loratadine: clinical use

Prescribing considerations

• Confirm that symptoms fit allergic rhinitis or chronic idiopathic urticaria and review persistent, changing or poorly controlled symptoms.
• Use caution in severe hepatic impairment because clearance is reduced.
• Loratadine can suppress dermal reactivity; coordinate treatment with planned allergy skin testing.
• Check formulation suitability by age, weight, excipient tolerance and ability to swallow tablets.

Contraindications and cautions

• Hypersensitivity to loratadine or a formulation excipient.
• The syrup is unsuitable in hereditary fructose intolerance because it contains maltitol and sorbitol.
• The tablet is unsuitable in specified rare hereditary disorders affecting galactose or lactose handling.

Monitoring

• Routine laboratory or ECG monitoring is not generally required for uncomplicated use.
• Assess symptom response, sedation and suspected hypersensitivity or cardiac, neurological or hepatic adverse effects.
• During breastfeeding, consider infant monitoring for drowsiness, irritability, poor feeding and weight gain.

Clinical pharmacology

A tricyclic, selective peripheral H1-receptor antagonist, rapidly absorbed and extensively metabolised mainly through CYP3A4 and CYP2D6 to active desloratadine. Protein binding is high, and elimination occurs through urine and faeces, predominantly as metabolites.

Formulation and product differences

• The selected tablet is uncoated and contains lactose.
• The selected syrup contains maltitol, sorbitol, propylene glycol and sodium benzoate and is essentially sodium-free.
• The syrup offers an age- and weight-appropriate option where the selected tablet is unsuitable.

Syrup

Route: Oral

Strengths: 1 mg/mL, 5 mg/5 mL

Tablet

Route: Oral

Strengths: 10 mg