loratadine

loratadine

(lor at' a deen)

Alavert, Claritin, Claritin Hives Relief, Claritin Reditabs, Claritin 24-Hour Allergy, Dimetapp Children's ND Non-Drowsy Allergy, Tavist ND, Triaminic Allerchews

Pregnancy Category B

Drug class

Antihistamine (nonsedating type)

Therapeutic actions

Competitively blocks the effects of histamine at peripheral H₁ receptor sites; has anticholinergic (atropine-like) and antipruritic effects.

Indications

·        Symptomatic relief of perennial and seasonal allergic rhinitis, vasomotor rhinitis, allergic conjunctivitis, and mild, uncomplicated urticaria and angioedema

·        Treatment of rhinitis and chronic urticaria in children > 2 yr

Contraindications and cautions

·        Contraindicated with allergy to any antihistamines; narrow-angle glaucoma, stenosing peptic ulcer, symptomatic prostatic hypertrophy, asthma, bladder neck obstruction.

·        Use cautiously with pyloroduodenal obstruction (avoid use or use with caution, condition may be exacerbated by drug); lactation, pregnancy.

Available forms

Tablets—10 mg; syrup—5 mg/5 mL; rapidly disintegrating tablets (Reditabs)—10 mg; orally disintegrating tablets—10 mg

Dosages

Place rapid dissolving tablets on tongue. Swallow with or without water.

ADULTS AND PATIENTS > 6 YR

10 mg daily PO on an empty stomach.

PEDIATRIC PATIENTS 2–5 YR

5 mg PO daily (syrup).

GERIATRIC PATIENTS OR PATIENTS WITH RENAL OR HEPATIC IMPAIRMENT

10 mg PO every other day.

Pharmacokinetics

Route	Onset	Peak	Duration
Oral	1–3 hr	8–12 hr	24 hr

Metabolism: Hepatic; T_1/2: 8.4 hr

Distribution: Crosses placenta; enters breast milk

Excretion: Feces, urine

Adverse effects

·        CNS: Headache, nervousness, dizziness, depression, drowsiness

·        CV: Palpitations, edema

·        GI: Appetite increase, nausea, diarrhea, abdominal pain

·        Respiratory: Bronchospasm, pharyngitis

·        Other: Fever, photosensitivity, rash, myalgia, arthralgia, angioedema, weight gain

Interactions

Drug-drug

·        Additive CNS depressant effects with alcohol or other CNS depressants

·        Increased and prolonged anticholinergic (drying) effects with MAOIs; avoid this combination

Drug-lab test

·        False skin testing procedures if done while patient is taking antihistamines

Nursing considerations

Assessment

·        History: Allergy to any antihistamines; narrow-angle glaucoma, stenosing peptic ulcer, symptomatic prostatic hypertrophy, asthma, bladder neck obstruction, pyloroduodenal obstruction; lactation, pregnancy

·        Physical: Skin color, lesions, texture; orientation, reflexes, affect; vision examinations; R, adventitious sounds; prostate palpation; serum transaminase levels

Interventions

·        Administer without regard to meals.

Teaching points

·        If using rapid or orally dissolving tablets, place on tongue, tablet will dissolve within seconds, swallow with or without water.

·        Avoid the use of alcohol; serious sedation could occur.

·        You may experienc these side effects: Dizziness, sedation, drowsiness (use caution if driving or performing tasks that require alertness); headache; thickening of bronchial secretions, dryness of nasal mucosa (use a humidifier).

·        Report difficulty breathing, hallucinations, tremors, loss of coordination, irregular heartbeat.

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