LORATIDINE

Drug class

Antihistamine

Indications

Allergic rhinitis, Chronic idiopathic urticaria

Temporary relief of symptoms associated with hay fever or other upper respiratory allergies (e.g.,
runny nose, itchy, watery eyes, sneezing, itching of the nose/throat)

Dosage

Oral capsule (10 mg), oral syrup (5 mg/5 mL), oral tablet (10 mg), oral tablet, chewable (5 mg), oral
tablet, disintegrating (10 mg; 5 mg)

1. Usual Adult Dose for Allergic Rhinitis:

 10 mg orally once a day - Maximum dose: 10 mg/day

2. Usual Adult Dose for Urticaria:

 10 mg orally once a day - Maximum dose: 10 mg/day

3. Usual Pediatric Dose for Allergic Rhinitis:

 2 to 5 years: 5 mg orally once a day - Maximum dose: 5 mg/day
 6 years and older: 10 mg orally once a day - Maximum dose: 10 mg/day

4. Usual Pediatric Dose for Urticaria:

 2 to 5 years: 5 mg orally once a day - Maximum dose: 5 mg/day
 6 years and older: 10 mg orally once a day 0- Maximum dose: 10 mg/day
Action

Description:

 Long-acting, second-generation, non-sedating tricyclic antihistamine (piperidine derivative)

with selective antagonistic properties to peripheral histamine H1-receptors.
 Loratadine selectively inhibits H1-receptors primarily located on respiratory smooth muscle
cells, vascular endothelial cells, the gastrointestinal tract, and immune cells.
 Loratadine binds to H1-receptors in different cells and causes a decrease in vascular
permeability (prevents edema and flushing), decreases smooth muscle tone
(bronchodilation), and decreases the activation of the peripheral nociceptive receptors
(decreases pain and pruritus)

Onset: 1-3 hours.

Duration: >24 hours.

Administration

May be taken with or without food.

Special Precautions

 Severe hepatic and renal impairment.

 Children.
 Woman pregnancy and lactation.

Adverse Reactions

Cardiac disorders: Very rarely, tachycardia, palpitation.

Gastrointestinal disorders: Very rarely, nausea, dry mouth, gastritis.

General disorders and administration site conditions: Fatigue (mainly in children).

Hepatobiliary disorders: Very rarely, abnormal hepatic function.

Immune system disorders: Very rarely, hypersensitivity reactions, including anaphylaxis and
angioedema.

Metabolism and nutrition disorders: Increased appetite.

Nervous system disorders: Headache, drowsiness. Very rarely, dizziness, convulsion.

Psychiatric disorders: Insomnia; nervousness (mainly in children).

Skin and subcutaneous tissue disorders: Very rarely, rash, alopecia.

Overdosage

Symptoms: Somnolence, headache, and tachycardia.

Management: Symptomatic and supportive treatment. Consider administration of activated charcoal

or performing gastric lavage.

Storage

Store below 30°C. Protect from moisture. Storage recommendations may vary among individual
products or between countries (refer to detailed product guideline).

Nursing Assessment

1. Assess symptoms
a. Type; e.g., sneezing, nasal congestion, runny nose and itchy or watery eyes
b. Frequency; occasional, seasonal, year around, environmental

2. Laboratory results
a. Liver and renal function tests

3. Medical history
a. QT interval prolongation; medications affecting QT interval
b. Narrow-angle glaucoma
c. Prostatic enlargement
d. Advanced age
e. Pregnancy, breastfeeding

4. Physical assessment
a. Vital signs
b. Respiration rate & Lung sounds
c. skin colour, texture, and lesions (monitor for anticholinergic effects or allergy)

5. Proper administration. Administer drug on an empty stomach, 1 hour before or 2 hours after
meals, to increase the absorption.

6. Continued monitoring
a. Side effects (skin dryness, GI upset, sedation and drowsiness, urinary retention,
thickened secretions, glaucoma).
b. Therapeutic effects: reduction of symptoms; improved quality of life
c. Relief from dry mouth which may lead to nausea and anorexia; suggest sugarless
candies or lozenges to relieve some of the discomforts.

7. Increase fluid intake to decrease the problem of thickened secretions and dry nasal mucosa.
 8. Safety measures. Provide safety measures as appropriate if CNS effects occur to prevent
patient injury.
9. Evaluate the effectiveness of the teaching plan (patient can name drug, dosage, adverse
effects to watch for, specific measures to avoid them, and measures to take to increase the
effectiveness of the drug.

10. Patient Counselling Information:

a. This drug may cause drowsiness, if affected, do not drive or operate machinery.
b. Avoid OTC drugs. Caution the patient to avoid excessive dose and to check OTC drugs
for the presence of antihistamines, which are found in many OTC preparations and
could cause toxicity.

11. Monitor the effectiveness of comfort and safety measures and compliance with the regimen.

References

Anon. Loratadine. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of
Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 05/07/2022.

Anon. Loratadine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc.
https://online.lexi.com. Accessed 05/07/2022.

Boots Hayfever Relief Instant Melts 10 mg Orodispersible Tablets (Sandoz Limited). MHRA.
https://products.mhra.gov.uk. Accessed 25/07/2022.

Buckingham R (ed). Loratadine. Martindale: The Complete Drug Reference [online]. London.
Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 05/07/2022.