Pronunciation:

(lor AT a deen)

U.S. Brand Names:

Generic Available:

Canadian Brand Names:

Use:

Pregnancy Risk Factor:

Pregnancy Implications:

Lactation:

Contraindications:

Warnings/Precautions:

Adverse Reactions:

Adults:

Central nervous system: Headache (12%), somnolence (8%), fatigue (4%)

Gastrointestinal: Xerostomia (3%)

Children:

Central nervous system: Nervousness (4% ages 6-12 years), fatigue (3% ages 6-12 years, 2% to 3% ages 2-5 years), malaise (2% ages 6-12 years)

Dermatologic: Rash (2% to 3% ages 2-5 years)

Gastrointestinal: Abdominal pain (2% ages 6-12 years), stomatitis (2% to 3% ages 2-5 years)

Neuromuscular & skeletal: Hyperkinesia (3% ages 6-12 years)

Ocular: Conjunctivitis (2% ages 6-12 years)

Respiratory: Wheezing (4% ages 6-12 years), dysphonia (2% ages 6-12 years), upper respiratory infection (2% ages 6-12 years), epistaxis (2% to 3% ages 2-5 years), pharyngitis (2% to 3% ages 2-5 years), flu-like symptoms (2% to 3% ages 2-5 years)

Miscellaneous: Viral infection (2% to 3% ages 2-5 years)

Adults and Children:<2%: Agitation, altered lacrimation, altered micturition, altered salivation, altered taste, amnesia, angioneurotic edema, anorexia, anxiety, appetite increased, arthralgia, back pain, blepharospasm, blurred vision, breast pain, bronchitis, bronchospasm, chest pain, confusion, constipation, cough, depression, dermatitis, diaphoresis increased, diarrhea, dizziness, dry hair, dry skin, dysmenorrhea, dyspepsia, dysphonia, dyspnea, earache, eye pain, flatulence, flushing, gastritis, hemoptysis, hiccup, hypertension, hypertonia, hypoesthesia, hypotension, impaired concentration, impotence, insomnia, irritability, laryngitis, leg cramps, libido decreased, loose stools, malaise, menorrhagia, migraine, myalgia, nasal dryness, nausea, palpitation, paresthesia, paroniria, photosensitivity, pruritus, purpura, rigors, sinusitis, sneezing, supraventricular tachyarrhythmia, syncope, tachycardia, thirst, tinnitus, tremor, urinary discoloration, urinary incontinence, urinary retention, urticaria, vaginitis, vertigo, vomiting, weakness, weight gain

Postmarketing and/or case reports: Abnormal hepatic function, alopecia, anaphylaxis, breast enlargement, erythema multiforme, hepatitis, hepatic necrosis, jaundice, peripheral edema, seizure, thrombocytopenia

Overdosage/Toxicology:

Drug Interactions:

CYP2C19 substrates: Loratadine may increase the levels/effects of CYP2C19 substrates. Example substrates include citalopram, diazepam, methsuximide, phenytoin, propranolol, and sertraline.

Protease inhibitors (amprenavir, ritonavir, nelfinavir) may increase the serum levels of loratadine

Increased toxicity: Other antihistamines

Ethanol/Nutrition/Herb Interactions:

Ethanol: Avoid ethanol (although sedation is limited with loratadine, may increase risk of CNS depression).

Food: Increases bioavailability and delays peak.

Herb/Nutraceutical: St John's wort may decrease loratadine levels.

Stability:

Rapidly-disintegrating tablets: Use within 6 months of opening foil pouch, and immediately after opening individual tablet blister. Store in a dry place.

Mechanism of Action:

Pharmacodynamics/Kinetics:

Onset of action: 1-3 hours

Peak effect: 8-12 hours

Duration: >24 hours

Absorption: Rapid

Distribution: Significant amounts enter breast milk

Metabolism: Extensively hepatic via CYP2D6 and 3A4 to active metabolite

Half-life elimination: 12-15 hours

Excretion: Urine (40%) and feces (40%) as metabolites

Dosage:

Children 2-5 years: 5 mg once daily

Children 6 years and Adults: 10 mg once daily

Elderly: Peak plasma levels are increased; elimination half-life is slightly increased; specific dosing adjustments are not available

Dosage adjustment in renal impairment: Clcr 30 mL/minute:

Children 2-5 years: 5 mg every other day

Children 6 years and Adults: 10 mg every other day

Dosage adjustment in hepatic impairment: Elimination half-life increases with severity of disease

Children 2-5 years: 5 mg every other day

Children 6 years and Adults: 10 mg every other day

Dietary Considerations:

Patient Education:

Rapidly-disintegrating tablets: Place tablet on tongue; it dissolves rapidly. May be used with or without water. Use within 6 months of opening foil pouch, and immediately after opening individual tablet blister.

Nursing Implications:

Cardiovascular Considerations:

Dental Health: Effects on Dental Treatment:

Dental Health: Vasoconstrictor/Local Anesthetic Precautions:

Mental Health: Effects on Mental Status:

Mental Health: Effects on Psychiatric Treatment:

Dosage Forms:

Syrup (Claritin®): 1 mg/mL (120 mL) [contains sodium benzoate; fruit flavor]

Tablet (Alavert™, Claritin®, Claritin® Hives Relief; Tavist® ND): 10 mg

Tablet, rapidly-disintegrating: 10 mg

Alavert™: 10 mg [contains phenylalanine 8.4 mg/tablet]

Claritin® RediTabs®: 10 mg [mint flavor]

Dimetapp® Children's ND: 10 mg [contains phenylalanine 8.4 mg/tablet]

International Brand Names: