Rupatadine is a second generation of agent that inhibits action of histamine via histamine receptors and platelet-activating factor (PAF) antagonist used to treat allergies which marketed under several brand.
This agent is second generation of antihistamine.

According to recent study, compared to Levocetirizine (third generation of antihistamine from antihistamine cetrizine), Rupatadine had greater improvement on the total nasal symptoms score (TNSS) and rhinoconjunctivitis quality of life questionnaire.

In the U.S., levocetrizine has been approved and marketed since 2007, including in Europe and elsewhere. However, rupatadine has not been tested and marketed in the U.S. and only marketed in Europe and elsewhere around the world.

The led of investigators, Dr. Rituparna Maiti from the Prathima Institute of Medical Sciences in Karimnagar, India, reported the study result in the August issue of Archives of Otolaryngology, that 2 weeks after Head and Neck Surgery, the comparison of TNSS between those taking rupatadine and levocetrizine were 36.67% vs. 18.02%. And rhinoconjunctivitis quality of life questionnaire percentage were 18.08% vs. 9.94%.

In the study that was not blinded, 60 patients randomized received either rupatadine and levocetrizine 10 mg daily.

According to the study result, the TNSS significant decrease clinically by 25% by following detail;
- 21 rupatadine and 12 levocetirizine patients showed significant improvement,
- in similar pattern, 17 rupatadine and 8 levocetrizine patients had clinically significant improvements of the quality of life questionnaire.

In addition, rupatadine also resulted in greater drops in several laboratory parameters, including differential and absolute eosinophil counts and serum immunoglobulin E.

Due to serious adverse effect, the investigator say there is no serious adverse effects. Overall, 11.5% of rupatadine patients reported some adverse effect compared 23.3% of levocetrizine patients.

The investigators suggest that rupatadine’s dual action as both an anti-histamine and a platelet-activating factor antagonist could explain its superiority in patients with allergic rhinitis.
They said, inhibition of platelet-activating factor will block vasodilation and the vascular permeability that might contribut to rhinorrhea and nasal congestion.