Accidental terfenadine ingestion in children

Terfenadine is a newly marketed non-sedating antihistamine. It binds strongly with peripheral H-1 receptors and only weakly with muscarinic, alpha and beta-adrenergic receptors. There is limited information about ingestion by children 1-5 years old and no reports in the literature of accidental ingestion. We performed a 1-year retrospective study at the DVRPCC and NJPIES. Twenty-eight cases of accidental ingestions of terfenadine by children aged 1-5 yrs were identified; 27 cases were treated at home and 1 treated in a hospital. Two cases (120 mg and 300 mg) received ipecac at home and were followed by telephone with 1.4 and 24 hr callbacks. No symptoms were reported. In 1 case (180 mg) ipecac was advised but the mother refused to give it. No symptoms were reported on followup. One case (2 yr, 900mg) was referred to a hospital and arrived asymptomatic 2 hr postingestion. The child received activated charcoal and sorbitol, remained asymptomatic and was discharged 6 hr postingestion. The remaining 24 cases (60 mg-120 mg) were treated at home with observation alone. Twenty-one of these cases reported no symptoms on followup. Three cases were lost to followup. Evidence suggests that accidental ingestions of small doses of terfenadine (60 mg-120 mg) in children will not produce toxicity. Larger studies may be needed to verify these findings.