Loratadine chemical structure
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Alavert

Loratadine is a drug used to treat allergies. It is marketed by Schering-Plough under several trade names such as Claritin®, Clarityn® or Claratyne® depending on the market, and by Wyeth as Alavert. It is also available as a generic. Its active metabolite, desloratadine, is also on the market, though loratadine itself is the only drug of its class available over the counter (at least in the US and UK) as of 2005. more...

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It is sometimes combined with pseudoephedrine to add a decongestant aspect to the treatment, making it somewhat useful for colds as well as allergies.

Available forms

Loratadine is available as tablets and oral suspension, and also in combination with pseudoephedrine. Also available are quick-dissolving tablets, which are advertised as being faster to get into one's system but which require special handling to avoid degrading in the package.

Mechanism of action

Loratadine is a tricyclic antihistamine, which has a selective and peripheral H1-antagonist action. It has a long-lasting effect and does not cause drowsiness because it does not readily enter the central nervous system.

Pharmacokinetics

Loratadine is rapidly absorbed from the gastro-intestinal tract and it has rapid first-pass hepatic metabolism. Loratadine is almost totally bound to plasma proteins. Its metabolite, desloratadine (descarboethoxyloratadine), is also active, but binds to plasma proteins only moderately. The half-life of loratadine is on average 8 hours, and its metabolites 28 hours. About 40% is excreted as conjugated metabolites into the urine and similar amount into the feces. Traces of unmetabolised loratadine can be found in the urine.

Recommended dosage

  • Adults and children 15+ years: 10mg once every 24 hours.
  • Children 2-14 years:
    • Bodyweight above 30kg: 10mg once every 24 hours.
    • Bodyweight below 30kg: 5mg once every 24 hours.

(From product packaging for Clarityn tablets.)

Side-effects

Most common side-effects are fatigue, drowsiness, dry mouth, headache, and gastrointestinal disturbances.

Loratadine vs. desloratadine

A November 2003 article published in the journal American Family Physician about the safety, tolerability, effectiveness, price, and simplicity of desloratadine concluded the following:

Desloratadine is similar in effectiveness to fexofenadine and would be expected to produce results similar to loratadine and other nonsedating antihistamines.Thus Desloratidine is of faster onset of action than Loratidine as the Loratidine is activated in the liver into Desloratidine (which was introduced into the american market under the name Aerius by Schering Plough corporation). However, it may be an option for patients whose medical insurance no longer covers loratadine if the co-pay is less than the cost of the over-the-counter product.

External links and references

  • Desloratadine for Allergic Rhinitis, a November 2003 article from American Family Physician
  • Packaging directions in PDF Format. Product Packaging for Claritin 24 hour tablets. URL accessed on January 3, 2005.


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How can I prevent and treat seasonal allergies?
From Natural Health, 6/1/04

Naturopath

Taking nettle supplements can provide an antihistamine effect and provide symptom relief. For permanent allergy elimination, I use a therapy developed by acupuncturist and chiropractor Devi Nambudripad called NAET. It begins with testing the patient's muscle response to various substances. The theory is that allergies interrupt the body's energy flow, which causes weakness in the muscles in the presence of the allergen. After I test the patients, I stimulate pressure points along the spine while the patient is holding the allergen. The acupressure treatment retrains the body to accept the allergen. It's important to treat the whole body while treating the allergies. (To find an allergy-elimination therapist, visit naet.com.)

--Melody Wong, N.D., Palo Alto, Calif., naturopath

Medical advisor

A cold passes in seven to 10 days, so symptoms lingering beyond that probably indicate an allergy. A symptom that's unique to allergies is an itch at both the back of your throat and in the eyes, along with a runny nose and congestion. Ask a doctor about treating allergies, since there's an overwhelming number of medications. Over-the-counter, non-sedating antihistamines like Alavert or Claritin are a first line of defense, but many don't relieve congestion, so you might try Claritin-D or Alavert Allergy & Sinus. If you still can't find relief, see your doctor about tests to identify your sensitivity, and to get a prescription for a more appropriate drug.

The best way to prevent allergic reactions is to avoid contact with the allergen. In summer, stay inside in the early morning, when pollen levels are high. Change your clothes as soon as you come inside, then take a quick shower to remove allergens.

--Derek Johnson, M.D, medical advisor to the Asthma and Allergy Foundation of America

Allergist

You can control allergy-related sneezing and runny nose by using a nasal steroid spray on a daily basis. I recommend getting a prescription, since over-the-counter nasal sprays are mostly decongestants that aren't as powerful and can cause rebound congestion. With grass allergies, which are common in June, you should avoid going outside right after your lawn's been mowed. If you have to do the mowing, take an antihistamine an hour beforehand and wear a mask and goggles.

Immunotherapy provides long-term relief by desensitizing patients to allergens. We do skin tests to confirm sensitivity to pollens and inhalants, then make an extract containing those allergens. The extracts, which are administered in a shot, contain increasing concentrations of the allergens. After six weekly shots, most patients will get allergy relief.

--Georgiana Marie Sanders, M.D.,assistant professor of internal medicine and pediatrics at the University of Michigan

COPYRIGHT 2004 Weider Publications
COPYRIGHT 2004 Gale Group

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