loratadine (Claritin, Claritin RediTabs, QlearQuil All Day and All Night 24 Hour Allergy Relief)

Dosing and uses of Claritin, Claritin Reditabs (loratadine)

• Adult
• Pediatric

 

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%)