12 years of age in tablet form; a 30 mg oral suspension is available for children aged 2 to 11 years.
Dosage form: Film-coated tablets: 120 mg (peach-coloured, capsule-shaped, biconvex, debossed with "012" on one side and "e" on the other) and 180 mg (peach-coloured, capsule-shaped, biconvex, debossed with "018" on one side and "e" on the other). The tablets should be swallowed whole and should not be crushed or chewed. A 30 mg oral suspension is available for paediatric use.
Onset of action: Fexofenadine is rapidly absorbed, with peak plasma concentrations reached approximately 2 to 3 hours after oral administration on an empty stomach. Symptomatic relief of allergic rhinitis and urticaria symptoms begins within 1 to 2 hours of dosing, with significant reductions in sneezing, rhinorrhoea, nasal pruritus, and ocular symptoms evident within the first day of treatment. The full therapeutic effect is achieved with regular once-daily dosing, and steady-state plasma concentrations are attained within 3 days.
Duration of action: Fexofenadine provides symptomatic relief for a full 24 hours after a single dose, supporting once-daily administration for all approved indications. The elimination half-life is approximately 14 hours, although this is prolonged in patients with renal impairment. The drug is minimally metabolised in the liver, with approximately 5% undergoing hepatic biotransformation, and is eliminated primarily as unchanged drug in the faeces (approximately 80%) and urine (approximately 11%). The duration of antihistaminic effect corresponds closely to plasma concentrations, with sustained suppression of histamine-induced wheal and flare responses over the entire 24-hour dosing interval.
Alcohol recommendation: Alcohol consumption is generally considered safe during treatment with fexofenadine, as this second-generation antihistamine does not potentiate the central nervous system depressant effects of alcohol to a clinically significant degree. Unlike first-generation antihistamines, which impair psychomotor performance and exacerbate alcohol-induced sedation, fexofenadine at therapeutic doses has demonstrated no meaningful interaction with alcohol in clinical studies of driving performance, cognitive function, and subjective drowsiness. Nevertheless, patients should be advised to exercise caution and to determine their individual response to the medication, particularly when first initiating treatment or when consuming large quantities of alcohol. Patients who experience dizziness, which is an uncommon side effect of fexofenadine, should avoid alcohol and activities requiring mental alertness.
Most common side effects: Fexofenadine is very well tolerated, and the overall incidence of adverse effects is comparable to placebo in clinical trials. Headache, drowsiness, nausea, and dizziness are the most commonly reported adverse effects, each occurring in less than 2% to 3% of patients. Dyspepsia and dry mouth have also been reported. Importantly, fexofenadine is not associated with clinically significant sedation or impairment of cognitive or psychomotor function at any licensed dose, and it does not prolong the QTc interval, distinguishing it from some earlier second-generation antihistamines. Rarely, hypersensitivity reactions, including angioedema, urticaria, pruritus, and rash, may occur and require immediate discontinuation. Tachycardia and palpitations have been reported very rarely. Fexofenadine is not associated with weight gain, a notable adverse effect of some other long-term antihistamine therapies.
Would you like to try Allegra (Fexofenadine) without a prescription?
| Country | Shipping method | Delivery time | Price | |
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 Delivery |
14-21 days | 10$ | Tracking# available in 4 days |
 Delivery |
9-14 days | 30$ | Tracking# available in 2 days |
At our pharmacy, you can buy Allegra without a prescription, with discreet and anonymous packaging delivered within 5-14 days across the UK.
Allegra contains fexofenadine, a second-generation antihistamine. It is used for hay fever, perennial allergic rhinitis, and chronic urticaria. Unlike first-generation antihistamines that cross the blood-brain barrier and cause sedation, fexofenadine was designed to stay outside the central nervous system. It relieves sneezing, itching, runny nose, and watery eyes without making you drowsy. For someone who needs to drive, operate machinery, or simply stay alert through a working day, that difference is not subtle. It is the reason the drug exists.
The standard dose for allergic rhinitis is 120 mg once daily. For chronic urticaria, 180 mg once daily. The tablets come in two strengths to match these indications. Fexofenadine is available over the counter in the UK as 120 mg tablets under various brand names, including Allevia. The 180 mg strength remains prescription-only. Onset of action is within 1 to 2 hours, and the effect lasts a full 24 hours. It can be taken long term without loss of efficacy. Tolerance does not develop the way it can with older antihistamines.
Fexofenadine is a selective peripheral H1 receptor antagonist. It blocks histamine at the receptor level on smooth muscle, endothelial cells, and sensory nerves. Histamine is the main mediator of the early allergic response. When mast cells degranulate in the nasal mucosa or skin, histamine binds to H1 receptors and triggers vasodilation, increased vascular permeability, and nerve stimulation. That produces the sneezing, itching, and congestion of hay fever and the wheals of urticaria. Fexofenadine occupies the receptor and prevents histamine from binding. It does not prevent mast cell degranulation. It blocks what happens after.
The drug is the active metabolite of terfenadine, an earlier antihistamine that was withdrawn because it caused QT prolongation and fatal arrhythmias. Terfenadine blocked potassium channels in the heart. Fexofenadine does not. The liver metabolises terfenadine to fexofenadine, which retains the antihistamine effect without the cardiac toxicity. That is why fexofenadine was developed as a drug in its own right. It has no significant effect on the QTc interval even at doses several times higher than therapeutic. Oral bioavailability is about 30% to 40%. Food, particularly a high-fat meal, reduces bioavailability, which is why it should be taken before meals. Peak plasma levels occur 1 to 3 hours after dosing. The drug is not significantly metabolised. It is excreted largely unchanged in faeces and, to a lesser extent, in urine. The half-life is about 14 hours, which supports once-daily dosing.
Take it with water, before a meal. Food, especially fruit juice, reduces absorption. Grapefruit, orange, and apple juice cut bioavailability by more than 30% in some studies. The mechanism is inhibition of the organic anion transporting polypeptide (OATP) that carries fexofenadine across the gut wall. Take the tablet with plain water, and wait at least an hour before eating or drinking anything other than water. If that is not practical, take it at a consistent time relative to meals so the absorption is at least predictable.
Take it once daily. The timing does not matter for efficacy, but morning dosing covers the daytime hours when pollen counts are highest. If you forget a dose, take it as soon as you remember. If it is nearly time for the next dose, skip the missed one. Do not double up. A missed dose during pollen season means a day of symptoms. Do not take two the next day to catch up. The dose-response curve flattens above the recommended dose, so taking more does not add benefit.
For hay fever, start a week before the pollen season if you know your triggers. Fexofenadine works best when it is already in your system before allergen exposure. Starting after symptoms are established means you are playing catch-up. The drug will still work, but the initial relief takes longer. For chronic urticaria, continuous daily dosing is the standard. It suppresses wheal formation and itching over weeks to months. Stopping abruptly leads to recurrence of symptoms within days.
Fexofenadine is one of the best-tolerated antihistamines. Headache occurs in about 5% to 10% of patients, usually mild and transient. Drowsiness is reported at a rate similar to placebo, around 2% to 3%. This is the defining advantage over first-generation antihistamines like diphenhydramine and chlorphenamine, where sedation affects more than 20% of users. If you feel tired on fexofenadine, it is more likely the allergy itself or something else in your day than the drug.
Dry mouth, nausea, and dizziness are reported in a small minority. These are usually mild and resolve without intervention. Rarely, a hypersensitivity reaction to the drug itself can occur, with rash, itching, and swelling. This is not histamine-mediated allergy to the environment. It is a reaction to the tablet. If it happens, stop the drug and report it. Menstrual irregularities and dysmenorrhoea have been reported in post-marketing surveillance, but a causal link is not established. The drug has no hormonal mechanism that would explain this.
Pregnancy is a cautious zone. Fexofenadine crosses the placenta. Animal studies at high doses showed no teratogenicity, but human data are limited. The preferred antihistamines in pregnancy are loratadine and cetirizine, which have more extensive human data. If a woman is on fexofenadine and becomes pregnant, the drug is usually switched to loratadine. If fexofenadine is the only drug that controls her symptoms and the benefit outweighs the uncertainty, it can be continued under obstetric guidance.
Breastfeeding is compatible with fexofenadine. Levels in breast milk are low, less than 1% of the maternal dose. Adverse effects in nursing infants have not been reported. Loratadine and cetirizine are also acceptable. The choice among second-generation antihistamines during lactation is driven by what works for the mother.
Renal impairment reduces fexofenadine clearance. The drug is excreted largely unchanged by the kidneys and gut. In moderate to severe renal impairment, eGFR below 50 mL/min, the dose should be reduced to 60 mg once daily for allergic rhinitis and 120 mg once daily for urticaria. The half-life can double in renal failure, and accumulation increases the risk of headache and dizziness. The starting dose in the elderly, who often have age-related renal impairment, should be adjusted based on eGFR.
Hepatic impairment does not significantly alter fexofenadine pharmacokinetics. The drug is minimally metabolised. No dose adjustment is needed in liver disease. This makes it a useful option in patients with hepatic dysfunction who need an antihistamine.
Older adults can use the standard dose if renal function is normal. If eGFR is reduced, dose adjustment as above. The lack of sedation and anticholinergic effects makes fexofenadine particularly suitable for the elderly. First-generation antihistamines cause confusion, urinary retention, and falls in this population. Fexofenadine does none of these things.
Fexofenadine does not impair alertness, reaction time, or coordination. Driving is safe. The drug was specifically designed to avoid CNS penetration, and clinical trials using objective measures of driving performance have confirmed that it does not impair driving ability. If you are drowsy from the allergy itself or from another medication, that is a different matter. The fexofenadine is not the cause.
Alcohol does not interact with fexofenadine pharmacologically. The drug does not potentiate the sedative effect of alcohol the way first-generation antihistamines do. A patient who has a glass of wine while on fexofenadine will not experience exaggerated drowsiness. Heavy drinking has its own consequences, but the antihistamine is not amplifying them.
Fruit juices are the most clinically relevant interaction, though it is not a drug in the conventional sense. Grapefruit, orange, and apple juice reduce fexofenadine absorption by inhibiting OATP transporters in the gut. Bioavailability drops by 30% to 40%. The clinical effect is reduced symptom control. Take the tablet with water, and separate it from fruit juice by at least an hour. This is a simple instruction with a significant impact on efficacy.
Antacids containing aluminium or magnesium reduce fexofenadine absorption by binding the drug in the gut. Separate fexofenadine from antacids by at least 2 hours. If you take an antacid for indigestion, take it in the evening and fexofenadine in the morning, or vice versa.
Ketoconazole and erythromycin increase fexofenadine plasma levels by inhibiting P-glycoprotein, which transports fexofenadine out of cells. The increase is modest, about 50% to 100%, and does not cause toxicity. No dose adjustment is needed. This interaction is more of a pharmacological curiosity than a clinical problem. The drug has such a wide therapeutic window that even a doubling of levels does not produce adverse effects.
Rifampicin can reduce fexofenadine levels by inducing P-glycoprotein and OATP transporters. The effect is a reduction in efficacy. If a patient on fexofenadine starts rifampicin for tuberculosis, the antihistamine dose may need to be increased or an alternative antihistamine considered. St. John's wort has similar inducing effects and can reduce fexofenadine levels, though the clinical significance is less well documented.
Cetirizine is the other widely used second-generation antihistamine. It is slightly more potent on a milligram basis and has a faster onset. It causes sedation in about 10% of patients, more than fexofenadine but far less than first-generation drugs. It is renally excreted and requires dose adjustment in renal impairment. Loratadine is less potent but also non-sedating. It is metabolised in the liver, so it is preferred in renal impairment but requires caution with drugs that inhibit CYP3A4. All three are available over the counter in the UK at standard doses.
Bilastine is a newer non-sedating antihistamine with a similar profile to fexofenadine. It is prescription-only in the UK and is taken on an empty stomach because food reduces its absorption even more than fexofenadine. It has no significant drug interactions and no cardiac effects. Rupatadine is another prescription option with additional anti-PAF (platelet-activating factor) activity, which may give it an edge in urticaria.
Intranasal corticosteroids, fluticasone, mometasone, beclometasone, are more effective than oral antihistamines for nasal congestion. They are the gold standard for moderate to severe allergic rhinitis. They take days to reach full effect, so they are not a replacement for the rapid relief of an antihistamine. The two are often used together. Montelukast, a leukotriene receptor antagonist, is licensed for allergic rhinitis in patients with concomitant asthma. It is not first-line for rhinitis alone.
Immunotherapy, grass pollen or house dust mite desensitisation, is the disease-modifying option. It involves 3 years of treatment and can produce lasting remission of symptoms. It is available on the NHS through specialist allergy clinics for patients who have failed maximal medical therapy. It is not for everyone. The commitment is significant, but for someone whose hay fever is disabling despite multiple drugs, it is worth pursuing.
INN (International Nonproprietary Name): Fexofenadine hydrochloride
Available brand names in the UK: Allegra, Allevia, Telfast, and generic fexofenadine products
ATC code: R06AX26
Forms and strengths: Tablets: 120 mg, 180 mg; Oral suspension: 30 mg/5 mL (for children)
Manufacturers: Sanofi (Allegra, Telfast), and diverse generic manufacturers including Teva, Accord, Zentiva. Allevia is the over-the-counter brand available in UK pharmacies.
Registration status in the UK: Fexofenadine 120 mg is registered as a General Sale List (GSL) medicine, available over the counter without a prescription. The 180 mg strength is registered as a Prescription Only Medicine (POM).
Classification: General Sale List (GSL) for 120 mg. Prescription Only Medicine (POM) for 180 mg.
The 120 mg tablet is for allergic rhinitis, hay fever and perennial symptoms. It is the over-the-counter dose. The 180 mg tablet is for chronic urticaria and for allergic rhinitis that has not responded adequately to 120 mg. The higher dose provides greater histamine blockade at the skin and nasal mucosa. Some patients with severe hay fever find that 180 mg is the dose that actually works. It is prescription-only, which is an inconvenience when the 120 mg is available off the shelf, but the difference in efficacy can be real.
Generic fexofenadine and branded Allegra are bioequivalent. The switch from brand to generic is routine. The tablets are film-coated and easy to swallow. The oral suspension is for children and adults who cannot swallow tablets. It contains 30 mg per 5 mL, so a 120 mg dose is 20 mL of suspension. The volume is large, and compliance in adults can be challenging for that reason. Tablets are preferred if they can be managed.
How quickly does Allegra work?
Onset is within 1 hour for histamine-driven symptoms, sneezing, itching, runny nose. The peak effect is at 2 to 3 hours. For nasal congestion, the effect is modest. Antihistamines are not decongestants. If congestion is the main symptom, a nasal corticosteroid spray is a more effective addition than increasing the antihistamine dose.
Can I take Allegra with fruit juice?
No. Grapefruit, orange, and apple juice reduce absorption by more than 30%. Take the tablet with plain water and wait at least an hour before drinking juice. If you have already taken it with juice, the dose will be partially absorbed. Do not take a second tablet. Wait until the next day and take it correctly.
Does Allegra cause drowsiness?
At standard doses, drowsiness occurs at the same rate as placebo, about 2%. It is the least sedating of the oral antihistamines. If you feel sleepy after taking it, consider whether the allergy itself, dehydration from a hot day, or another medication is the cause. Fexofenadine is structurally excluded from the brain by P-glycoprotein transporters at the blood-brain barrier. That is the basis for its lack of sedation.
Can I take Allegra long term?
Yes. It is safe for continuous use through pollen season and year-round for perennial rhinitis and chronic urticaria. There is no tachyphylaxis. The efficacy does not diminish over time. Patients with chronic urticaria have taken fexofenadine daily for years without loss of effect or cumulative toxicity.
Can I take a higher dose if 120 mg is not enough?
The 180 mg dose is licensed for urticaria and for rhinitis that has not responded to 120 mg. Doses above 180 mg have been studied and are well tolerated, but there is no evidence of additional benefit. If 180 mg is not controlling symptoms, the diagnosis should be reviewed and additional treatments, nasal steroids, eye drops, montelukast, should be considered. Taking more fexofenadine beyond the licensed dose is unlikely to help.
We ship Allegra to all parts of the United Kingdom. Delivery times depend on your location:
All shipments are packed discreetly with no branding or indication of contents on the outside. At our pharmacy, you can purchase Allegra without a prescription, with delivery across the UK.
