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Bilastine + levocetirizine is a combination therapy consisting of two second-generation H1-antihistamines, currently being evaluated by Derma Techno Pakistan for the treatment of chronic spontaneous urticaria (CSU). Bilastine is a highly selective peripheral H1-receptor antagonist known for its non-sedating properties and lack of hepatic metabolism. Levocetirizine is the active R-enantiomer of cetirizine and serves as a potent, selective H1-receptor antagonist. This combination is typically utilized in clinical practice for patients who remain symptomatic despite standard antihistamine monotherapy. The rationale for the combination is to achieve superior control of pruritus and wheals through additive antihistaminic effects. In clinical trials, this regimen is often compared against up-dosed bilastine monotherapy to determine the most effective and safe approach for managing treatment-resistant CSU.
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