Kestine (Ebastine)

Ebastine acts as a selective peripheral H1‑receptor antagonist, providing relief in allergic conditions.

• Allergic rhinitis: reduces nasal congestion, sneezing, itching and rhinorrhea.
• Chronic idiopathic urticaria: diminishes wheal formation and pruritus.
• Seasonal allergic conjunctivitis: alleviates eye itching and redness.

• Ebastine selectively blocks peripheral H1 histamine receptors, preventing histamine‑mediated vasodilation, increased vascular permeability, and sensory nerve stimulation. By inhibiting these pathways, it reduces the inflammatory response and symptom manifestation in allergic disorders without significant central nervous system penetration.

Adverse reactions may occur with ebastine therapy.

Common Side Effects

• Headache: mild to moderate intensity.
• Dry mouth: transient sensation of oral dryness.
• Drowsiness: occasional mild sedation.
• Fatigue: feeling of reduced energy.
• Nausea: mild gastrointestinal upset.

Serious or Rare Side Effects

• Cardiac arrhythmia: irregular heart rhythm, requires medical attention.
• Elevated liver enzymes: possible hepatic involvement, monitor liver function.
• Severe skin reactions: such as Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Anaphylaxis: acute, life‑threatening hypersensitivity reaction.

Before initiating ebastine, consider the following precautions.

• Hepatic function: assess liver status; use with caution in hepatic impairment.
• Renal function: adjust use in severe renal insufficiency.
• CYP3A4 inhibitors: avoid concomitant strong inhibitors that may increase ebastine levels.
• Pregnancy: only if benefit outweighs risk; discuss with healthcare provider.
• Lactation: avoid unless essential, as drug may pass into breast milk.
• Store below 25°C: keep in the original packaging, protect from moisture and direct sunlight.

Ebastine may interact with other medicines; awareness of interaction severity is important.

Major Interactions (Avoid)

• Ketoconazole: strong CYP3A4 inhibitor that can raise ebastine plasma concentrations.
• Erythromycin: potent CYP3A4 inhibitor, may increase risk of adverse effects.
• Ritonavir: potent CYP3A4 inhibitor, should be avoided.

Moderate Interactions (Monitor Closely)

• Theophylline: may increase plasma levels of both drugs; monitor for toxicity.
• Carbamazepine: enzyme inducer that can reduce ebastine effectiveness.
• Fluconazole: moderate CYP3A4 inhibitor, may require dose adjustment.
• Cimetidine: may increase ebastine exposure; monitor patient response.