Claritin


loratadine

Aerius (CA), Alavert, Allertin, Claritin, Claritin RediTabs, Clarityn (UK)

Pharmacologic class: Histamine1-receptor antagonist (second-generation)

Therapeutic class: Antihistamine (nonsedating)

Pregnancy risk category B

Action

Selective histamine1-receptor antagonist. Blocks peripheral effects of histamine release during allergic reactions, decreasing or preventing allergy symptoms.

Availability

Syrup: 1 mg/ml

Tablets: 10 mg

Tablets (rapidly disintegrating): 10 mg

Indications and dosages

➣ Seasonal allergies; chronic idiopathic urticaria

Adults and children ages 6 and older: 10 mg P.O. daily

Children ages 2 to 5: 5 mg P.O. daily

Dosage adjustment

• Renal or hepatic impairment

Contraindications

• Hypersensitivity to drug

Precautions

Use cautiously in:

• renal or hepatic impairment

• elderly patients

• pregnant patients

• children younger than age 2 (safety not established).

Administration

• Give once a day on empty stomach.

• Place rapidly disintegrating tablet on tongue; give with or without water.

• Use rapidly disintegrating tablets within 6 months of opening foil pouch and immediately after opening individual tablet blister.

Adverse reactions

CNS: headache, nervousness, insomnia

EENT: conjunctivitis, earache, epistaxis, pharyngitis

GI: abdominal pain; dry mouth; diarrhea, stomatitis (in children)

Skin: rash, photosensitivity, angioedema

Other: tooth disorder (in children), fever, flulike symptoms, viral infections

Interactions

Drug-food. Any food: increased drug absorption

Patient monitoring

• Watch for adverse reactions, especially in children.

• Assess patient's response to drug.

• Watch for new symptoms or exacerbation of existing symptoms.

Patient teaching

• Advise patient to take exactly as prescribed, once a day on empty stomach.

• Tell patient to report persistent or worsening symptoms.

• Instruct patient to report adverse reactions, such as headache or nervousness.

• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.

• As appropriate, review all other significant adverse reactions and interactions, especially those related to the foods mentioned above.

loratadine

(lor-a-ta-deen) loratadine,

Alavert Allergy 24 Hour

(trade name),

Alavert Children's Allergy

(trade name),

Claritin

(trade name),

Claritin 24-Hour Allergy

(trade name),

Claritin Children's Allergy

(trade name),

Claritin Liqui–Gels 24-Hour Allergy

(trade name),

Claritin Reditabs 24 Hour Allergy

(trade name),

Loradamed

(trade name),

Tavist ND Allergy

(trade name)

Classification

Therapeutic: antihistamines
Pregnancy Category: B

Indications

Relief of symptoms of seasonal allergies.Management of chronic idiopathic urticaria.Management of hives.

Action

Blocks peripheral effects of histamine released during allergic reactions.

Therapeutic effects

Decreased symptoms of allergic reactions (nasal stuffiness; red, swollen eyes, itching).

Pharmacokinetics

Absorption: Rapidly absorbed after oral administration (80%).Distribution: Unknown.Protein Binding: Loratadine—97%; descarboethoxyloratadine—73–77%.Metabolism and Excretion: Rapidly and extensively metabolized during first pass through the liver. Much is converted to descarboethoxyloratadine, an active metabolite.Half-life: Loratadine—8.4 hr; descarboethoxyloratadine—28 hr.

Time/action profile (antihistaminic effects)

ROUTEONSETPEAKDURATION
PO1–3 hr8–12 hr>24 hr

Contraindications/Precautions

Contraindicated in: Hypersensitivity.Use Cautiously in: Hepatic impairment or CCr <30 mL/min (↓ dose to 10 mg every other day); Lactation: Usually compatible with breast feeding (AAP); Obstetric / Pediatric: Pregnancy or children <2 yr (safety not established). Syrup contains sodium benzoate, avoid use in neonates; Geriatric: ↑ risk of adverse reactions.

Adverse Reactions/Side Effects

Central nervous system

  • confusion
  • drowsiness (rare)
  • paradoxical excitation

Ear, Eye, Nose, Throat

  • blurred vision

Gastrointestinal

  • dry mouth
  • GI upset

Dermatologic

  • photosensitivity
  • rash

Metabolic

  • weight gain

Interactions

Drug-Drug interaction

The following interactions may occur, but are less likely to occur with loratidine than with more sedating antihistamines.MAO inhibitors may intensify and prolong effects of antihistamines.↑ CNS depression may occur with other CNS depressants, including alcohol, antidepressants, opioid analgesics, and sedative/hypnotics.Amiodarone may ↑ loratadine levels and ↑ risk of QTc interval prolongationKava-kava, valerian, or chamomile can ↑ CNS depression.

Route/Dosage

Oral (Adults and Children ≥6 yr) 10 mg once daily.Oral (Children ≥2–5 yr) 5 mg once daily.

Renal Impairment

Oral (Adults) CCr <30 mL/min—10 mg every other day.

Hepatic Impairment

Oral (Adults) 10 mg every other day.

Availability (generic available)

Rapidly disintegrating tabletsmint: 10 mgOTCTablets: 10 mgOTCCapsules: 10 mgOTCChewable tablets: 5 mgOTC (grape flavored) Syrupgrape, fruit: 5 mg/5 mLOTCIn combination with: pseudoephedrine (Claritin-D)OTC. See combination drugs.

Nursing implications

Nursing assessment

  • Assess allergy symptoms (rhinitis, conjunctivitis, hives) before and periodically during therapy.
  • Assess lung sounds and character of bronchial secretions. Maintain fluid intake of 1500–2000 mL/day to decrease viscosity of secretions.
  • Lab Test Considerations: May cause false-negative result on allergy skin testing.

Potential Nursing Diagnoses

Ineffective airway clearance (Indications)
Risk for injury (Adverse Reactions)

Implementation

  • Do not confuse Claritin (loratadine) with Claritin Eye (ketotifen fumarate).
  • Oral: Administer once daily.
    • For rapidly disintegrating tablets (Alavert, Claritin Reditabs)—place on tongue. Tablet disintegrates rapidly. May be taken with or without water.

Patient/Family Teaching

  • Instruct patient to take medication as directed.
  • May cause dizziness or drowsiness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
  • Caution patient to use sunscreen and protective clothing to prevent photosensitivity reactions.
  • Advise patient to avoid taking alcohol or other CNS depressants concurrently with this drug.
  • Advise patient that good oral hygiene, frequent rinsing of mouth with water, and sugarless gum or candy may minimize dry mouth. Patient should notify dentist if dry mouth persists >2 wk.
  • Instruct patient to contact health care professional immediately if dizziness, fainting, or fast or irregular heartbeat occurs or if symptoms persist.

Evaluation/Desired Outcomes

  • Decrease in allergic symptoms.
  • Management of chronic idiopathic urticaria.
  • Management of hives.

Claritin

(klâr′ĭ-tn) A trademark for the drug loratadine.

Claritin®

Allergy medicine A nonsedating sympathomimetic antihistamine containing loratidine and pseudoephedrine, used for seasonal allergies Contraindications MAOI therapy, narrow-angle glaucoma, urinary retention, HTN, CAD. See Antihistamine.