Home Drug Guide Loratadine and Pseudoephedrine Sulfate

Drug Guide

Generic Name

Loratadine and Pseudoephedrine Sulfate

Brand Names Claritin-D, Claritin-D 24 Hour, Loratadine and Pseudoephedrine Sulfate

Classification

Therapeutic: Nasal decongestant and antihistamine combination

Pharmacological: Antihistamine and sympathomimetic agent

FDA Approved Indications

  • Relief of nasal congestion, sneezing, watery eyes, and runny nose associated with allergic rhinitis and chronic idiopathic urticaria

Mechanism of Action

Loratadine is a selective peripheral H1 antihistamine that blocks the effects of histamine. Pseudoephedrine is a sympathomimetic agent that constricts blood vessels in the nasal passages, decreasing nasal congestion.

Dosage and Administration

Adult: Loratadine 10 mg and pseudoephedrine 120 mg once daily. For 24-hour formulation, same doses every 24 hours.

Pediatric: Not generally recommended for children under 12; consult specific pediatric dosing guidance.

Geriatric: Adjust dose as needed; be cautious due to potential cardiovascular effects of pseudoephedrine.

Renal Impairment: Dose adjustment may be necessary; consult specific guidelines.

Hepatic Impairment: No specific adjustment necessary, but monitor patient.

Pharmacokinetics

Absorption: Both components are absorbed well from the gastrointestinal tract.

Distribution: Loratadine is extensively bound to plasma proteins; pseudoephedrine has minimal protein binding.

Metabolism: Loratadine is metabolized in the liver; pseudoephedrine undergoes minimal metabolism.

Excretion: Primarily excreted in urine; loratadine metabolites are also excreted via feces.

Half Life: Loratadine approximately 8 hours; pseudoephedrine about 6-12 hours.

Contraindications

  • Hypersensitivity to loratadine, pseudoephedrine, or any component.
  • Severe hypertension or coronary artery disease (due to pseudoephedrine).
  • Use in patients with severe or uncontrolled hypertension.
  • Use cautiously in patients with glaucoma, urinary retention, or hyperthyroidism.

Precautions

  • Use with caution in patients with cardiovascular disease, diabetes, glaucoma, or hyperthyroidism. May cause insomnia, nervousness, or increase blood pressure.

Adverse Reactions - Common

  • Headache (Common)
  • Dry mouth (Common)
  • Insomnia or nervousness (pseudoephedrine) (Common)

Adverse Reactions - Serious

  • Hypertension or palpitations (pseudoephedrine) (Serious)
  • Allergic reactions (rash, swelling) (Serious)

Drug-Drug Interactions

  • MAO inhibitors (risk of hypertensive crisis), other sympathomimetics, CNS depressants.

Drug-Food Interactions

  • Avoid excessive caffeine intake.

Drug-Herb Interactions

  • Beware of herbal products that may elevate blood pressure or cause CNS effects.

Nursing Implications

Assessment: Monitor blood pressure, heart rate, and for signs of CNS stimulation. Assess for allergic symptoms.

Diagnoses:

  • Ineffective airway clearance
  • Risk for hypertension
  • Insomnia

Implementation: Administer as prescribed, typically once daily. counsel patient on avoiding caffeine and other stimulants.

Evaluation: Monitor effectiveness in relieving allergy symptoms and adverse effect profile.

Patient/Family Teaching

  • Take medication as directed. Do not exceed recommended dose.
  • Report any increase in blood pressure, palpitations, or nervousness.
  • Be aware that pseudoephedrine can cause sleeplessness; best taken earlier in the day.

Special Considerations

Black Box Warnings:

  • Pseudoephedrine may elevate blood pressure and increase risk of cardiovascular events, especially in patients with pre-existing hypertension or cardiac disease.

Genetic Factors: No specific genetic markers affect response.

Lab Test Interference: Pseudoephedrine may interfere with urinary drug testing and cause false positives for amphetamines.

Overdose Management

Signs/Symptoms: Severe hypertension, tachycardia, agitation, hallucinations.

Treatment: Symptomatic and supportive care; consider antihypertensive agents if needed.

Storage and Handling

Storage: Store at room temperature, away from light and moisture.

Stability: Stable up to the expiration date on the package.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.