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Once an allergen is introduced to Ig E-sensitized mast cells, a degranulation is triggered which causes histamine to be released.

The effects of histamines are mediated through several receptors including H1, H2, H3, and H4 receptors that belong to the superfamily of G-protein-coupled receptors [5].

Research into aspects of pharmacokinetics and efficacy and adverse effect profiles of bilastine in children under 12 years of age is needed as are dose-response assessments and studies planned rigorously with the aim of assessing quality of life effects.

Current guidelines for diagnosis and treatment of allergic rhinoconjunctivitis and urticaria recommend nonsedating antihistamines as first line treatment [1, 2].

Bilastine is a new, well-tolerated, nonsedating H1 receptor antihistamine.

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

H1 antihistamines work as inverse agonists that drive the balance toward the inactive side and suppress the effects of histamine.

Like other antihistamines bilastine is an H1 receptor inverse agonist.Bilastine does not undergo any significant metabolization.Approximately, 95% is excreted intact in faeces (67%) or in urine (33%) [11].The observations indicate that non-sedating antihistamines, as opposed to what has been thought previously, may be helpful in patients with allergic rhinitis in whom nasal obstruction is a major concern.Current international guidelines need to be revised in the light of the recent evidence.

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