Za Pharmacy
Drugs, Supplies and Delivery
Loratadine
Loratadine is a well-tolerated, non-sedating antihistamine for managing allergic rhinitis and urticaria. Its once-daily dosing and minimal drug interactions make it suitable for long-term use. Adherence to BNF guidelines, particularly in hepatic impairment, ensures safety and efficacy.
Loratadine is a second-generation antihistamine that selectively antagonizes peripheral H₁ histamine receptors, inhibiting histamine-mediated allergic responses. Key features include:
- Peripheral Selectivity: Minimal penetration of the blood-brain barrier, reducing sedative effects compared to first-generation antihistamines (Lippincott).
- Anti-inflammatory Effects: Blocks histamine-induced vasodilation, bronchoconstriction, and pruritus.
- Long Duration: Provides 24-hour relief with once-daily dosing due to prolonged receptor binding (Lange).
Loratadine is approved for:
- Allergic Rhinitis:
- Seasonal (hay fever) and perennial allergic rhinitis in adults and children ≥2 years (BNF).
- Chronic Idiopathic Urticaria:
- Reduces itching and hives in patients ≥2 years.
- Off-Label Uses:
- Mild allergic conjunctivitis (adjunct therapy).
Adults and Adolescents (≥12 years):
- Oral: 10 mg once daily.
Children:
- 2–12 years (≥30 kg): 10 mg once daily.
- 2–12 years (<30 kg): 5 mg once daily (syrup or tablet).
Special Populations:
- Hepatic Impairment: Reduce dose to 10 mg every other day (BNF).
- Renal Impairment: No dose adjustment required.
- Elderly: Standard dosing applies unless hepatic impairment is present.
Administration Tips:
- Take with or without food.
- Avoid grapefruit juice (may inhibit CYP3A4, increasing plasma levels).
- Common (≥1%): Headache, dry mouth, fatigue, somnolence.
- Rare (<1%):
- Dizziness, gastrointestinal disturbances (nausea, diarrhea).
- Hypersensitivity reactions (angioedema, rash).
- Palpitations (isolated reports).
- Contraindications:
- Hypersensitivity to loratadine, desloratadine, or components.
- Pregnancy/Lactation:
- BNF Category: Use only if benefits outweigh risks (limited human data).
- Excreted in breast milk; avoid during lactation.
- Hepatic Impairment: Dose adjustment required (see above).
- Activities Requiring Alertness: Caution when driving or operating machinery.
Loratadine, metabolized by CYP3A4/2D6, interacts with:
- CYP3A4 Inhibitors (e.g., ketoconazole, erythromycin): Increase loratadine levels (monitor for side effects).
- CYP2D6 Inhibitors (e.g., fluoxetine, quinidine): May elevate plasma concentrations.
- Alcohol: No significant interaction, but avoid excess (Lange).
Central Nervous System Depressants: Minimal additive sedation
- Generic: Loratadine.
- Brand Names:
- UK: Clarityn®, Alavert®.
- US: Claritin®, Alavert®.
Others: Lisino® (India), Lorfast® (Europe).
