desloratadine

Blocks peripheral effects of histamine released during allergic reactions.

Therapeutic effects:

Decreased symptoms of allergic reactions (nasal stuffiness, red swollen eyes). Decreased pruritus, reduction in number and size of hives in chronic idiopathic urticaria.

Pharmacokinetics ⬆ ⬇

Absorption: Well absorbed; absorption for orally-disintegrating tablets and oral tablets is identical.

Distribution: Enters breast milk.

Metabolism/Excretion: Extensively metabolized to 3-hydroxydesloratadine, an active metabolite; small percentage of patients may be slow metabolizers.

Half-Life: 27 hr.

Time/Action Profile ⬆ ⬇

(antihistaminic effects)

ROUTE	ONSET	PEAK	DURATION
PO	unknown	3 hr	24 hr

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity (cross-sensitivity to loratadine may occur);
Lactation: Lactation.

Use Cautiously in:

Hepatic or renal impairment (↓ dose to 5 mg every other day);
OB: Use during pregnancy only if potential maternal benefit justifies potential fetal risk;
Pedi: Children 6 mo (safety not established);
Geri: Dosing for older adults should consider hepatic, renal, or cardiac function, concomitant diseases, other drug therapy and risk of adverse reactions.

Adv. Reactions/Side Effects ⬆ ⬇

EENT: pharyngitis

GI: dry mouth

Neuro: drowsiness (rare)

Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS)

Interactions ⬆ ⬇

Drug-drug:

The following interactions may occur, but are less likely to occur with desloratidine than with more sedating antihistamines.
MAO inhibitors may ↑ and prolong effects of antihistamines.
↑CNS depression may occur with other CNS depressants including alcohol, antidepressants, opioids, and sedative/hypnotics.

Route/Dosage ⬆ ⬇

PO (Adults and Children ≥12 yr): 5 mg once daily.
PO (Children 6–11 yr): Oral solution: 2.5 mg once daily.
PO (Children 12 mo–5 yr): Oral solution: 1.25 mg once daily.
PO (Children 6–11 mo): Oral solution: 1 mg once daily.

Renal Impairment

PO (Adults and Children ≥12 yr): 5 mg every other day.

Hepatic Impairment

Availability ⬆ ⬇

(Generic available)

Oral solutionbubblegum: 0.5 mg/mL
Orally-disintegrating tabletstutti frutti: 2.5 mg; 5 mg
Tablets: 5 mg
In combination with: pseudoephedrine (Clarinex-D 12 Hour, Clarinex-D 24 Hour; see Appendix [not included in this PDA edition]).

Assessment ⬆ ⬇

Assess allergy symptoms (rhinitis, conjunctivitis, hives) before and periodically during therapy.
Assess lung sounds and character of bronchial secretions. Maintain fluid intake of 1500–2000 mL/day to decrease viscosity of secretions.

Lab Test Considerations:

May cause false-negative result on allergy skin testing.

Implementation ⬆ ⬇

PO: May be administered without regard to meals.
Pedi: Use calibrated measuring device to ensure accurate dose of syrup for children.
For orally disintegrating tablets: Place on tongue. Tablet disintegrates rapidly. May be taken with or without water. Administer immediately after opening the blister.

Patient/Family Teaching ⬆ ⬇

Instruct patients to take desloratidine as directed. Do not increase dose or frequency; does not increase effectiveness and may increase side effects. Advise patient to read Patient Information before starting therapy and with each Rx refill in case of changes.
May rarely cause drowsiness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
Advise patient to avoid taking alcohol or other CNS depressants concurrently with this drug.
Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications.
Advise patient that good oral hygiene, frequent rinsing of mouth with water, and sugarless gum or candy may minimize dry mouth. Patient should notify dentist if dry mouth persists >2 wk.
Advise patient to stop taking desloratidine and notify health care professional if signs and symptoms of hypersensitivity (rash, pruritus, urticaria, edema, dyspnea, swelling of lips, mouth or throat) occur.
Rep: Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected and to avoid breastfeeding during therapy.

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇

Action ⬆ ⬇