LORATADINE

(lor'a-ta-deen)

Alavert, Claritin, Claritin Reditabs
Classifications: antihistamine; h₁-receptor antagonist; nonsedating;
Therapeutic: nonsedating antihistamine; h₁-receptor antagonist
Pregnancy Category: B

Availability

10 mg tablets; 1 mg/mL syrup

Action

Long-acting nonsedating antihistamine with selective peripheral H₁-receptor sites, thus blocking histamine release. It has poor affinity to CNS H₁ receptors. Loratadine is a long-acting H₁-receptor antagonist of histamine that disrupts capillary permeability, edema formation, and constriction of respiratory, GI, and vascular smooth muscle.

Therapeutic Effect

Effective in relieving allergic reactions related to histamine release.

Uses

Relief of symptoms of seasonal allergic rhinitis; idiopathic chronic urticaria.

Contraindications

Hypersensitivity to loratadine.

Cautious Use

Hepatic and renal impairment, renal disease, renal failure; asthma; pregnancy (category B).

Route & Dosage

Allergic Rhinitis
Adult: PO 10 mg once/d on an empty stomach; start patients with liver disease with 10 mg every other day
Child: PO <30 kg, 5 mg q.d.; >30 kg, 10 mg q.d.

Administration

Oral

Give on an empty stomach, 1 h before or 2 h after a meal.
Store in a tightly closed container.

Adverse Effects (≥1%)

CNS: Dizziness, dry mouth, fatigue, headache, somnolence, altered salivation and lacrimation, thirst, flushing, anxiety, depression, impaired concentration. CV: Hypotension, hypertension, palpitations, syncope, tachycardia. GI: Nausea, vomiting, flatulence, abdominal distress, constipation, diarrhea, weight gain, dyspepsia. Body as a Whole: Arthralgia, myalgia. Special Senses: Blurred vision, earache, eye pain, tinnitus. Skin: Rash, pruritus, photosensitivity.

Pharmacokinetics

Absorption: Readily from GI tract. Onset: 1–3 h. Peak: 8–12 h; reaches steady state levels in 3–5 d. Duration: 24 h. Distribution: Distributed into breast milk. Metabolism: In liver to active metabolite, descarboethoxyloratidine. Elimination: In urine and feces. Half-Life: 12–15 h.

Nursing Implications

Assessment & Drug Effects

Assess carefully for and report distressing or dangerous S&S that occur after initiation of the drug. a variety of adverse effects, although not common, are possible. Some are an indication to discontinue the drug.
Monitor cardiovascular status and report significant changes in BP and palpitations or tachycardia.

Patient & Family Education

Drug may cause significant drowsiness in older adult patients and those with liver or kidney impairment.
Note: Concurrent use of alcohol and other CNS depressants may have an additive effect.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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