LORATADINE  (lor'a-ta-deen)  Alavert, Claritin, Claritin Reditabs Classifications: antihistamine; h1-receptor antagonist; nonsedating; Therapeutic: nonsedating antihistamine; h1-receptor antagonist Pregnancy Category: B
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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.
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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: 13 h.
Peak: 812 h; reaches steady state levels in 35 d.
Duration: 24 h.
Distribution: Distributed into breast milk.
Metabolism: In liver to active
metabolite, descarboethoxyloratidine.
Elimination: In urine and feces.
Half-Life: 1215 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.