Desloratadine

Availability
5 mg tablets; 2.5 mg, 5 mg orally dissolving tablets; 0.5 mg/mL syrup
Actions
A long-acting, nonsedating antihistamine with selective H1 receptor antagonist p
roperties. The drug reduces human mast cell release of the inflammatory cytokine
s. Therefore, it also exhibits antiallergic effects.
Therapeutic Effects
It is more potent than loratadine as an antagonist at H1 receptors. Desloratadin
e is effective in controlling allergic rhinitis and inhibiting histamine-induced
wheals and flare (hives).
Uses
Treatment of seasonal or perennial allergic rhinitis and idiopathic urticaria.
Contraindications
Hypersensitivity to desloratadine or loratadine; neonates; pregnancy (category C
); lactation.
Cautious Use
Renal and hepatic insufficiencies; bladder neck obstruction or urinary retention
; prostatic hypertrophy; glaucoma. Safety and efficacy in children <12 y not kno
wn.
Route & Dosage
Allergic Rhinitis, Idiopathic Urticaria
Adult: PO 5 mg q.d.
Renal Impairment
Adult:: PO Clcr <50 mL/min: 5 mg every other day
Hepatic Impairment
Adult: PO 5 mg every other day
Administration
Oral
Note that drug should be given q.o.d. to patients with significant renal or hepa
tic impairment.
Store between 2 25 C (36 77 F).
Adverse Effects ( 1%)
Body as a Whole: Pharyngitis, fatigue, flu-like symptoms, myalgia. CNS: Somnolen
ce, dizziness. GI: Dry mouth, nausea, dry throat. Urogenital: Dysmenorrhea.
Interactions
Drug: No clinically significant interactions established.
Pharmacokinetics
Absorption: Well absorbed. Peak: 3 h. Distribution: 85 89% protein bound. Metaboli
sm: Extensively metabolized in liver to 3-hydroxydesloratadine, an active metabo
lite. Elimination: Excreted equally in urine and feces. Half-Life: 27 h.
Nursing Implications
Assessment & Drug Effects
Assess carefully for and report distressing or dangerous S&S that occur after in
itiation of the drug. A variety of adverse effects, although not common, are pos
sible. Some are an indication to discontinue the drug.
Monitor cardiovascular status and report significant changes in BP and palpitati
ons or tachycardia.
Lab tests: Monitor periodically renal and liver function tests.
Concurrent drugs: Monitor ECG when used in combination with any other drug that
can increase blood level of desloratidine in patients with preexisting cardiac d
isease.
Patient & Family Education
Drug may cause significant drowsiness in older adult patients and those with liv
er or kidney impairment.
Note: Concurrent use of alcohol and other CNS depressants may have an additive e
ffect.

Do not take this drug more often than every other day if you have renal impairme
nt.
Do not breast feed while taking this drug without consulting physician.