Loratadine (Claritin) Dosing Recommendations
For adults and children 6 years and over, the recommended dose of loratadine is 10 mg (2 teaspoonfuls of syrup or 1 tablet) once daily. For children 2 to under 6 years of age, the dose is 5 mg (1 teaspoonful of syrup) once daily. 1
Adult Dosing
- 10 mg once daily
- No dosage adjustment needed for elderly patients based on age alone
- For patients with liver or kidney disease, consult with a healthcare provider before use
Pediatric Dosing
- Ages 6 years and older: 10 mg (2 teaspoonfuls) once daily
- Ages 2 to under 6 years: 5 mg (1 teaspoonful) once daily
- Under 2 years of age: Consult a healthcare provider
Special Populations
Renal Impairment
- Loratadine should be used with caution in severe renal impairment 2
- Unlike some other antihistamines that require significant dose adjustments, loratadine has less stringent requirements for renal dose modification
Hepatic Impairment
- Patients with liver disease should consult a healthcare provider before use 1
Clinical Advantages of Loratadine
Loratadine is a second-generation antihistamine with several advantages:
- Once-daily dosing improves compliance 3
- Fast onset of action (within 1 hour) 3
- Long duration of effect (at least 24 hours) 3
- Minimal sedation compared to first-generation antihistamines 4
- No significant cardiac concerns (unlike some other second-generation antihistamines) 4
Efficacy
Loratadine has demonstrated effectiveness in:
- Allergic rhinitis
- Chronic urticaria
Clinical studies have shown loratadine to be superior to placebo and comparable in efficacy to other antihistamines including cetirizine, terfenadine, and chlorphenamine 4.
Safety Considerations
- Loratadine is generally well-tolerated with minimal sedation
- Common side effects include somnolence, fatigue, and headache, though these occur at rates similar to placebo 4
- Unlike first-generation antihistamines, loratadine causes significantly less sedation and cognitive impairment 5
- No serious ventricular arrhythmias have been reported with loratadine, unlike some other second-generation antihistamines 4
Practical Considerations
- Loratadine is available in multiple formulations including tablets, rapidly-disintegrating tablets, and syrup
- The syrup formulation is particularly useful for children who may have difficulty swallowing tablets 6
- For allergic conditions requiring additional symptom relief, combination products with pseudoephedrine are available, though these have different dosing schedules 7
Common Pitfalls to Avoid
- Using higher than recommended doses does not provide additional benefit but may increase side effects
- Not accounting for renal or hepatic impairment when appropriate
- Expecting immediate relief of nasal congestion (antihistamines primarily address histamine-mediated symptoms like sneezing, itching, and rhinorrhea)
- Using loratadine alone for anaphylaxis (epinephrine is the first-line treatment for anaphylaxis, not antihistamines) 5
Loratadine's favorable safety profile, once-daily dosing, and minimal sedative effects make it an appropriate first-line agent for the treatment of allergic rhinitis and urticaria in both adults and children.