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Asian Journal of Research in Medical and Pharmaceutical Sciences

5(3): 1-5, 2018; Article no.AJRIMPS.41871 ISSN: 2457-0745

The Efficacy and Safety of Primalan (Mequitasine) in the Treatment of Chronic Recurrent Urticaria

Fathi Al-Ballali1*, Omran Bugrein1 and Iman Amghaiab2

1Department of Dermatology, Faculty of Medicine, Benghazi University, Libya. 2Department of Histology, Faculty of Medicine, Benghazi University, Libya.

Authors’ contributions

This work was carried out in collaboration between all authors. Author FA designed the study, performed the statistical analysis, wrote the protocol, and wrote the first draft of the manuscript. Authors OB and IA managed the analyses of the study. Author IA managed the literature searches. All authors read and approved the final manuscript.

Article Information

DOI:10.9734/AJRIMPS/2018/41871 Editor(s): (1) Dr. Somdet Srichairatanakool, Professor, Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200,Thailand. (2) Dr. John Yahya I. Elshimali, Professor, Department of Pathology and Oncology, UCLA School of Medicine, Charles R. Drew University of Medicine and Science, California, USA. (3) Dr. Raghvendra Vijay Ramdasi, Professor, Department of Neurosurgery, Jaslok Hospital & Research Centre, Mumbai, India. Reviewers: (1) F. Solano, University of Murcia, Spain. (2) Sujoy Khan, Apollo Gleneagles Hospital, India. (3) Renshan Sun, Third Military Medical University, China. (4) Nwachukwu Francis Chukwuedozie, Nigeria Police Academy, Nigeria. (5) Sheikh Mohd Saleem, Government Medical College, India. Complete Peer review History: http://www.sciencedomain.org/review-history/27896

Received 02 May 2018 Original Research Article Accepted 09 December 2018 Published 21 December 2018

ABSTRACT

Objective: To assess the effect of Primalan (mequitazine) in the treatment of chronic recurrent urticaria. Patients and Methods: Twenty four males (57%) and eighteen females (43%) (between ages 22- 64 years) were selected, the mean age was 38 years. The disease duration was (4-12 months). All the patients received primalan (mequitazine) in a dose 0f 5 mg tablet twice daily, the urticarial symptoms and side effects of primalan were assessed for four weeks of the treatment. Result: Primalan (mequitazine) proved to be effective against urticarial symptoms (good and very good response in 29 patients 69%, satisfactory in seven patients 17% and in six patients14% unsatisfactory). Good primalan tolerance in our patients was reported. Adverse event that is ______

*Corresponding author: E-mail: [email protected];

Al-Ballali et al.; AJRIMPS, 5(3): 1-5, 2018; Article no.AJRIMPS.41871

usually mild and transient and did not require the drug withdrawal (sleepiness in five patients 12%, dryness of the mucosa in four patients 9%). Primalan (mequitazine) can be recommended for chronic recurrent urticaria and wide application in therapy of allergic diseases. Conclusion: Primalan (mequitazine) appears to be an effective and safety treatment of urticaria that is improve chronic urticarial symptoms and quality of life. This might benefit patients who do not respond to other anti-allergic drugs.

Keywords: Primalan (Mequitazine); chronic recurrent urticaria; quality of life.

1. INTRODUCTION Mechanism of action Mequitazine binds to the H1 receptor sites on effector cells in Chronic recurrent urticaria, is a transient vascular the gastrointestinal tract, blood vessels, and reaction pattern characterized by short-lived respiratory tract. This blocks the action of circumscribed erythematous, edematous and endogenous histamine, which subsequently itchy wheals. It usually last for a few hours to few leads to temporary relief of the negative days for a period of at least six weeks or more symptoms brought on by histamine. without an identifiable causes and it negatively influences the quality of life. It's a disabling Mequitazine is used as the treatment of Hay affliction that considerably limits patients' daily fever, urticaria (hives) and allergic activities [1]. Mequitazine (trade name Primalan) is an H antagonist and of the Primalan is a histamine . It chemical class. It is used to treat provides effective in urticaria and in allergic [4]. rhinitis mechanism of action Primalan binds to the sites on effector cells 2. PATIENTS AND METHODS and block the action of endogenous histamine [2]. This subsequently leads to temporary relief of In the present study, forty-two patients had the negative symptoms brought on by histamine. chronic recurrent urticaria, which included twenty four males (57%) and eighteen females (43%) Primalan indication for the treatment of urticaria, (between ages 22-64 years), as shown in Fig. 1 allergic rhinitis and other allergic diseases [3]. the mean age was 38 years. The disease Mequitazine is a histamine H1 antagonist duration was (4-12 months) the average was six (). It competes with histamine for months. the normal H1-receptor sites on effector cells of the gastrointestinal tract, blood vessels and The patients were attended to dermatology respiratory tract. department to receive the primalan (mequitazine) treatment in a dose of 5 mg twice daily for four It provides effective, temporary relief of sneezing, weeks, during the time period from August 2015 watery and itchy eyes, and runny nose due to to November 2016. hay fever and other upper respiratory allergies.

Fig. 1. Total patients

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Al-Ballali et al.; AJRIMPS, 5(3): 1-5, 2018; Article no.AJRIMPS.41871

All the patients were investigated thoroughly to Chronic recurrent urticaria, it`s a transient rule out any septic focus or any other cause of vascular reaction pattern characterized by short- urticaria and their complete laboratory lived circumscribed erythematous, edematous investigations were analyzed before starting the and itchy wheals usually lasting for a few hours treatment. General and systemic examinations to few days for a period of at least six weeks or were conducted. Pregnant women and lactating more without an identifiable causes and its mothers were not included. negative influence on the quality of life. It's a disabling affliction that considerably limits All the patients received primalan (mequitazine) patients' daily activities [6]. in a dose of 5 mg tablet twice daily, the urticarial symptoms and side effects of primalan were In the present study, mequitazine show assessed for four weeks of the treatment. significantly improvement of urticarial lesions that decrease wheals, size, number and duration of 3. RESULTS the disease whereas mequitazine in previous studies it more used to treat allergic rhinitis, Hay Primalan (mequitazine) proved to be effective fever and allergic conjunctivitis. This agrees with against urticarial symptoms (good and very good our present study were mequitazine used in the response in 29 patients 69%, satisfactory in treatment of urticaria [7]. seven patients 17% and in six patients14% unsatisfactory) Fig. 2. Good primalan tolerance in Nevertheless mequitazine in previous studies our patients was reported. Adverse event that is proved to be effective againstallergic rhinitis, Hay usually mild and transient and did not require the fever and allergic conjunctivitis. Whereas in drug withdrawal (sleepiness in five patients 12%, present studyit has been shown to be effective in dryness of the mucosa in four patients 9%). the treatment of urticaria [8]. Primalan (mequitazine) can be recommended for chronic recurrent urticaria and wide application in Additionally, mequitazine show in our study therapy of allergic diseases. significantly improvement of urticarial lesions that decrease wheals, size, number and duration of 4. DISCUSSION the urticaria [9].

Mequitazine is a so-called non-sedative In accordance to our present studymequitazine second-generation antihistamine even though has been shown avery good tolerance in our it has never been firmly established that this patients. Whereas unsatisfactory response drug's sedative potential actually differs from that reported only in few patients. That agrees with of the 'sedative' first-generation previous studies regarding mequitazine in the [5]. treatment of other allergic diseases.

Fig. 2. Results

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Al-Ballali et al.; AJRIMPS, 5(3): 1-5, 2018; Article no.AJRIMPS.41871

Similarly, mequitazine has been shown that ETHICAL APPROVAL controlled symptoms of allergic rhinitis and conjunctivitis in previous studies [10]. As per international standard or university standard written ethical approval has been However, previous studies focus on more used collected and preserved by the authors. mequitazine5mg or10 mg once daily in the treatment of allergic rhinitis, Hay fever and DISCLAIMER allergic Conjunctivitis. Therefore our preset study has been used mequitazine in the treatment of This paper is based on preliminary dataset. urticaria [11]. Readers are requested to consider this paper as preliminary research article, as authors wanted to Moreover, patients were found to have few CNS publish the initial data as early as possible. effects. Mequitazine produced levels of Authors are aware that detailed statistical drowsiness, fatigue and produced driving analysis is required to get a scientifically impairment similar to the non-sedating established conclusion. Readers are requested antihistamines [12]. to use the conclusion of this paper judiciously as statistical analysis is absent. Authors also Although the effects on allergic diseases found recommend detailed statistical analysis for for mequitazine confirm our present results, they similar future studies are supported by two earlier studies [13]. Additionally, mequitazine 5 and 10 mg do not ACKNOWLEDGEMENT produce significantly acute daytime drowsiness, Whereas in our study mild transient side effects We thankfully acknowledge of the reviewers. were reported [14].

In fact in line with those of our present and COMPETING INTERESTS previous studies, showing no significant impairment of mequitazine on performance in Authors have declared that no competing psychomotor or on subjective measures of interests exist. sedation. REFERENCES Additionally, this might indicate that drug is not good predictor of driving ability or that the effect 1. Fathi. A.B, Iman. A, Omran. B. 2018. of these antihistamine were too subtle to be Treatment of Chronic Idiopathic Urticaria picked [15]. with and Hcl in Libyan Patients. Asian Journal of In fact, according the previous studies of Research in Dermatological Science. 1(1): mequitazine in the treatment of urticaria we 1- 6 found a very limitedspecific studiesregarding use 2. Ilyina, N.I. &Latysheva, T.V. mequitazine in the urticaria [16]. Thus means &Varfolomeeva, M.I.. (2003). Clinical maybe our present study has been adding option assessment of primalan (mequitasine) in in use ofmequitazine in the urticaria. And our allergology. TerapevticheskiiArkhiv. 75. 58- result agrees with results of previous studies 60. regarding mequitazine in the treatment of various 3. Persi L, Dupin O, Arnaud B, et al. Efficacy allergic diseases. of mequitazine in comparison with placebo assessed by ocular challenge with allergen 5. CONCLUSION in allergic conjunctivitis. 1997;52:451–54. Mequitazine (primalan) appear to be an effective 4. Kapp A, Pichler WJ. mequitasine is an and safety treatment of urticaria thatis improve effective treatment in patients suffering chronic urticarial symptoms and quality of life. from chronic idiopathic urticaria: A And might benefit patients who do not respond to randomized, double-blind, placebo- other anti-allergic drugs. controlled, parallel, multicenter study. IntJDermatol 2006;45:469-74. CONSENT 5. Zuberbier T, Maurer M. Urticaria: Current opinions about etiology, diagnosis and It is not applicable.

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Peer-review history: The peer review history for this paper can be accessed here: http://www.sciencedomain.org/review-history/27896

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