Review Article

Chronic Urticaria: Indian Context—Challenges and Treatment Options

Table 2

Overview of medications available in India for urticaria and angioedema.

TypeGeneric nameAvailabilityPrice CIMS India*

Antihistamine H1CetirizineWidely available
(41 brands)
Re$ 1/tablet to Rs 4.75/tab

Antihistamine H1ChlorphenamineWidely available
(17 brands)
4 mg (500 tablets) from Rs 25.79 to Rs 29.12;
Syrup (0.5 mg/5 mL) 60 mL at Rs 23.80

Antihistamine H1DesloratadineWidely available
(11 brands)
Rs 1.99/tablet to Rs 5.50/tablet

Antihistamine H1FexofenadineWidely available
(11 brands)
30 mg 10 tablets for Rs 31.00
120 mg 10 tabs from Rs 40 to Rs 99.15
180 mg 10 tabs from Rs 60 to Rs 111.80

Antihistamine H1HydroxyzineWidely available
(4 brands)
10 mg 10 tablets for Rs 9.00
25 mg 10 tablets from Rs 16.00 to Rs 23.00
Syrup (10 mg/5 mL) 100 mL at Rs 40.18

Antihistamine H1LevocetirizineWidely available
(60 brands)
5 mg 10 tablets from Rs 8.90 to 55.32
Syrup (2.5 mg/5 mL) 30 mL from Rs 18.90 to Rs 29.00

Antihistamine H1LoratidineWidely available
(6 brands)
10 mg 10 tablets from Rs 19.50 to Rs 150.00
Syrup (5 mg/5 mL) 30 mL for Rs 46.00
Suspension 1 mg 30 mL for Rs 17.85

Leukotriene receptor antagonist (LTRA)Montelukast
Zafirlukast
Montelukast is widely available
(14 brands)
Zafirlukast is not available
4 mg 10 tablets from Rs 62.50 to 89.00
5 mg 10 tablets from Rs 70 to 98.00
10 mg 10 tablets from Rs 83.20 to 149
Sachet 4 mg 1 sachet costs Rs 5.85

Combinations anti-H1 + LTRALevocetirizine 5 mg + Montelukast 4/5/10 mgWidely available
(16 brands)
Rs 5.90 to Rs 16/tablet (adult)
Rs 3.80 to Rs 6.30/tablet (kid)

Combinations
anti-H1 + LTRA
Fexofenadine 120 mg + Montelukast 4/10 mgLimited to no availability in smaller cities10 tablets for Rs 125.00

Anti-PAFRupatadine 10 mgLimited availability
(3 brands)
10 mg tablets Rs 5-6/tablet

Combinations anti-PAF + LTRARupatadine 10 mg + Montelukast 10 mgLimited availability10 tablets for Rs 84.60 (Rs 8.46/tablet)

ImmunosuppressantHydroxychloroquineWidely available200 mg tablets 10 from Rs 59 to Rs 80

ImmunosuppressantMethotrexateWidely available2.5 mg tablets 10 from Rs 15.00 to 57.85

ImmunosuppressantCyclosporinWidely available25 mg tablets from Rs 21.60–32.60/tab
50 mg tablets from Rs 43.20–65.20/tab
100 mg tablets from Rs 82.60–130.40/tab

Anti-IgEOmalizumab (Xolair, Novartis)Very limited availability, expensive, and available through select Central Govtenment Health Schemes at reduced costs in India150 mg injection, frequency, and dose calculated on body weight and IgE level is
256.15 + VAT per vial (NHS, UK) or
US$10,000/year (1-2 injections/month)

Ref: CIMS 115 Oct 2011 (Update-4); costs of the last 4 of 5 drugs were obtained from Medline India.
$Indian currency in Rupees (Rs), exchange rate Rs 56.83 = 1 US$ (as on 6 June, 2013).
Abbreviations: PAF: platelet activating factor, LTRA: leukotriene receptor antagonist, IgE: immunoglobulin E, and NHS: national health service.