Onset and duration of the effects of three antihistamines in current use--astemizole, loratadine and terfenadine forte--studied during prolonged, controlled allergen challenges in volunteers.

In a three-way, double-blind, crossover study the onset of action and effects at the end of the dosing interval of 10 mg/day astemizole, 10 mg/day loratadine and 120 mg/day terfenadine forte given for 3 days to six atopic volunteers were assessed using the Vienna challenge chamber (VCC). With each treatment, two long-term pollen challenges were performed in the VCC: the first to assess the onset of action started 1 h before the first dose and lasted continuously for 5 h; the second to assess the effects at the end of dosing took place 21 h after the last of the three doses and lasted 3 h. All three drug treatments initiated 1 h after the beginning of challenge with grass pollen reversed the adverse effects of challenge on the subjective symptoms (runny, blocked or itchy nose, sneezing, itchy eyes, tears) and the objective parameters (nasal secretions, nasal resistance, nasal flow, flow increase, nasal peak flow) within 1-3 h. The mean time to onset of action was 107 min for astemizole, 117 min after treatment for loratadine and 153 min for terfenadine forte. During the second allergen challenge, 21-24 h after intake, astemizole consistently provided better protection for all parameters than did loratadine or terfenadine forte; however the differences were not statistically significant.