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Allergy Medicines: Why Fexofenadine Doesn’t Work for Some

Ever wonder why a certain medication may work great for a friend and do nothing for you? Interestingly, it could involve specific genes that transport the medication into and out of your cells.

Let’s take fexofenadine (brand names are Allegra, Aller-ease), for example. You may have watery eyes and a drippy nose during spring allergy season, and take some fexofenadine to help with the symptoms. Once swallowed, that medication dissolves, goes through absorption, and then transports to the cells where it acts. Plus, it must stay inside those target cells.

How the medication stays inside the cells – instead of being transported right back out of the cell – plays into genetics.

Certain medications and toxins are transported back out of cells by an ATP-binding cassette transporter protein encoded by the ABCB1 gene.

In the epithelial cells lining your intestines, the ABCB1 proteins involve the pumping of substances back into the intestinal lumen. So imagine taking an fexofenadine; it then dissolves, gets absorbed, and then part of that gets pumped back into the intestines to be eliminated.

Genetic variants in ABCB1 affect the amount staying in the cells vs. the elimination. (through intestines, bile, urine). In general, it is a good thing for the body to get rid of a substance that it thinks might be toxic.

While an allergy medication not working well for you isn’t really a big deal, the real problem comes when trying to keep chemotherapy drugs inside of cancer cells. Thus, this gene has been studied in depth for drugs that treat cancer.


ABCB1 Genotype Report:

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Lifehacks:

If you carry one of the variants above, you may be wondering what you can do to increase the effectiveness of your allergy medicine during this pollen season.

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Why join Genetic Lifehacks?

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~ You'll see your genetic data in the articles and reports.

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Related Articles and Topics:

Are you allergic to grass pollen? It may be genetic.
Allergies are usually due to a mix of genetic susceptibility and being exposed to certain triggering molecules. Several different gene variants have ties to an increased risk of grass pollen allergies.

Top 10 Genes to Check in Your Genetic Raw Data
These are 10 genes with important variants that can have a big impact on health. So check them out, cross them off your list if you don’t have them — and read the articles to learn more if you do carry the variant.


About the Author:
Debbie Moon is the founder of Genetic Lifehacks. Fascinated by the connections between genes, diet, and health, her goal is to help you understand how to apply genetics to your diet and lifestyle decisions. Debbie has a BS in engineering from Colorado School of Mines and an MSc in biological sciences from Clemson University. Debbie combines an engineering mindset with a biological systems approach to help you understand how genetic differences impact your optimal health.