Ebastine

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Ebastine
Ebastine.svg
Systematic (IUPAC) name
4-(4-benzhydryloxy-1-piperidyl)-1-(4-tert-butylphenyl)butan-1-one
Clinical data
AHFS/Drugs.com International Drug Names
Legal status ?
Routes Oral
Pharmacokinetic data
Protein binding Greater than 95%
Metabolism Hepatic (CYP3A4-mediated), to carebastine
Half-life 15 to 19 hours (carebastine)
Identifiers
CAS number 90729-43-4 YesY
ATC code R06AX22
PubChem CID 3191
ChemSpider 3079 YesY
UNII TQD7Q784P1 YesY
ChEMBL CHEMBL305660 YesY
Chemical data
Formula C32H39NO2 
Mol. mass 469.658 g/mol
 YesY (what is this?)  (verify)

Ebastine (trade names Evastin, Kestine, Ebastel, Aleva, Ebatrol) is a H1 antihistamine with low potential for causing drowsiness.

It does not penetrate the blood–brain barrier to a significant amount and thus combines an effective block of the H1 receptor in peripheral tissue with a low incidence of central side effects, i.e. seldom causing sedation or drowsiness.[1][2][3]

The patent in which the structure of ebastine is first mentioned is EP 134124  in Europe and US 4550116  in the US. The substance is often provided in micronised form due to poor water solubility.

Uses and availability[edit]

Ebastine is a second-generation H1 receptor antagonist that is indicated mainly for allergic rhinitis and chronic idiopathic urticaria.[4] It is available in 10 and 20 mg tablets[5] and as fast-dissolving tablets,[6] 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, Ebet, Ebastel FLAS, Kestine, KestineLIO, KestinLYO, EstivanLYO, Evastel Z, Ebatrol, etc.

Pharmacokinetic profile[edit]

After oral administration, ebastine undergoes extensive first-pass metabolism by hepatic cytochrome P450 3A4 into its active carboxylic acid metabolite, carebastine. This conversion is practically complete.

Carebastine, the active metabolite

Efficacy[edit]

Data from over 8,000 patients in more than 40 clinical trials[not in citation given] and studies[3][4][5][7][8][9] suggest efficacy of ebastine in the treatment of intermittent allergic rhinitis, persistent allergic rhinitis and other indications.

Safety[edit]

Ebastine has shown overall safety and tolerability profile with no cognitive/psychomotor impairment[5] and no sedation[5] worse than placebo,[2] and cardiac safety, that is, no QT prolongation.[5] 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.

While experiments in pregnant animals showed no risk for the unborn, no such data are available in humans. It is not known whether ebastine passes into the breast milk.[2]

References[edit]

  1. ^ Tagawa, M; Kano, M; Okamura, N (2001). "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 52 (5): 501–509. PMC 2014616. PMID 11736858.  open access publication - free to read
  2. ^ a b c Dinnendahl, V, Fricke, U, ed. (2010). Arzneistoff-Profile (in German) 4 (23 ed.). Eschborn, Germany: Govi Pharmazeutischer Verlag. ISBN 978-3-7741-98-46-3. 
  3. ^ a b Bousquet, J; Gaudaño, EM; Palama Carlos, AG (1999). "A 12-week, placebo-controlled study of the efficacy and safety of ebastine, 10 and 20 mg once daily, in the treatment of perennial allergic rhinitis". Allergy 54 (6): 562–568. PMID 10435469. 
  4. ^ a b Van Cauwenberge, P; de Belder, T; Sys, L (2004). "A review of the second-generation antihistamine ebastine for the treatment of allergic disorders". Exp Rew Pharmacother 5 (8): 1807–13. PMID 15264995. 
  5. ^ a b c d e Sastre, J (2008). "Ebastine in allergic rhinitis and chronic idiopathic urticaria". Allergy 63 (Suppl 89): 1–20. doi:10.1111/j.1398-9995.2008.01897.x. PMID 19032340. 
  6. ^ Antonijoan, R; García-Gea, C; Puntes, M (2007). "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 29 (5): 814–22. PMID 17697901. 
  7. ^ Ratner, P; Falqués, M; Chuecos, F (2005). "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 138 (4): 312–8. PMID 16224195. 
  8. ^ Antonijoan; García-Gea, C; Puntes, M (2007). "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 27 (7): 453–61. PMID 17563125. 
  9. ^ Gehanno, P; Bremard-Oury, C; Zeisser, P (1996). "Comparison of ebastine to cetirizine in seasonal allergic rhinitis in adults". Annals of Allergy, Asthma and Immunol 76 (6): 507–12. PMID 8673684. 
  • Salvà, M; Carreño, B; Pintos, M (2004). "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 14 (4 (Suppl 1)): S5. 
  • Peyri, J; Vidal, J; Marrón, J (1991). "Ebastine in chronic urticaria: a double-blind placebo controlled study". J Dermatol Treat 2: 51–3. 

External links[edit]