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Astemizole (marketed under the brand name Hismanal) is a second generation antihistamine drug which has a long duration of action. It has been withdrawn from the market in most countries because of rare but potentially fatal interactions with CYP34A enzyme inhibitors.

Pharmacology


Astemizole is an histamine H1-receptor antagonist. It is structurally similar to terfenadine and haloperidol (a butyrophenone antipsychotic). It has anticholinergic and antipruritic effects.

Astemizole competitively binds to histamine H1-receptor sites in the gastrointestinal tract, uterus, blood vessels, and bronchial muscle. This suppresses the formation of edema and pruritus (caused by histamine).

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Hismanal Withdrawn - Federal Register Aug. 22, 1999 relating to the withdrawal of Hismanal (astemizole) 10mg tablets from the US market (PDF)

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