Fexofenadine: What It Does and How to Pick the Right Allergy Option

Fexofenadine is a non-drowsy antihistamine many people reach for when sneezes, itchy eyes, or a runny nose start ruining the day. It blocks histamine, the chemical that causes most allergic symptoms, and usually works within an hour and lasts about 24 hours. You can buy it over the counter in common doses like 60 mg (twice daily) or 180 mg (once daily).

How fexofenadine works, safety, and common issues

Fexofenadine targets peripheral histamine receptors, so it rarely causes the heavy sleepiness older antihistamines do. Common side effects include headache, mild nausea, and sometimes dizziness. Serious reactions are rare but require immediate medical attention.

Important practical points: take fexofenadine with water, not fruit juice—apple, orange, and grapefruit juices can cut absorption and make the pill less effective. If you have kidney problems, your doctor may change the dose. Pregnant or breastfeeding? Talk with your clinician—most OTC antihistamines are used cautiously in pregnancy, but you should check first.

Alternatives and real-world tips that help

If fexofenadine doesn’t control your symptoms, you have several options. Other oral, low-sedation antihistamines include loratadine and cetirizine; cetirizine can be slightly more sedating for some people. Levocetirizine is another option and may work better for a few patients. Outside pills, consider intranasal corticosteroid sprays like fluticasone or budesonide—those often work better for nasal congestion and long-term control.

For people with persistent or severe allergies, montelukast (a leukotriene blocker) or referral to an allergist for testing and immunotherapy (allergy shots or sublingual tablets) can change the game. Immunotherapy reduces sensitivity over time instead of just masking symptoms.

Non-drug strategies matter: reduce indoor allergens with a HEPA filter, keep windows closed during high pollen days, wash bedding weekly in hot water, and rinse nasal passages with saline when congestion flares. These steps often let you use less medication while staying comfortable.

When to see a doctor: if you get shortness of breath, facial swelling, or symptoms that don’t improve with OTC options, seek care. Also check in if you rely on daily antihistamines—your clinician can confirm the diagnosis and rule out other causes of chronic nasal issues.

Short practical checklist: 1) Take fexofenadine with water; avoid fruit juices. 2) Try cetirizine or loratadine if it’s not working. 3) Use a nasal steroid for congestion. 4) Consider allergy testing or immunotherapy for long-term relief. 5) See a doctor for severe or worsening symptoms.

Use this guide to pick the next step that fits your life—fexofenadine is a solid, non-drowsy option for many, but it’s not the only route to clear breathing and better days.