desloratadine: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
desloratadine: clinical details
Prescribing considerations
- Confirm that rhinitis is allergic, particularly in children under 2, in whom infectious rhinitis is common.
- Use cautiously in severe renal impairment because systemic exposure is increased.
- Review personal or family seizure history, especially in young children.
- Consider pregnancy or breastfeeding alternatives with more established UK preference.
Contraindications and cautions
- Hypersensitivity to desloratadine, loratadine or a formulation excipient.
- The selected oral solution must not be used in hereditary fructose intolerance because it contains sorbitol.
Monitoring
- Assess symptom response and adverse effects, including somnolence despite its less-sedating profile.
- Stop and reassess if a new seizure occurs.
- Investigate clinically significant palpitations, jaundice or suspected hypersensitivity.
Clinical pharmacology
Desloratadine is loratadine's primary active metabolite and a selective peripheral H1-receptor antagonist. It is well absorbed, moderately protein-bound and has a terminal half-life of approximately 27 hours. The responsible metabolic enzyme has not been identified; it does not inhibit CYP3A4 in vivo or CYP2D6 in vitro and is neither a P-glycoprotein substrate nor inhibitor.
Formulation and product differences
- The selected film-coated tablet is licensed from 12 years and contains Sunset Yellow Aluminium Lake, which may cause allergic reactions.
- The selected oral solution is licensed over 1 year and contains sorbitol, propylene glycol and benzyl alcohol.
- Benzyl alcohol requires particular caution in young children and people with liver or kidney impairment.
- Use the supplied measuring device for oral solution.
desloratadine preparations and strengths
Tablet
Route: Oral
Strengths: 5 mg
desloratadine interactions
Clinically important interactions appear uncommon, but medicines and alcohol should still be reviewed.
Alcohol
Use caution because reports include alcohol intolerance and intoxication; avoid driving if sleepy or impaired.
Other antihistamines, including combination cough or cold products
Combining products can duplicate antihistamine exposure and increase side effects; check with a pharmacist or prescriber first.
Erythromycin or ketoconazole
Clinical studies found no clinically relevant interaction, although the wider medication list should still be reviewed.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.