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Loratadine

Antihistamine · Allergy Relief

AntihistamineAllergy Relief
CDSCO approved
EXCRETION
not curated
INTERACTIONS
none in our sources
PREGNANCY
Most manufacturers advise avoiding antihistamine use during pregnancy, though there is no evidence of teratogenicity.
FDA category + note

Mechanism

Loratadine is a second-generation, non-sedating antihistamine that works by blocking histamine H1 receptors. It achieves far lower brain concentrations than older antihistamines due to its minimal penetration of the blood-brain barrier. This reduced central nervous system penetration leads to less sedation and psychomotor impairment.

Indications

Nasal allergiesSeasonal allergic rhinitis (hayfever)Vasomotor rhinitisPrevention of urticariaUrticarial rashesPruritusInsect bites and stingsDrug allergiesChronic idiopathic urticariaallergic rhinitisconjunctivitishay feverpollinosisurticariadermographismatopic eczemaacute allergic reactions to drugs and foodsatopic dermatitis

Dosing

Adult
10 mg oral
Renal adjustment
Adults: Avoid if eGFR less than 10 mL/minute/1.73 m2. Use half normal dose if eGFR 30–50 mL/minute/1.73 m2. Use half normal dose and reduce dose frequency to alternate days if eGFR 10–30 mL/minute/1.73 m2. Children: Avoid if estimated glomerular filtration rate less than 10 mL/minute/1.73 m2. Use half normal dose if estimated glomerular filtration rate 30–50 mL/minute/1.73 m2.…
Geriatric
First-generation antihistamines are potentially inappropriate in elderly patients (STOPP criteria) due to the availability of safer, less toxic second-generation antihistamines like loratadine.

Pharmacokinetics

Half-life
Active metabolite has t½ of 17 hr
Bioavailability
L: —
Protein binding
L: 97%
Metabolism
Loratadine is metabolized to desloratadine (an active metabolite).
Excretion
L: Negligible

Contraindications

  • Hypersensitivity to loratadine

Side effects

Common
AstheniaDry mouthHeadacheDrowsiness (generally minimal)less central side effects such as sedationpractically nonsedating
Serious
  • Akathisia
  • Arrhythmias
  • Diarrhoea
  • Dizziness
  • Gastrointestinal discomfort
  • Hallucination
  • Hepatic disorders
  • Insomnia
  • Myalgia
  • Nausea
  • Palpitations
  • Seizure
  • Vomiting
  • Abnormal behaviour
  • Photosensitivity reaction
  • QT interval prolongation
  • seizures (in overdose)

Pregnancy & lactation

Pregnancy

Most manufacturers advise avoiding antihistamine use during pregnancy, though there is no evidence of teratogenicity.

Lactation

Most antihistamines are present in breast milk in varying amounts; manufacturers generally advise avoiding their use in breastfeeding mothers, although harm is not known.

Drug interactions

Cimetidine
Moderate
Database

Increased risk of dose-related adverse effects of loratadine, such as sedation, headache, and dry mouth. While loratadine is generally non-sedating, higher concentrations could potentially lead to more pronounced CNS effects.

Monitor for increased adverse effects. Consider a lower dose of loratadine if co-administration is necessary and adverse effects occur. Patients should be advised about the potential for increased sedation.

Clarithromycin
Moderate
Database

Increased risk of dose-related adverse effects of loratadine, such as sedation, headache, and dry mouth. Although loratadine is generally non-sedating, higher concentrations might enhance these effects.

Monitor for increased adverse effects. If co-administration is necessary, advise patients about the potential for increased sedation and other side effects. Dose adjustment of loratadine is generally not required unless adverse effects are prominent.

Source: DDInter

Erythromycin
Moderate
Database

Increased risk of dose-related adverse effects of loratadine, such as sedation, headache, and dry mouth. Although loratadine is generally non-sedating, higher concentrations might enhance these effects.

Monitor for increased adverse effects. If co-administration is necessary, advise patients about the potential for increased sedation and other side effects. Dose adjustment of loratadine is generally not required unless adverse effects are prominent.

Source: DDInter

Fluconazole
Moderate
Database

Increased risk of dose-related adverse effects of loratadine, such as sedation, headache, and dry mouth. Although loratadine is generally non-sedating, higher concentrations might enhance these effects.

Monitor for increased adverse effects. If co-administration is necessary, advise patients about the potential for increased sedation and other side effects. Dose adjustment of loratadine is generally not required unless adverse effects are prominent.

Source: DDInter

Ketoconazole
Moderate
Database

Increased risk of dose-related adverse effects of loratadine, such as sedation, headache, and dry mouth. While loratadine is generally non-sedating at recommended doses, higher concentrations could potentially lead to more pronounced CNS effects.

Monitor for increased adverse effects. Consider a lower dose of loratadine if co-administration is necessary and adverse effects occur. Patients should be advised about the potential for increased sedation.

Source: DDInter

7 additional low-confidence interactions hidden — those rows lack a documented mechanism or management plan in our sources.

Related guidelines

Other Antihistamine drugs

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Sources: KD Tripathi 7e, Goodman & Gilman 14e, Katzung, BNF·Verified: 2026-05-13 · House clinical team