From the Guidelines
Loratadine is a first-line treatment for allergic conditions in adults, as it is a second-generation, non-sedating antihistamine that effectively treats symptoms of seasonal and perennial allergic rhinitis and chronic urticaria. The standard adult dose is 10 mg once daily, which provides 24-hour symptom relief with minimal drowsiness compared to older antihistamines. Loratadine works by selectively blocking peripheral H1 receptors, preventing histamine from binding and causing allergy symptoms like sneezing, itching, watery eyes, and runny nose. It's preferred as a first-line option because it rarely crosses the blood-brain barrier, resulting in minimal sedation and cognitive impairment, as noted in studies such as 1. Loratadine is available over-the-counter, making it accessible for most patients. It can be taken with or without food, though absorption may be slightly delayed when taken with a high-fat meal. Patients with severe liver impairment may need a reduced dosing schedule of 10 mg every other day. Side effects are generally mild and may include headache, dry mouth, and rarely, fatigue.
Some key points to consider when prescribing loratadine include:
- It is a second-generation antihistamine, which means it has less potential for sedation and cognitive impairment compared to first-generation antihistamines, as discussed in 1 and 1.
- It is effective in treating symptoms of seasonal and perennial allergic rhinitis and chronic urticaria, as noted in 1 and 1.
- It can be used in combination with other medications, such as intranasal corticosteroids, for moderate to severe seasonal allergic rhinitis, as recommended in 1, 1, and 1.
- It is available over-the-counter, making it easily accessible for patients.
- Patients with severe liver impairment may require a reduced dosing schedule, as noted in 1.
Overall, loratadine is a safe and effective treatment option for adults with allergic conditions, and its use is supported by recent guidelines, such as those published in 1, 1, 1, and 1.
From the FDA Drug Label
PRINCIPAL DISPLAY PANEL Loratadine Oral Solution USP, 5 mg/5mL 120 mL Carton Label The FDA drug label does not answer the question.
From the Research
First-Line Treatment for Allergies in Adults
Loratadine is considered a first-line treatment for mild intermittent or mild persistent allergic rhinitis in adults, according to a study published in JAMA 2.
Characteristics of Loratadine
Some key characteristics of loratadine include:
- It is a long-acting antihistamine with partial selectivity for peripheral histamine H1-receptors 3
- It has a fast onset of action and is essentially non-sedating 3, 4
- It is well-tolerated, with common adverse events including somnolence, fatigue, and headache 3, 4
Efficacy of Loratadine
Studies have shown that loratadine is effective in relieving symptoms of allergic rhinitis, including:
- Nasal congestion, rhinorrhea, and itching of the eyes, nose, and throat 2, 5
- It has been shown to be superior to placebo and as effective as other second-generation antihistamines, such as azatadine, cetirizine, and terfenadine 3, 4
- It provides early symptom control in seasonal allergic rhinitis, with significant reductions in total symptom scores compared to fexofenadine and placebo 5
Comparison with Other Treatments
Loratadine has been compared to other second-generation antihistamines, including: