Loratadine-pseudoephedrine

What is loratadine-pseudoephedrine?

Loratadine-pseudoephedrine is a combination drug (two drugs in one) taken orally as a tablet to treat allergies and cold symptoms, such as runny nose, congestion, and itchy eyes and nose. Loratadine is an antihistamine that provides allergy relief, while pseudoephedrine is a decongestant that improves breathing by relieving stuffy nose and promoting sinus drainage.¹ ²

What is loratadine-pseudoephedrine used to treat?

The combination of drugs in loratadine-pseudoephedrine makes it an effective treatment for the symptoms of nasal allergies and upper respiratory infections like colds and flu. The medication is US Food and Drug Administration (FDA)-approved for treating these symptoms in patients aged 12 years and older.

The antihistamine component of the drug, loratadine, relieves allergic symptoms. Whenever the body detects a foreign substance, it releases a compound called histamine, which expands blood vessels and causes inflammation to fight off the harmful substance. These effects are part of an allergic reaction accompanied by symptoms like itching of the eyes and nose, watery eyes, sneezing, runny nose, and nasal congestion. Other symptoms can include skin rashes, itchy skin, and hives. Antihistamines work by blocking the effects of histamine to reduce these symptoms.³

Pseudoephedrine, the decongestant part of the drug, works by narrowing blood vessels in the tissues lining the nasal passages, which reduces swelling and clears congestion in the nose and sinuses.⁴

Dosage forms and strengths

Loratadine-pseudoephedrine is sold over the counter (without a prescription) as a tablet for oral administration. The drug is available in two extended-release formulations:

• 12-hour (Claritin-D 12-Hour, Alavert D-12): Each tablet contains loratadine 5mg and pseudoephedrine sulfate 120mg⁵ ⁶

• 24-hour (Claritin-D 24-Hour): Each tablet contains loratadine 10mg and pseudoephedrine sulfate 240mg⁷

How to take loratadine-pseudoephedrine

The dosing instructions are based on the particular formulation, depending on whether you are taking a 12- or 24-hour tablet.

When taking loratadine-pseudoephedrine, swallow the tablet whole with a glass of water. Never crush, chew, or dissolve the tablet in water. This medication can be taken with or without meals.⁸

To reduce the risk of adverse effects, follow the instructions on the label and make sure not to exceed the maximum dose.

Loratadine-pseudoephedrine is prescribed for short-term use and should not be taken for more than seven days. If your symptoms persist beyond a week, consult your doctor.

Note: Loratadine-pseudoephedrine is not recommended for use in children under 12 years of age unless prescribed by a doctor. The package directions for loratadine-pseudoephedrine are intended for adults and children 12 years and older. Always consult your doctor before giving this drug to a child younger than 12 years.⁹

Seeing results

The two components of this drug have different rates of onset. Loratadine is effective within 1–3 hours and reaches peak effectiveness within 8–12 hours. Pseudoephedrine begins to work within 30 minutes and reaches peak levels in the blood after about two hours. Their combined effects last between 12 and 24 hours, depending on the formulation.¹⁰

Symptom relief can begin as early as 30 minutes after taking the medication.¹¹

Who should not take loratadine-pseudoephedrine?

Despite the drug’s availability over the counter, loratadine-pseudoephedrine is not suitable for everyone. Its safety and efficacy have not been established in children younger than 12 years, and loratadine-pseudoephedrine should not be given to patients in this age group except under a doctor’s supervision.¹²

The drug is also not recommended for people with any of the following:¹³ ¹⁴

• Known allergy or previous allergic reaction to loratadine, pseudoephedrine, or any other antihistamines or decongestants

• Coronary artery disease or other heart conditions

• Severely high blood pressure

• First trimester of pregnancy

• Urinary retention

• Angle-closure glaucoma

• Use of monoamine oxidase inhibitors (MAOIs) within the past two weeks

Patients with the following conditions should use caution when taking loratadine-pseudoephedrine:¹⁵ ¹⁶

• Liver disease

• Kidney disease

• Abnormal heart rhythms

• Diabetes mellitus

• Hyperthyroidism

• Enlarged prostate

• Seizure disorder

• Pregnancy and breastfeeding

Potential side effects of loratadine-pseudoephedrine

The side effects of loratadine pseudoephedrine vary from person to person and range from mild to severe.¹⁷

The most common side effect associated with loratadine-pseudoephedrine is headache, which occurs in more than 10% of people taking the drug.¹⁸

Other known side effects include the following:

• Drowsiness, fatigue

• Dry mouth, throat, or nose

• Hoarse voice

• Headache

• Abdominal pain

• Nervousness

• Insomnia

• Conjunctivitis (redness of the white parts of the eyes)

• Excessive movements, restlessness

• Upper respiratory tract infections

Most side effects of loratadine-pseudoephedrine are usually mild and resolve without intervention. However, some people experience serious reactions requiring medical attention. Depending on the severity of your reaction, speak with your doctor, call 911, or go to your nearest emergency department if you notice any of the following while taking loratadine-pseudoephedrine: 

• Rapid or irregular heartbeat

• Chest pain

• Blurred vision

• Urinary retention

• Severe dizziness

• Signs of an allergic reaction

Overdose

Taking more than the required dose of this drug can cause any of the adverse effects mentioned above, including seizures, nausea and vomiting, extreme nervousness, and a rapid or irregular heartbeat. 

Toxic symptoms of pseudoephedrine can be severe and include hallucinations, sedation, apnea, wide pupils, blood pressure abnormalities, and coma. Overdoses of loratadine are also serious and can manifest with tachycardia, abnormal heart rhythms, agitation, skin flushing, and urinary retention.¹⁹ ²⁰

Call 911 immediately if you have any of the above symptoms or think you might have overdosed on loratadine-pseudoephedrine.

Allergy information

Some people are allergic to one or more of the active or inactive ingredients in this medication. Stop taking the drug and seek urgent medical care if you notice any of the following while taking loratadine-pseudoephedrine:

• Rash, hives, or itching

• Swelling of the face, lips, or tongue

• Wheezing or difficulty breathing

• Rapid heart rate

• Vomiting

• Loss of consciousness

Long-term use of loratadine-pseudoephedrine

Loratadine is considered safe for long-term use, but you should only use it as needed. In contrast, long-term use of pseudoephedrine may reduce your body’s response to the drug and increase the risk of adverse effects, including anxiety, increased blood pressure, and psychological dependence.²¹

If you’re using loratadine-pseudoephedrine without your doctor’s guidance and your symptoms don’t improve within seven days, or if your symptoms are accompanied by a fever, speak with your doctor.²²

Loratadine-pseudoephedrine and pregnancy

The US FDA designated loratadine as a pregnancy category B drug. The research investigating its safety in humans during pregnancy is inadequate, but animal studies did not demonstrate a risk to the fetus.²³

Pseudoephedrine was given a pregnancy category C designation. Animal studies did demonstrate a risk to the fetus, but there’s a lack of research to confirm if the same risk exists for humans.²⁴

There is evidence that pseudoephedrine reduces blood flow to the uterus, but the effects on pregnancy outcomes (if any) are unclear. Speak with your doctor about the benefits and potential risks before taking loratadine-pseudoephedrine during pregnancy.²⁵ ²⁶

Breastfeeding

It is not recommended for breastfeeding mothers to take loratadine-pseudoephedrine. Both drugs are known to pass into breast milk, but little information is available about the potential side effects of the drug in breastfeeding infants. There are some reports of decreased milk production in mothers taking loratadine and pseudoephedrine separately. Speak with your doctor about the risks and benefits of taking this medication while breastfeeding.²⁷ ²⁸ ²⁹

Missed doses

Loratadine-pseudoephedrine is often taken on an as-needed basis. So, if you miss a dose, take it as soon as you remember. Don’t double your dose, as it may lead to toxic side effects.

Drug interactions

Loratadine-pseudoephedrine has significant interactions with many different medications, ranging from mild to severe.

The following drugs should be taken with caution or avoided while taking loratadine-pseudoephedrine:³⁰

• Attention-deficit/hyperactivity disorder (ADHD) medications like dexmethylphenidate (Focalin) and methamphetamine (Desoxyn)

• Blood pressure medications, such as midodrine, furosemide (Lasix), and diltiazem (Cardizem)

• Chemotherapy drugs, including procarbazine (Matulane) and erdafitinib (Balversa)

• Caffeine (excessive intake)

• Decongestants like phenylephrine (NeoSynephrine)

• Heart medicines, such as mavacamten (Camzyos) and digoxin (Lanoxin)

• Immune modulators like ozanimod (Zeposia), cyclosporine, and sirolimus (Rapamune)

• Loperamide (Imodium)

• MAOIs, including:

  • Antibiotics like linezolid (Zyvox), isoniazid, clarithromycin (Biaxin), and ketoconazole

  • Antidepressants, including isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), and others

  • Antiparkinsonism drugs, such as selegiline (Eldepryl), rasagiline (Azilect), and safinamide (Xadago)³¹

• Other types of antidepressants, such as:

  • Selective serotonin receptor inhibitors (SSRIs) like fluoxetine (Prozac) and fluvoxamine (Luvox)

  • Selective serotonin and norepinephrine reuptake inhibitors (SNRIs), such as desvenlafaxine (Pristiq) and venlafaxine (Effexor)

  • Tricyclics, including amitriptyline, amoxapine, doxepin (Silenor), and desipramine (Norpramin)

• Migraine medications, such as dihydroergotamine (Migranal) and ergotamine (Cafergot)

• Prostate medications like terazosin (Hytrin)

• Pulmonary medications, including albuterol (Proventil), inhaled epinephrine, salmeterol (Advair), doxapram (Dopram), and ivacaftor (Kalydeco)

• Recreational drugs like cocaine and ephedra

• Steroids, such as cortisone, dexamethasone, hydrocortisone, and prednisone

This is not an exhaustive list of all drugs that interact with loratadine-pseudoephedrine. So it’s best to review all of your medications with your doctor before taking this drug.

Can I drink alcohol while taking loratadine-pseudoephedrine?

You should not drink alcohol (or take other sedatives) while taking loratadine-pseudoephedrine because it can amplify the sedating effects of the drug, possibly leading to extreme drowsiness and impaired judgment.³²

What to discuss with your doctor before taking loratadine-pseudoephedrine

Loratadine-pseudoephedrine is available and can be taken without a prescription. However, you should speak with your doctor first if you have any medical problems, are taking any other medications, or are pregnant or breastfeeding.

At your appointment, you should discuss the following:³³

• All medications, herbs, vitamins, and supplements you take regularly or occasionally

• Recent medical procedures, especially transplants

• Your medical history and any health conditions you have

• Any history of a previous allergic reaction to a medication

• Your symptoms prompting you to take loratadine-pseudoephedrine

Stopping loratadine-pseudoephedrine

It's safe to stop loratadine-pseudoephedrine at any time or if your symptoms improve. 

Drug approval history

• 1994: The US FDA approved loratadine-pseudoephedrine under the brand name Claritin-D³⁴

Tips for taking loratadine-pseudoephedrine

• Always take the drug as prescribed and never exceed the maximum daily dose.

• Do not use alcohol or other recreational drugs when taking loratadine-pseudoephedrine.

• Check with your doctor if you're pregnant, planning a pregnancy, or breastfeeding before taking loratadine-pseudoephedrine.

• Stop using the drug and talk with your doctor if you develop a fever or your symptoms do not improve within seven days.

• Store your medication in a dry place at room temperature, making sure to keep it out of the reach of children.

• Avoid engaging in activities requiring alertness, such as driving, until you know how this drug affects you.

• Do not crush, chew, or split the tablets.³⁵

• Take each tablet with a full glass of water.³⁶

Frequently asked questions

What happens if I stop taking loratadine-pseudoephedrine?

There are no known adverse effects associated with suddenly stopping loratadine-pseudoephedrine. It's safe to stop taking the drug at any time or if your symptoms improve.

How long does it take for loratadine-pseudoephedrine to wear off?

12–24 hours, depending on which formulation of the drug you’re taking. 

Can I use loratadine-pseudoephedrine to treat coughs?

Yes, in certain cases. Loratadine-pseudoephedrine may be effective in treating allergy-related cough, along with other allergy symptoms.