Lo Rat A Dine

loratadine (lor at' a deen) Alavert, Claritin, Claritin Reditabs Pregnancy Category B Drug class

Antihistamine (nonsedating type) Therapeutic actions

Competitively blocks the effects of histamine at peripheral H1 receptor sites; has anticholinergic (atropine-like) and antipruritic effects. Indications

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Symptomatic relief of perennial and seasonal allergic rhinitis, vasomotor rhinitis, allergic conjunctivitis, and mild, uncomplicated urticaria and angioedema Treatment of rhinitis and chronic urticaria in children > 2 yr

Contraindications and cautions

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Contraindicated with allergy to any antihistamines; narrow-angle glaucoma, stenosing peptic ulcer, symptomatic prostatic hypertrophy, asthma, bladder neck obstruction. Use cautiously with pyloroduodenal obstruction (avoid use or use with caution, condition may be exacerbated by drug); lactation, pregnancy.

Available forms

Tablets—10 mg; syrup—1 mg/mL; rapidly disintegrating tablets (Reditabs)—10 mg Dosages

Place rapid dissolving tablets on tongue. Swallow with or without water. ADULTS AND PATIENTS > 6 YR

10 mg daily PO on an empty stomach. PEDIATRIC PATIENTS 2–5 YR

5 mg PO daily (syrup). GERIATRIC PATIENTS OR PATIENTS WITH HEPATIC IMPAIRMENT

10 mg PO every other day. Pharmacokinetics Route Oral

Onset 1–3 hr

Peak 8–12 hr

Duration 24 hr

Metabolism: Hepatic; T1/2: 8.4 hr Distribution: Crosses placenta; enters breast milk Excretion: Urine and feces Adverse effects

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CNS: Headache, nervousness, dizziness, depression, drowsiness

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CV: Palpitations, edema GI: Appetite increase, nausea, diarrhea, abdominal pain Respiratory: Bronchospasm, pharyngitis Other: Fever, photosensitivity, rash, myalgia, arthralgia, angioedema, weight gain

Interactions

Drug-drug • Additive CNS depressant effects with alcohol or other CNS depressants • Increased and prolonged anticholinergic (drying) effects with MAOIs; avoid this combination Drug-lab test • False skin testing procedures if done while patient is on antihistamines Nursing considerations Assessment

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History: Allergy to any antihistamines; narrow-angle glaucoma, stenosing peptic ulcer, symptomatic prostatic hypertrophy, asthma, bladder neck obstruction, pyloroduodenal obstruction; lactation, pregnancy Physical: Skin color, lesions, texture; orientation, reflexes, affect; vision exams; R, adventitious sounds; prostate palpation; serum transaminase levels

Interventions

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Administer on an empty stomach 1 hr before or 2 hr after meals.

Teaching points

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Take this drug on an empty stomach 1 hr before or 2 hr after meals or food. If using rapid dissolving tablets, place on tongue, tablet will dissolve within seconds, swallow with or without water. Avoid the use of alcohol; serious sedation could occur. These side effects may occur: Dizziness, sedation, drowsiness (use caution if driving or performing tasks that require alertness); headache; thickening of bronchial secretions, dryness of nasal mucosa (use a humidifier). Report difficulty breathing, hallucinations, tremors, loss of coordination, irregular heartbeat.

Adverse effects in Italic are most common; those in Bold are life-threatening.