Juice and Allegra

First off -wow!  Thank you for all the comments/questions in response to Catie’s Orange Juice and Allegra article.  Her article was about the Zyrtec commercial about not being able to drink juice and take Allegra at the same time.  Since she posted that article, we have received great questions/comments that we want to follow up on. 

I LOVE juice -what do I do?  Take the Allegra at night!  It is actually best to take the daily antihistamines (Allegra, Zyrtec, Claritin) at night.  This is because it is best to take the antihistamine 2-5 hours before being exposed to allergens.  And guess when pollen levels are at their worse?  Usually between 5-10 AM!  So, if Allegra is taken at night, you wake up ready to fight off allergens and free to drink as much juice as you want!

Does it hurt me to drink juice and take Allegra at the same time?  No, nothing bad will happen to you if you drink juice and take Allegra at the same time.  However, drinking juice and taking Allegra at same time can actually decrease the amount of Allegra that is absorbed (up to 50% in one study) -this means the Allegra doesn’t work as well.

What about orange juice, cranberry juice, grapefruit juice, grape juice….? Most of the stuidies have been with grapefruit juice, however what causes the interaction is in all fruit juices -so no juice is “safe”.

How long must I separate drinking juice and taking Allegra?  It is best to separate drinking juice and taking Allegra by at least 4 hours.  It is time dependent -so, if you take it together up to 50% won’t be absorbed, if you wait 2 hours 25% won’t be absorbed, if you wait 4 hours mostly all of it will be absorbed.

Can I just take twice the prescribed dose in order to overcome the loss caused by the orange juice? Not a great choice for a couple of reasons.  First, because it is not an exact science of how much Allegra is absorbed so most likely too much Allegra will get into the body.  This increases the risk of side effects.  And because doubling the dose is not very cost effective!

Is it the vitamin C in the juice that causes the interaction? No it is not the vitamin C that causes the interaction.  It is most likely caused by fruit juices inhibiting an organic anion transporting peptide (OATP1A2).  By inhibiting OATP1A2, the absorption of Allegra is reduced.

Why would Zyrtec advertise for Allegra? I really don’t know… :)

Which is better -Zyrtec, Allegra or Claritin? All three -Zyrtec (cetirizine), Claritin (loratadine) and Allegra (fexofenadine) are now available OTC and all work well.   Studies show that Zyrtec and Claritin are more likely to cause drowsiness then Allegra.  I must admit I am slightly biased because I heart me some Allegra  :) but others claim Zyrtec or Claritin works better for them.  I would think about cost and what works best with the least side effects for you personally.

If you decide OTC Allegra is for you -go visit their website and get a coupon! 

I hope this clears some questions up!  Thank you for all your comments and questions -please keep them coming!

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Comments

Thanks for this! I saw that commercial and I figured it was nothing major, but it did make me curious about why I shouldn’t be taking my Allegra with OJ! I’ve been taking Allegra for years, it’s the only antihistamine that actually works for me. Claritin and Zyrtec don’t even make a dent in my allergies. It’s good to know I can still drink my OJ, even if I have to wait a few hours to do it!

This is the type of thing that happens when pharmaceutical companies are allowed to market their products as though they were some common item like cars or pancake mix… Zyrtec, Allegra and Claritin are available OTC, and therefore advertising them is perfectly legal, but I really see a problem when prescription medication is hocked on television (along with the side effects of taking the drug), and you are instructed to call you doctor and suggest the med… how backwards is that?
Proof of the problem is the fact that the commercials for various medications are interspersed with commercials for Lawyers willing to sue for the damage you might incur by taking these medications!
I think the decision for what medication is best for your condition should be left to medical professionals, and pharmaceutical advice should only be taken from Pharmacists, Nurses, and Doctors.

Hello, what about alavert. I bought a box of 10mg loratidine. It is supposed to be non drowsy. I just started so I dont know if it will be non drowsy.
1) Should I tale alavert at night too?
2) It is ok to drink it with hot tea?
2a) with OJ.
3) Is it ok to take a decongestant(sudafed) with Alavert?

Also, added a subscription button to this blog would be great. That way we would all now when you Pharm reply. Thanks so much for all your help.

Thank you for posting a clarification article to people who were frankly going conspiracy theorist on the facts and in turn creating crap facts.

“The main thing is different medicines work differently for different people, because everyone’s body is different and responds differently.” -My mom, grandmother and aunt two of which were LPN’s and my momma a dental hygienist.

Hi Lilkunta,

Just FYI for all -Alavert (loratadine) is the same as Claritin (loratadine).

1) Yes, Alavert (loratadine) is best if taken at night b/c pollen is typically worst in the morning.
2) It is okay to drink with hot tea.
2a) It is okay to take loratadine with OJ*.
3) It is okay to take Sudafed (pseudophedrine) with Alavert (loratadine).

*Here is the odd and quite possibly confusing part! Juices including OJ are Pgp inhibitors and loratadine is a Pgp substrate. This means that there is a small possibility that taking loratadine and juice together can actually increase the amount of loratadine absorbed.

I really want to thank you for your advice. We are not the most knowledgeable computer people (we are learning) and I appreciate your input. It is a really good idea- we will definitely look into it!

Thanks,
Nova

Hello, I found your webpage because I had an intereaction with Allegra last night. I took a dose of Allegra in the morning and that evening I had a cocktail with lime juice in it. At first I had just a sip of this cocktail and I began to feel “funny”. I just dismissed it as it being hot in the room and I went outside to get some air. Not really thinking it was related to the drink I later went back to it and had another small amount, more than a sip, more like an ounce or so. The drink was watered down by this time as well. About 30 min later I began to feel faint and naseaous. I then threw up and felt very weak. I went home and went to bed not really knowing what the heck happened. I began to research it this morning and realized that there was significant amount of lime juice, a skinny girl margarita brand margarita, in the drink and it probably reacted with the allegra. So… no more allegra with fruit juices.

I highly doubt that the reaction was because of the Lime Juice. The only issue w/taking the medication with the juice is the possibility of absorption to be decreased. Most likely, you had a reaction to the Allegra itself.

I read the post and I was wondering does that include the actual fruit I.E Oranges, grapefruits?

Hi Denitra,

Thanks for leaving a comment and great question! There is no information about eating fruit and taking Allegra (fexofenadine) at the same time. From the studies about fruit juice and Allegra, I surmise that there are two things that make fruit okay. 1) Concentration -you would have to eat 4 oranges to equal 8 ounces of OJ and 2) Absorption -solid fruit is absorbed much slower then the juice.

I would say that it is fine to eat fruit with Allegra.

Take care,
Nova
Nova Simpson, Pharm.D.

What about a chewable vitamin C supplement with “orange juice powder” listed as an ingredient?

Hi Pete,

Thanks for leaving a comment. From what I have found in my research, it shouldn’t drastically effect the absorption of Allegra. However, if it remains a concern -I would recommend just taking them separately.

Take care,
Nova

Do you know why Allegra was previously taken off the market? Several years ago it was frequently prescribed for Allergies, before Zyrtec came around. Then it disappeared. Just wondering why?

Hi Alecia, I don’t believe Allegra (fexofenadine) was taken off the market since its release. However, Seldane (terfenadine) was taken off the market because it interacted with some drugs to cause irregular heart rythmes (that could possibly lead to death). When Seldane was taken orally it was broken down into an active drug, fexofenadine.

Fexofenadine was then released as Allegra. It has all the benefits of Seldane without the negative effects on the heart!

Hi,
This article was very helpful. I heard, from other than a doctor, that you shouldn’t drink OJ with your allergy medicine. So this article cleared that up from a reliable source, not the public. I also didn’t realize that I should be taking the medicine at night. That definately makes more sense.
Thank you,

I just had Naked Juice and,like the,dork I am took my 24hour Allegra.before bed its 10:55pm and,now I am to.nervous to go to bed first time I ever take allergy medicine hope all is,well.read all these comments and have noclue what to think super
night

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