Names and pronunciation
(lor-a′ti-deen) Alavert, Childrens Loratadine, Claritin Allergy Childrens, Claritin Childrens, Claritin Reditabs, , Claritin, Clear-Atandine Dimetapp , Triaminic AllerChews
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Drug reference
(lor-a′ti-deen) Alavert, Childrens Loratadine, Claritin Allergy Childrens, Claritin Childrens, Claritin Reditabs, , Claritin, Clear-Atandine Dimetapp , Triaminic AllerChews
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Func. class.: Antihistamine, 2nd generation
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Chem. class.: Selective histamine (H1)-receptor antagonist
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Do not confuse: loratadine/lovastatin/ LORazepam/losartan
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ACTION: Binds to peripheral hista- mine receptors, thereby providing anti- histamine action without sedation
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USES: Seasonal rhinitis, chronic idio- pathic urticaria for those ≥2 yr
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CONTRAINDICATIONS: Hyper- sensitivity, acute asthma attacks, lower respiratory tract disease Precautions: Pregnancy, breastfeed- ing, increased intraocular pressure, bronchial asthma, hepatic/renal disease
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SIDE EFFECTS CNS: Sedation (more common with increased doses), headache, fatigue, restlessness EENT: Dry mouth
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INTERACTIONS Increase: CNS depressant effects—alco- hol, antidepressants, other antihista- mines, sedative/hypnotics, MAOIs Increase: loratadine level—cimetidine, ketoconazole, macrolides (clarithromy- cin, erythromycin) Drug/Herb Increase: CNS depression—chamomile, kava, valerian Drug/Lab Test False negative: skin allergy tests (dis- continue antihistamine 3 days before testing)
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DOSAGE AND ROUTES • Adult and child ≥6 yr: PO 10 mg/day • Child 2-5 yr: PO 5 mg/day Renal/hepatic dose • Adult: PO CCr <30 mL/min or hepatic disease, 10 mg every other day • Child 2-5 yr: PO GFR <50 mL/min; 5 mg every other day
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Available forms: Tabs 10 mg; rapid- disintegrating tabs 10 mg; orally disinte- grating tabs 10 mg; syr 1 mg/mL; susp 5 mg/mL, ext rel tab 10 mg
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Administer: • Rapid-disintegrating tabs by placing on tongue, to be swallowed after disinte- grated with/without water • Use within 6 mo of opening pouch and immediately after opening blister pack • On empty stomach daily Ext Rel Tab • Do not break, crush, or chew
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Assess: • Allergy: hives, rash, rhinitis; monitor respiratory status • Beers: avoid in older men; may de- crease urinary flow and cause urinary retention • Pregnancy/breastfeeding: use only if clearly needed; cautious use in breast- feeding
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Evaluate: • Therapeutic response: absence of run- ning or congested nose, other allergy symptoms
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • To avoid driving, other hazardous ac- tivities if drowsiness occurs • To avoid use of other CNS depres- sants HIGH ALERT
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PHARMACOKINETICS Onset 1-3 hr, peak 8-12 hr, duration 24 hr, metabolized in liver to active metabolites, excreted in urine, active metabolite desloratadine half-life 20 hr
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• Adult and child ≥6 yr: PO 10 mg/day
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• Child 2-5 yr: PO 5 mg/day Renal/hepatic dose
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• Adult: PO CCr <30 mL/min or hepatic disease, 10 mg every other day
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• Child 2-5 yr: PO GFR <50 mL/min; 5 mg every other day
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