Can loratadine help with pruritus?

From the Guidelines

Loratadine can help with itching, as it is a non-sedative antihistamine that blocks histamine, a substance that causes itching and other allergic symptoms. According to the British Association of Dermatologists' guidelines for the investigation and management of generalized pruritus in adults without an underlying dermatosis, 2018 1, loratadine 10 mg is considered a treatment option for relieving itch in patients with generalized pruritus. The guidelines suggest that nonsedative antihistamines such as fexofenadine 180 mg, loratadine 10 mg, or mildly sedative agents such as cetirizine 10 mg may be effective in relieving itch.

Key Points to Consider

• Loratadine is available over-the-counter under brand names like Claritin or as generic versions.
• The standard dose for adults and children 6 years and older is 10 mg once daily, while children 2-5 years old typically take 5 mg once daily.
• Loratadine is considered a non-drowsy antihistamine, meaning it's less likely to cause sleepiness compared to older antihistamines like diphenhydramine (Benadryl).
• For best results, take loratadine regularly as directed rather than only when symptoms occur.
• It may take a few days to reach full effectiveness, and if itching is severe or doesn't improve after a week of treatment, a healthcare provider should be consulted as the itching might have a cause that requires different treatment.

Additional Considerations

• Other treatment options for generalized pruritus include paroxetine, fluvoxamine, mirtazapine, naltrexone, butorphanol, gabapentin, pregabalin, ondansetron, or aprepitant orally 1.
• Sedative antihistamines are recommended only in the short-term or palliative setting, such as hydroxyzine 1.
• Acupuncture in combination with Chinese herbal remedies or as a second-line therapy may also be considered for patients with generalized pruritus 1.

From the FDA Drug Label

Temporarily relieves these symptoms due to hay fever or other upper respiratory allergies: • runny nose • itchy, watery eyes • sneezing • itching of the nose or throat

Loratadine can help with itching, specifically itching of the nose or throat due to hay fever or other upper respiratory allergies 2.

• It is used to relieve symptoms of allergies, including itching.
• The itching relief is limited to the nose or throat.

From the Research

Loratadine and Itching Relief

• Loratadine is a second-generation antihistamine that has been shown to be effective in relieving symptoms of allergic reactions, including itching 3.
• A study on mosquito-bite-sensitive children found that loratadine decreased the size of wheals by 45% and accompanying pruritus by 78% at 15 min compared to placebo 4.
• Another study found that loratadine significantly suppressed itching produced by histamine, codeine, and allergens in skin prick tests 5.
• Loratadine is considered a treatment of choice for chronic idiopathic urticaria, which is characterized by itchy wheals 6.

Mechanism of Action

• Loratadine works by blocking the action of histamine, a chemical released during an allergic reaction that causes blood vessels to dilate and lead to itching and swelling 3.
• The drug's antiallergic properties may also contribute to its effectiveness in relieving itching symptoms 3.

Comparison to Other Treatments

• Loratadine has been compared to other antihistamines, such as montelukast, and has been found to be effective in suppressing itching and wheal size in skin prick tests 5.
• The choice of antihistamine for treating urticaria, including itching, depends on the specific type of urticaria and the patient's individual needs 6.