Loratadine

A to Z Drug Facts

 Action Competitively antagonizes histamine at the H₁-receptor site.

 Indications Symptomatic relief (nasal and nonnasal) of symptoms associated with seasonal allergic rhinitis; treatment of chronic idiopathic urticaria.

 Contraindications Hypersensitivity to antihistamines; use in nursing women.

 Route/Dosage

ADULTS and CHILDREN ³ 6 yr: PO 10 mg once daily.

CHILDREN 2 to 5 yr: PO 5 mg once daily.

Hepatic Impairment

ADULTS and CHILDREN ³ 6 yr: PO Start with 10 mg every other day.

CHILDREN 2 to 5 yr: PO Start with 5 mg every other day.

Renal Impairment (GFR < 30 mL/min):

ADULTS and CHILDREN ³ 6 yr: PO Start with 10 mg every other day.

CHILDREN 2 to 5 yr: PO Start with 5 mg every other day.

 Interactions

Alcohol, CNS depressants: Additive CNS depressant effects.

Azole Antifungals (eg, ketoconazole, itraconazole): Use of these agents with similar antihistamines has resulted in serious cardiac toxicity, including death.

Food: May increase absorption of loratadine.

MAO Inhibitors: Concomitant use may prolong and intensify anticholinergic effects of loratadine and may result in hypotensive episodes.

 Lab Test Interferences May prevent or diminish otherwise positive reactions to dermal reactivity indicators.

 Adverse Reactions

CARDIOVASCULAR: Hypotension; hypertension; palpitations; tachycardia. CNS: Hyperkinesia; paresthesia; dizziness; migraine; tremor; vertigo; headache; somnolence; fatigue. DERMATOLOGIC: Dermatitis; dry hair; dry skin; urticaria; rash; pruritus; purpura; photosensitivity. EENT: Conjunctivitis; blurred vision; earache; eye pain; blepharospasm; dysphonia; altered taste. GI: Anorexia; increased appetite and weight gain; nausea; vomiting; diarrhea; constipation; flatulence; gastritis; dyspepsia; dry mouth. GU: Urinary discoloration; altered micturation; menstrual irregularities. RESPIRATORY: Nasal dryness; pharyngitis; epistaxis; nasal congestion; dyspnea; coughing; rhinitis; hemoptysis; sinusitis; sneezing; bronchospasm; bronchitis; laryngitis. OTHER: Breast pain; arthralgia; myalgia.

 Precautions

Pregnancy: Category B. Lactation: Excreted in breast milk. Children: Safety and efficacy not established in children < 12 yr. Hepatic Impairment: Use drug with caution in patients with hepatic impairment. Hypersensitivity: Hypersensitivity may occur.

 Administration/Storage

• Administer on empty stomach 1 hr before or 2 hr after eating.
• Store at room temperature.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies, especially to antihistamines.
• Obtain baseline BP, respirations, and pulse before beginning therapy.
• Monitor closely for signs of hypersensitivity if patient has history of allergic reactions to other antihistamines.
• Observe for dizziness, excessive sedation, syncope, confusion, and hypotension, especially in elderly patients.

 Patient/Family Education

• Warn patient not to increase dose to obtain quicker relief of symptoms.
• If patient is to have allergy skin testing, advise to avoid taking medication for 4 days before test.
• Tell patient that drug may be used alone for symptoms of sneezing and runny nose with slight nasal congestion.
• Advise patient not to take any otc medications without consulting health care provider.
• Instruct patient to maintain fluid intake of 1½ to 2 quarts/day to decrease viscosity of secretions.
• Caution patient to avoid exposure to sunlight and to use sunscreen or wear protective clothing to avoid photosensitivity reaction.
• Instruct patient to avoid intake of alcoholic beverages or other CNS depressants (eg, sedatives, hypnotics, tranquilizers).
• Advise patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness until response to medication is known.
• Explain that rapidly disintegrating tablet will disintegrate on the tongue and may be administered with or without water.

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Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts