Rupatadine belongs to the class of medications called second-generation antihistamines, specifically the class known as histamine receptor antagonists. It works by blocking the action of one of the body's natural chemicals known as histamine. Histamine is responsible for many of the symptoms caused by allergies.

Rupatadine is used for the relief of symptoms associated with seasonal and year-round allergies, including sneezing, itchy and runny nose, and tearing and redness of the eyes. It is also used for the relief of symptoms associated with allergic skin conditions, including chronic hives, itching, and other skin disorders.

Rupatadine usually starts working within 2 hours and lasts for 24 hours.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The recommended dose of rupatadine for adults and adolescents 12 years of age and older is 10 mg taken by mouth once daily.

The dose for children 2 to 11 years old is based on body weight. Children weighing 10 kg to 25 kg should be given 2.5 mg (2.5 mL) taken by mouth once daily. Children weighing more than 25 kg should take 5 mg (5 mL) by mouth once daily.

Use an oral syringe to measure each dose of the liquid, as it gives a more accurate measurement than household teaspoons. Wash the syringe after each use.

This medication may be taken with food or on an empty stomach.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Tablet
Each round, light-salmon-coloured tablet contains 10 mg of rupatadine (as 12.8 mg of rupatadine fumarate). Nonmedicinal ingredients: lactose monohydrate, magnesium stearate, microcrystalline cellulose, pregelatinised maize starch, red iron oxide, and yellow iron oxide.

Oral Solution
Each 1 mL of clear yellow, banana-flavoured liquid contains 1 mg of rupatadine (as 1.28 mg/mL of rupatadine fumarate). Nonmedicinal ingredients: banana flavor, citric acid anhydrous, disodium phosphate anhydrous, methyl parahydroxybenzoate, propylene glycol, purified water, quinoline yellow, saccharin sodium, and sucrose.

Do not take this medication if you:

• are allergic to rupatadine or any ingredients of the medication
• are taking other certain other medications that are broken down in the liver, including but not limited to:
  • ketoconazole, itraconazole
  • erythromycin
  • diltiazem
  • "statin" medications to lower cholesterol
• have a history of irregular heart beat including QT prolongation, torsade de pointes, or other arrhythmia
• have hereditary problems of galactose intolerance, the Lapp lactase deficiency, or glucose-galactose malabsorption (tablets contain lactose)
• have hereditary problems of fructose intolerance, glucose-galactose malabsorption, or sucrose-isomaltase insufficiency (oral solution contains sucrose)

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• cough
• diarrhea
• dizziness
• drowsiness
• dry mouth
• headache
• menstrual pain
• nausea
• red eyes
• tiredness
• vomiting
• weakness

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• abdominal pain
• increased frequency of cold or flu symptoms (e.g., chills, fever, sore throat, cough, nasal congestion, runny nose)
• signs of muscle damage (e.g., unexplained muscle pain, tenderness or weakness, or brown or discoloured urine)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
• symptoms of abnormal heart rhythm (e.g., fast, slow or pounding heartbeat, cold sweats, feeling faint, lightheadedness, nausea, shortness of breath)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Abnormal heart rhythms: This medication can cause abnormal heart rhythms. Certain medications (e.g., sotalol, quinidine, thioridazine, chlorpromazine, pimozide, gatifloxacin, moxifloxacin, mefloquine, pentamidine, arsenic trioxide,  tacrolimus) can increase the risk of a type of abnormal heart rhythm called QT prolongation, and should not be used in combination with rupatadine. You are more at risk for this type of abnormal heart rhythm and its complications if you:

• are female
• are older than 65 years of age
• have a family history of sudden cardiac death
• have a history of heart disease or abnormal heart rhythms
• have a slow heart rate
• have congenital prolongation of the QT interval
• have diabetes
• have had a stroke
• have low potassium, magnesium, or calcium levels
• have nutritional deficiencies

If you have heart disease and abnormal heart rhythms, or people are taking certain medications (e.g., verapamil, atazanavir), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Kidney function: The safety and effectiveness of this medication have not been established for people with reduced kidney function. This medication is not recommended for people with reduced kidney function.

Liver function:  The safety and effectiveness of this medication have not been established for people with reduced liver function. This medication is not recommended for people with reduced liver function.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if rupatadine passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The tablet form of this medication is not recommended for children less than 12 years of age. The safety and effectiveness of using this medication have not been established for children younger than 2 years of age.

Seniors: Seniors may be more likely to experience side effects with this medication.

There may be an interaction between rupatadine and any of the following:

• aclidinium
• alcohol
• amantadine
• amiodarone
• antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
• "azole" antifungals (e.g., itraconazole, ketoconazole, voriconazole)
• barbiturates (e.g., butalbital, phenobarbital)
• benzodiazepines (e.g., alprazolam, diazepam, lorazepam)
• benztropine
• betahistine
• buprenorphine
• butorphanol
• cannabis
• chloral hydrate
• clidinium
• clonidine
• cobicistat
• darifenacin
• diltiazem
• dimenhydrinate
• diphenoxylate
• disopyramide
• domperidone
• donepezil
• efavirenz
• eluxadoline
• entacapone
• esketamine
• everolimus
• fesoterodine
• gabapentin
• galantamine
• glucagon
• glycopyrrolate
• grapefruit juice
• guanfacine
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• ipratropium
• kava kava
• lamotrigine
• letermovir
• levetiracetam
• macrolide antibiotics (e.g., azithromycin, clarithromycin, erythromycin)
• maprotiline
• methadone
• metoclopramide
• mifepristone
• moclobemide
• muscle relaxants (e.g., cyclobenzaprine, orphenadrine, methocarbamol, tizanidine)
• nabilone
• narcotic pain relievers (e.g., codeine, fentanyl, hydromorphone, morphine, oxycodone)
• nitroglycerin
• other antihistamines (e.g., azelastine, bilastine, cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
• oxybutynin
• pizotifen
• pomalidomide
• potassium chloride
• pramipexole
• pregabalin
• primidone
• procainamide
• prochlorperazine
• protein kinase inhibitors (e.g., ceritinib, idelalisib, imatinib, nilotinib)
• quinidine
• rivastigmine
• ropinirole
• rotigotine
• scopolamine
• sirolimus
• "statin" anti-cholesterol medications (e.g., atorvastatin, lovastatin, simvastatin)
• tacrolimus
• tetrabenazine
• thiazide diuretics (water pills; e.g., hydrochlorothiazide, indapamide)
• tiotropium
• trazodone
• tricyclic antidepressants (e.g., amitriptyline, nortriptyline, trimipramine)
• trospium
• umeclidinium
• valerian
• verapamil
• zolpidem
• zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.