desloratadine

desloratadine

(dess lor at' a deen)

Clarinex, Clarinex Reditabs

Pregnancy Category C

Drug class

Antihistamine (nonsedating type)

Therapeutic actions

Competitively blocks the effects of histamine at peripheral H₁-receptor sites.

Indications

·        Relief of nasal and non-nasal symptoms of seasonal allergic rhinitis in patients > 2 yr

·        Treatment of chronic idiopathic urticaria and allergies caused by indoor and outdoor allergens in patients > 6 mo

Contraindications and cautions

·        Contraindicated with allergy to desloratadine, loratadine, or any components of the product; lactation.

·        Use cautiously with hepatic or renal impairment or pregnancy.

Available forms

Tablets—5 mg; rapidly disintegrating tablets—5 mg; syrup—2.5 mg/5 mL

Dosages

ADULTS AND CHILDREN > 12 YR

5 mg/day PO or 2 tsp (5 mg/10 mL) syrup PO once daily.

PEDIATRIC PATIENTS < 12 YR

6–11 yr: 1 tsp syrup (2.5 mg/5 mL) PO once daily.

12 mo –5 yr: 1/2 tsp syrup (1.25 mg/2.5 mL) PO once daily.

6–11 mo: 2 mL syrup (1 mg) PO once daily.

PATIENTS WITH HEPATIC OR RENAL IMPAIRMENT

5 mg PO every other day.

Pharmacokinetics

Route	Onset	Peak	Duration
Oral	1 hr	3 hr	24 hr

Metabolism: Hepatic; T_1/2: 27 hr

Distribution: Crosses placenta; enters breast milk

Excretion: Feces, urine

Adverse effects

·        CNS: Somnolence, nervousness, dizziness, fatigue

·        CV: Tachycardia

·        GI: Dry mouth, nausea

·        Respiratory: Bronchospasm, pharyngitis, dry throat

·        Other: Flulike symptoms, hypersensitivity

Nursing considerations

Assessment

·        History: Allergy to desloratadine, loratadine, other antihistamines; hepatic or renal impairment; pregnancy; lactation

·        Physical: T, orientation, reflexes, affect, R, adventitious sounds, LFTs, renal function tests

Interventions

·        Administer without regard to meals.

·        Arrange for use of humidifier if thickening of secretions, throat dryness become bothersome; encourage adequate intake of fluids.

·        Provide sugarless lozenges to suck and regular mouth care if dry mouth is a problem.

·        Provide safety measures if CNS effects occur.

Teaching points

·        Take this drug exactly as prescribed, with or without food.

·        Place rapidly disintegrating tablets on tongue immediately after opening blister pak; administer with or without water.

·        You may experience these side effects: Dizziness, fatigue (use caution if driving or performing tasks that require alertness); dry throat, thickening of bronchial secretions, dryness of nasal mucosa (use a humidifier if this becomes a problem); dry mouth (sucking on sugarless lozenges and frequent mouth care may help).

·        Report difficulty breathing, tremors, palpitations.

Adverse effects in Italic are most common; those in Bold are life-threatening.