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Loratadine
Pronunciation
U.S. Brand Names
Generic Available
Pharmacological Index
Use
Pregnancy Risk Factor
Contraindications
Warnings/Precautions
Adverse Reactions
Overdosage/Toxicology
Drug Interactions
Mechanism of Action
Pharmacodynamics/Kinetics
Usual Dosage
Mental Health: Effects on Mental Status
Mental Health: Effects on Psychiatric Treatment
Dental Health: Local Anesthetic/Vasoconstrictor Precautions
Dental Health: Effects on Dental Treatment
Patient Information
Nursing Implications
Dosage Forms
References

Pronunciation
(lor AT a deen)

U.S. Brand Names
Claritin®

Generic Available

No


Pharmacological Index

Antihistamine


Use

Relief of nasal and non-nasal symptoms of seasonal allergic rhinitis


Pregnancy Risk Factor

B


Contraindications

Hypersensitivity to loratadine or any of its components


Warnings/Precautions

Patients with liver impairment should start with a lower dose (10 mg every other day), since their ability to clear the drug will be reduced; use with caution in lactation


Adverse Reactions

>10%:

Central nervous system: Headache, somnolence, fatigue

Gastrointestinal: Xerostomia

1% to 10%:

Cardiovascular: Hypotension, hypertension, palpitations, tachycardia

Central nervous system: Anxiety, depression

Endocrine & metabolic: Breast pain

Neuromuscular & skeletal: Hyperkinesia, arthralgias

Respiratory: Nasal dryness, pharyngitis, dyspnea

Miscellaneous: Diaphoresis


Overdosage/Toxicology

Symptoms of overdose include somnolence, tachycardia, headache

No specific antidote is available, treatment is first decontamination, then symptomatic and supportive; loratadine is not eliminated by dialysis


Drug Interactions

CYP2D6 and 3A3/4 enzyme substrate

Increased toxicity: Procarbazine, other antihistamines, alcohol


Mechanism of Action

Long-acting tricyclic antihistamine with selective peripheral histamine H1-receptor antagonistic properties


Pharmacodynamics/Kinetics

Onset of action: Within 1-3 hours

Peak effect: 8-12 hours

Duration: >24 hours

Absorption: Rapid

Metabolism: Extensive to an active metabolite

Half-life: 12-15 hours

Elimination: Significant excretion into breast milk


Usual Dosage

Children greater than or equal to 6 years and Adults: Oral: 10 mg/day on an empty stomach


Mental Health: Effects on Mental Status

Drowsiness is common; may cause anxiety or depression


Mental Health: Effects on Psychiatric Treatment

None reported


Dental Health: Local Anesthetic/Vasoconstrictor Precautions

No information available to require special precautions


Dental Health: Effects on Dental Treatment

>10% of patients experience dry mouth (normal salivary flow returns with cessation of drug therapy)


Patient Information

Take as directed; do not exceed recommended dose. Avoid use of other depressants, alcohol, or sleep-inducing medications unless approved by prescriber. You may experience drowsiness or dizziness (use caution when driving or engaging in tasks requiring alertness until response to drug is known); or dry mouth or nausea (frequent small meals, frequent mouth care, chewing gum, or sucking hard candy may help). Report persistent dizziness, sedation, or seizures; chest pain, rapid heartbeat, or palpitations; swelling of face, mouth, lips, or tongue; difficulty breathing; changes in urinary pattern; yellowing of skin or eyes, dark urine, or pale stool; or lack of improvement or worsening or condition. Breast-feeding precautions: Breast-feeding is not recommended.


Nursing Implications

Drink plenty of water; may cause dry mouth, sedation, drowsiness, and can impair judgment and coordination


Dosage Forms

Syrup: 1 mg/mL (480 mL)

Tablet: 10 mg

Rapid-disintegrating tablets: 10 mg (RediTabs®)


References

Clissold SP, Sorkin EM, and Goa KL, "Loratadine: A Preliminary Review of Its Pharmacodynamic Properties and Therapeutic Efficacy," Drugs, 1989, 37(1):42-57.

Lin CC, Radwanski E, Affrime M, et al, "Pharmacokinetics of Loratadine in Pediatric Subjects," Am J Therapeut, 1995, 2:504-8.

Luck JC and Evrard HM, "Atrial Fibrillation Associated With Loratadine Use," J Allergy Clin Immunol, 1995, 95(2):282.

Lutsky BN, Klose P, Melon J, et al, "A Comparative Study of the Efficacy and Safety of Loratadine Syrup and Terfenadine Suspension in the Treatment of 3 to 6 Year Old Children With Seasonal Allergic Rhinitis," Clin Ther, 1993, 15(5):855-65.

Simons FE, "Loratadine, a Nonsedating H1-Receptor Antagonist (Antihistamine)," Ann Allergy, 1989, 63(4):266-8.


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