Last update Oct. 29, 2024

C32 H41 NO2

Likely Compatibility

Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.

2nd generation antihistamine, piperidine derivative, with minimal sedative effect. It is entirely metabolized to fexofenadine. Oral administration once a day. 

Its high percentage of protein binding explains the minimal observed passage of fexofenadine into milk. (Lucas 1995)

In a telephone follow-up, 10% of infants born to mothers taking terfenadine had colic and irritability, which did not require treatment. (Ito 1993)

American Academy of Pediatrics: medication usually compatible with breastfeeding. (AAP 2001)

It has been withdrawn from the market in most countries because of the risk of serious cardiac arrhythmias when taken with other drugs and/or grapefruit juice (Benton 1996, Smith 1994, Monahan 1990). Its metabolite, fexofenadine, does not cause arrhythmias.


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Alternatives

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Other names

C32 H41 NO2 is Terfenadine in Molecular formula.

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Group

C32 H41 NO2 belongs to this group or family:

Tradenames

Main tradenames from several countries containing C32 H41 NO2 in its composition:

Pharmacokinetics

Variable Value Unit
Molecular weight 472 daltons
Protein Binding 97 %
Tmax 2 - 4 hours
16 - 23 hours
M/P ratio 0.2 -
Theoretical Dose 0.006 mg/Kg/d
Relative Dose 0.3 - 0.7 %

References

  1. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  2. Benton RE, Honig PK, Zamani K, Cantilena LR, Woosley RL. Grapefruit juice alters terfenadine pharmacokinetics, resulting in prolongation of repolarization on the electrocardiogram. Clin Pharmacol Ther. 1996 Abstract
  3. Lucas BD Jr, Purdy CY, Scarim SK, Benjamin S, Abel SR, Hilleman DE. Terfenadine pharmacokinetics in breast milk in lactating women. Clin Pharmacol Ther. 1995 Abstract
  4. Smith SJ. Cardiovascular toxicity of antihistamines. Otolaryngol Head Neck Surg. 1994 Abstract
  5. Ito S, Blajchman A, Stephenson M, Eliopoulos C, Koren G. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993 May;168(5):1393-9. Abstract
  6. Monahan BP, Ferguson CL, Killeavy ES, Lloyd BK, Troy J, Cantilena LR Jr. Torsades de pointes occurring in association with terfenadine use. JAMA. 1990 Abstract

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