From the Guidelines
Fexofenadine is generally preferred over loratadine for patients who need to avoid sedation completely, as it has virtually no sedative effects and doesn't cross the blood-brain barrier, as noted in studies such as 1 and 1. When considering the treatment of allergic conditions, both loratadine and fexofenadine are effective second-generation antihistamines. However, they have some differences that may make one more suitable than the other depending on individual needs.
- Loratadine (brand name Claritin) typically works at a standard dose of 10mg once daily, while fexofenadine (brand name Allegra) is usually taken as 60mg twice daily or 180mg once daily.
- Fexofenadine may be preferable for patients who need to avoid sedation completely, as it has virtually no sedative effects and doesn't cross the blood-brain barrier, as supported by 1 and 1.
- Loratadine, while still considered non-sedating for most people, may cause mild drowsiness in some individuals, particularly at higher doses.
- Fexofenadine also has fewer drug interactions since it doesn't undergo significant liver metabolism, making it safer for patients with liver impairment or those taking multiple medications, as mentioned in 1 and 1.
- However, loratadine may have a slightly longer duration of action and can be more affordable as a generic medication.
- Both medications are generally well-tolerated, with minimal side effects, and can be taken with or without food, though fexofenadine should be taken on an empty stomach for optimal absorption and should not be taken with fruit juices. It's essential to consider the individual patient's needs and medical history when choosing between loratadine and fexofenadine, as noted in 1 and 1.
From the Research
Comparison of Loratadine and Fexofenadine
- Loratadine and fexofenadine are both second-generation antihistamines used to treat allergic rhinitis and urticaria 2, 3, 4, 5, 6
- A study comparing the efficacy of loratadine and fexofenadine in the treatment of seasonal allergic rhinitis found that loratadine provided significantly better therapeutic response than fexofenadine in patients who failed to respond to initial therapy with the other drug 4
- Loratadine has been shown to be effective in relieving symptoms of seasonal allergic rhinitis, with 80% of patients experiencing mild or no disease symptoms after treatment 6
- Fexofenadine has also been shown to be effective in treating seasonal allergic rhinitis and chronic urticaria, with significant reductions in symptom severity and improvement in quality of life 3
- In terms of safety, both loratadine and fexofenadine are generally well-tolerated, with common adverse events including somnolence, fatigue, and headache 2, 3
Efficacy and Tolerability
- A study evaluating the safety and efficacy of desloratadine, a metabolite of loratadine, found that it was safe, well-tolerated, and efficacious in treating seasonal allergic rhinitis and chronic urticaria 3
- Loratadine has been shown to have a faster onset of action and be as effective as other second-generation antihistamines, such as azatadine and cetirizine 2, 6
- Fexofenadine has been shown to have a faster onset of symptom relief compared to other second-generation antihistamines, such as loratadine and cetirizine 3
Pharmacological Properties
- Loratadine is a long-acting antihistamine agent with partial selectivity for peripheral histamine H1-receptors 2
- Fexofenadine is also a long-acting antihistamine agent with selective peripheral H1-receptor antagonism 3
- Loratadine has been shown to have antiallergic properties, which may warrant its use in specific treatment situations 5