Desloratadine

Class
Antihistamines
Subclass
Second-generation H1-antihistamines
Substance name
Desloratadine
Brand names
Clarinex®
Common formulations
Film-coated tablet
Dosage and administration
Adults patients
Allergic rhinitis • Seasonal or perennial
•
5 mg PO daily
Chronic spontaneous urticaria
•
5 mg PO daily
Acute urticaria • Off-label
•
5-20 mg PO daily
Chronic urticaria • Off-label
•
Maintenance: 5-10 mg PO daily
•
Maximum: 10 mg per day
Other off-label uses
•
Treatment of allergic conjunctivitis
Indications for use
Labeled indications
Adults
•
Treatment of allergic rhinitis (seasonal or perennial)
•
Treatment of chronic spontaneous urticaria
Children
•
Treatment of allergic rhinitis (seasonal or perennial)
•
Treatment of chronic urticaria
Off-label indications
Adults
•
Treatment of acute urticaria
•
Treatment of allergic conjunctivitis
•
Treatment of chronic urticaria
Safety risks
Contraindications
Hypersensitivity to desloratadine or its components
Warnings and precautions
Exacerbation of phenylketonuria
•
Use caution in patients with phenylketonuria, as PO disintegrating tablets contain phenylalanine.
Specific populations
Renal impairment
eGFR 0-90 mL/min/1.73 m²
•
Start at dose of 5 mg q48h.
Renal replacement therapy
Continuous renal replacement
•
Start at a dose of 5 mg q48h.
Intermittent hemodialysis
•
Start at a dose of 5 mg q48h.
Peritoneal dialysis
•
Start at a dose of 5 mg q48h.
Hepatic impairment
Any severity
•
Start at dose of 5 mg q48h.
Pregnancy and breastfeeding
Pregnancy
All trimesters • Australia Category: B1
•
Use only if clearly needed. First- and second-generation antihistamines do not seem to increase fetal risk in any trimester.
•
The British Association of Dermatologists guidelines suggest offering loratadine or cetirizine as acceptable second-generation H1-antihistamines during pregnancy, preferably after the first trimester.
Breastfeeding
Use only if benefits outweigh potential risks.
Unknown drug levels in breastfed infants.
No overt adverse effects on lactation reported.
Adverse reactions
Very common > 10%
•
Headache
Common 1-10%
•
Acute hepatitis, peripheral edema, pharyngitis, dizziness, dry mouth, dysmenorrhea, dyspepsia, fatigue, myalgia, nausea, somnolence, urticaria
Unknown frequency
•
Anaphylaxis, dystonia, hyperactivity, ↑ liver enzymes, ↑ serum TBIL, involuntary movements, extrapyramidal signs, dyspnea, ↑ appetite, palpitations, pruritus, restlessness, seizure, skin rash, tachycardia
Interactions
Drug(s)
Check Interactions
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