loratadine (Claritin, Claritin RediTabs, QlearQuil All Day and All Night 24 Hour Allergy Relief)
Classes: Antihistamines, 2nd Generation
Dosing and uses of Claritin, Claritin Reditabs (loratadine)
Adult dosage forms and strengths
syrup
- 5mg/5mL
tablet
- 10mg
tablet, chewable
- 5mg
tablet, disintegrating
- 5mg
- 10mg
capsule
- 10mg
Allergic Rhinitis
10 mg PO qDay or 5 mg twice daily; not to exceed 10 mg qDay
Urticaria
10 mg PO qDay; not to exceed 10 mg qDAy
Dosing Considerations
Renal impairment (GFR <30 mL/min): 10 mg PO every other day
Hepatic impairment: 10 mg PO every other day
Administration
Claritin RediTabs: Dissolve on tongue
Pediatric dosage forms and strengths
syrup
- 5mg/5mL
tablet
- 10mg
tablet, chewable
- 5mg
tablet, disintegrating
- 5mg
- 10mg
capsule
- 10mg
Allergic Rhinitis
<2 years: Safety and efficacy not established
2-6 years: 5 mg PO qDay
>6 years: 10 mg PO qDay; not to exceed 10 mg qDay
Urticaria
<6 years: Safety and efficacy not established
> 6 years: 10 mg PO qDay
Dosing Modifications
Renal impairment (GFR <30 mL/min)
- 2-6 years: 5 mg PO every other day
- >6 years: 10 mg PO every other day
Hepatic impairment
- 2-6 years: 5 mg PO every other day
- >6 years: 10 mg PO every other day
Administration
Claritin RediTabs: Dissolve on tongue
Claritin, Claritin Reditabs (loratadine) adverse (side) effects
>10%
Headache (12%)
1-10%
Somnolence (8%)
Drowsiness (8%)
Nervousness (4%)
Fatigue (3-4%)
Dry mouth (3%)
Hyperkinesia (3%)
Conjunctivitis (2%)
Dysphonia (2%)
Malaise (2%)
URTI (2%)
Abdominal pain (2%)
Frequency not defined
Autonomic nervous system: Altered lacrimation, altered salivation, flushing, hypoesthesia, impotence, increased sweating, thirst
Cardiovascular: HTN, hypotension, palpitations, supraventricular tachyarrhythmias, syncope, tachycardia
CNS: Blepharospasm, dizziness, dysphonia, hypertonia, migraine, paresthesia, tremor, vertigo
GI: Altered taste, anorexia, constipation, diarrhea, dyspepsia, flatulence, gastritis, hiccup, increased appetite, loose stools, nausea, vomiting
Musculoskeletal: Arthralgia, myalgia
Psychiatric: Agitation, amnesia, anxiety, confusion, decreased libido, depression, impaired concentration, insomnia, irritability, paroniria
Reproductive: Breast pain, dysmenorrhea, menorrhagia, vaginitis
Respiratory: Bronchitis, bronchospasm, coughing, dyspnea, hemoptysis, laryngitis, nasal dryness, sinusitis, sneezing
Skin: Dermatitis, dry hair, dry skin, photosensitivity reaction, pruritus, purpura, urticaria
Urinary: Altered micturition, urinary discoloration, urinary incontinence, urinary retention
Other
- Angioneurotic edema
- Asthenia
- Back pain
- Blurred vision
- Chest pain
- Earache
- Eye pain
- Fever
- Leg cramps
- Malaise
- Rigors
- Tinnitus
- Weight gain
Warnings
Contraindications
Hypersensitivity
Cautions
Caution in hepatic and renal impairment
Elderly patients are at increased risk for comorbidities related to anticholinergic effects; may be potentially inappropriate in this population (Beers criteria)
Effects of ethanol and other sedative drugs may be potentiated when used concurrently
Benzyl alcohol, which is associated with the fatal toxicity, gasping syndrome in neonates; use caution
Some products may contain phenylalanine
Pregnancy and lactation
Pregnancy category: B
Lactation: Excreted in breast milk; avoid (AAP Committee states compatible with nursing)
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Claritin, Claritin Reditabs (loratadine)
Mechanism of action
Long-acting tricyclic antihistamine with selective peripheral histamine H1-receptor antagonistic activity
Absorption
Onset: 1-3 hr
Peak effect: 8-12 hr
Duration : 24 hr
Metabolism
Hepatic CYP3A4 (major), CYP2D6 (minor)
Metabolites: Descarboethoxyloratadine
Elimination
Half-life: 12-15 hr
Excretion: Urine (40%); feces (40%)