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Loratadine vs Cetirizine
Introduction
For patients suffering from allergies, certain medications that inhibit the release of histamine, a compound in the body responsible for allergic reactions, can help manage symptoms. Loratadine and Cetirizine are two such drugs often prescribed to alleviate allergy symptoms. Each interferes with histamine production differently but both have symptom-relieving effects on patients suffering from allergies. Loratadine is a second-generation antihistamine primarily used to treat hay fever (allergic rhinitis) and hives. It works by blocking H1 receptors in the body which prevents the actions of histamine at these sites reducing allergy symptoms. On the other hand, Cetirizine also belongs to this class but it has more sedative properties compared to Loratadine due to its higher propensity for crossing blood-brain barrier making it less ideal than loratadine if drowsiness could be problematic.
What is Loratadine?
Loratadine (also known as Claritin) was one of the first non-sedating antihistamines, marking a significant advancement from the earlier generation of sedative antihistamines. Loratadine received FDA approval in 1993 and is used to relieve allergy symptoms such as runny nose, sneezing, itchy or watery eyes, and itching of the nose or throat. It works by blocking histamine—a substance in your body that causes allergic symptoms—effectively "trapping" it and preventing it from causing discomfort.
On the other hand, Cetirizine (known by Zyrtec among other brand names), another second-generation antihistamine approved later than Loratadine in 1995 by FDA has similar effects but with slight differences. While both drugs are effective at relieving allergy symptoms without causing drowsiness, some patients report that Cetirizine can still cause mild sleepiness for them; hence its influence on alertness might be slightly stronger compared to Loratadine.
What conditions is Loratadine approved to treat?
Loratadine is approved for the treatment of various allergic reactions:
- Seasonal and perennial allergic rhinitis, commonly known as hay fever
- Chronic idiopathic urticaria, or unknown origin hives
- Other forms of allergies that cause rashes or itchiness
How does Loratadine help with these illnesses?
Loratadine helps to manage allergies by blocking the action of histamine, a chemical in the body that is produced as part of an allergic reaction. It does this by binding to the H1 receptor sites on cells located throughout the body, which prevents histamine from attaching and triggering allergy symptoms. Histamine plays a significant role in many bodily functions including dilation of blood vessels, contraction of smooth muscle in airways, and regulation of gastric secretions; it's also integral to inflammation responses during allergic reactions. Therefore, individuals with allergies have an overactive response involving histamine release. By blocking histamine's action, Loratadine can alleviate negative effects like sneezing, itching or runny nose related to seasonal or perennial allergies.
Cetirizine works similarly but is often chosen for its faster onset action - usually within one hour compared to loratadine’s 1-3 hours - however it may cause slightly more sedation than Loratadine.
What is Cetirizine?
Cetirizine, marketed under various brand names including Zyrtec, is a second-generation antihistamine used in the treatment of hay fever, allergies, and urticaria (hives). Like loratadine, cetirizine blocks the effects of histamine but it does not cross the blood-brain barrier as much. This means it has less potential to cause sedation and drowsiness - common side effects associated with older antihistamines. Approved by the FDA in 1995, cetirizine can be beneficial for individuals who do not respond well or have adverse reactions to first-generation antihistamines. It's available over-the-counter in forms such as tablets, chewable tablets and syrup. The most common side effect of cetirizine is sleepiness while other less common side effects include dry mouth and headache.
What conditions is Cetirizine approved to treat?
Cetirizine, an over-the-counter antihistamine, is recognized for its efficacy in treating conditions such as:
- Seasonal and perennial allergic rhinitis (aka hay fever)
- Chronic urticaria (a condition characterized by the development of hives, typically lasting longer than six weeks)
How does Cetirizine help with these illnesses?
Histamine, much like norepinephrine, plays a crucial role in various body processes. It is an integral part of the immune response, leading to inflammation and other typical allergy symptoms such as itching, sneezing, runny nose and watery eyes. Cetirizine works by blocking histamine receptors in the body thereby reducing these allergy symptoms. Its action on inflammatory cytokines also contributes to its effectiveness as an antihistamine medication. Unlike loratadine which merely blocks peripheral H1 receptors, cetirizine has been found to suppress eosinophil migration into nasal passages following allergen exposure due to its effects on cell adhesion molecules. Therefore it can be a great choice for individuals who don't respond well enough to loratadine or those with moderate to severe allergic reactions.
How effective are both Loratadine and Cetirizine?
Both loratadine and cetirizine are second-generation antihistamines with established histories of efficacy in treating allergy symptoms. They were approved by the FDA only two years apart, and since they act on the same receptors, they can be interchangeably prescribed under similar circumstances. The effectiveness of loratadine and cetirizine in alleviating allergic rhinitis was studied directly in a double-blind clinical trial in 2001; both drugs showed comparable efficacy in controlling symptoms like sneezing, runny nose, itchy or watery eyes.
In terms of side effects, both medications are considered non-sedating antihistamines but some studies suggest that cetirizine could cause more drowsiness than loratadine for certain individuals. A review from 2003 reported that both these medicines have become extensively used worldwide due to their well-tolerated profiles even among elderly and pediatric populations.
A 2015 meta-analysis indicated that loratadine seems to provide quicker relief from symptoms when compared to cetirizine. However, this does not necessarily make one medicine superior over another as the choice between these two will depend on individual patient response and preference regarding potential sedation effect or speed of symptom relief.
At what dose is Loratadine typically prescribed?
Oral dosages of Loratadine for adults and children over 6 years old typically start at 10 mg/day to manage allergy symptoms. For younger children aged 2-5 years, the dosage is usually halved to 5 mg/day. On the other hand, Cetirizine's standard adult and child (over 6 years) dose also begins at 10 mg/day. However, for smaller children aged between 2-5 years, it may be reduced to a daily dose of either a single-use of 2.5mg or twice-daily use with a total sum not exceeding this amount in a day based on their response and tolerance level. In any case, neither medication should exceed its maximum recommended daily dosage.
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At what dose is Cetirizine typically prescribed?
Cetirizine treatment is typically started at a dosage of 5-10 mg/day for adults and children over six years old. This dose can be taken once daily, preferably in the evening as cetirizine may cause drowsiness in some individuals. For children between two to six years old, the recommended initial dosage is 2.5 mg (half a tablet) once daily, which can be increased to 5mg if needed. It's essential not to exceed the maximum dose of 10mg per day unless advised by your healthcare provider. The effectiveness of this medication should become evident within an hour or two after administration; however, it may take a few days of regular usage for its full effect on allergy symptoms.
What are the most common side effects for Loratadine?
Common side effects of loratadine include:
- Headache
- Fatigue or feeling tired
- Dry mouth
- Nervousness
- Stomach pain, diarrhea
- Red eyes, blurred vision
Whereas cetirizine is associated with the following common side effects:
- Drowsiness, fatigue or feeling tired.
- Dry mouth
- Nausea and constipation.
- Changes in vision (blurriness)
It's important to note that while both antihistamines are generally well-tolerated, they may affect individuals differently. Should you experience any of these symptoms severely or persistently when taking either medication, it's advised to seek medical attention promptly.
Are there any potential serious side effects for Loratadine?
Loratadine and cetirizine are both antihistamines, but they can have different effects on individuals:
- Rarely some people may experience severe allergic reactions to either medication: symptoms include hives, difficulty breathing, facial or throat swelling
- Some users report blurred vision or eye pain; in very rare cases, there could be redness or swelling around the eyes.
- Rapid heartbeat, palpitations or feelings of faintness are uncommon side effects but should not be ignored if experienced.
- Low sodium levels - although extremely rare with these medications - can cause headache, confusion, slurred speech, severe weakness and loss of coordination.
- A serious nervous system reaction is highly unlikely with these drugs but watch out for rigid muscles high fever sweating confusion fast heartbeats tremors feeling like you might pass out.
Remember that this list is not exhaustive. Always speak to your healthcare provider about potential side effects before starting a new medication.
What are the most common side effects for Cetirizine?
Cetirizine, another commonly used antihistamine for allergy symptoms, may cause a variety of side effects including:
- Dry mouth, sore throat
- Drowsiness or fatigue
- Nausea or stomach upset
- Headache or dizziness
- Difficulty urinating or not being able to urinate at all
- Blurred vision
- Changes in appetite and weight gain While most people tolerate Cetirizine well, it may also lead to more serious side effects such as confusion and agitation. It's best to consult with your healthcare provider before starting new medication.
Are there any potential serious side effects for Cetirizine?
While cetirizine is generally well-tolerated and safe for use, there are some potential side effects to be aware of. These include:
- Severe allergic reactions: symptoms can be similar to those of the allergies you're trying to treat, like hives or swelling in your face or throat.
- Difficulty breathing: if this occurs, seek medical attention immediately.
- Rapid or irregular heartbeat: although uncommon, it's important to notify a healthcare provider if you notice this symptom.
- Confusion or unusual changes in mood/behavior: while rare, these could signal an adverse reaction.
- Blurred vision and seeing halos around lights may occur; however, they are not common side effects but should still be reported.
If any such symptoms arise when taking cetirizine - even ones that seem less serious like mild sleep problems - discontinue its usage and consult with your healthcare provider as soon as possible.
Contraindications for Loratadine and Cetirizine?
Both loratadine and cetirizine, along with most other antihistamine medications, may cause drowsiness in some people. If you notice an increase in fatigue or a decrease in alertness after taking these medicines, please consult your doctor immediately.
Neither loratadine nor cetirizine should be taken if you are using or have recently stopped using central nervous system depressants (like sedatives and tranquilizers), muscle relaxants, or alcohol. Always inform your physician about all the medications that you are currently taking; central nervous system depressants will require a period of clearance from the body to prevent potentially hazardous interactions with loratidin and cetirizne. Moreover, both drugs should be used cautiously by patients who have kidney or liver problems as they can affect the drug's metabolism and elimination from the body.
How much do Loratadine and Cetirizine cost?
For the brand name versions of these drugs:
- The price of 30 tablets of Claritin (10 mg Loratadine) averages around $20, which works out to about $0.67 per day.
- The price of 30 tablets of Zyrtec (10 mg Cetirizine) is about $18, working out to approximately $0.60 per day.
Thus, if you are using either drug at the recommended dosage (one tablet daily), then brand-name Zyrtec could be less expensive on a daily treatment basis. Please note that cost should not be your primary consideration in determining which antihistamine is best for you.
For the generic versions Loratadine and Cetirizine, costs are significantly lower:
- Loratadine (10 mg tablets) is available in packs ranging from 30 up to several hundred tablets with approximate costs ranging from as low as $0.15/day for larger containers.
- Generic cetirizine can also be purchased in various quantity packs; prices start as low as roughly $0.12/day when buying larger quantities.
The choice between loratadine and cetirizine depends more on personal tolerance and symptom relief than pricing since both generics offer affordable options for allergy sufferers.
Popularity of Loratadine and Cetirizine
Loratadine, available in generic form and under brand names such as Claritin, was estimated to have been prescribed to about 24 million people in the US during 2015-2016. Loratadine accounted for just over 22% of antihistamine prescriptions in the US. However, it stands out as a non-sedating or second-generation antihistamine (less likely to cause drowsiness compared to first-generation or traditional antihistamines). The use of loratadine has generally remained stable since its introduction.
Cetirizine, including brand versions such as Zyrtec, was prescribed to around 19 million people in the USA during that same period. In the US, cetirizine accounts for just under 18% of second-generation antihistamine prescriptions but is also less likely than other medications in this category to cause drowsiness. The prevalence of cetirizine has increased significantly since its over-the-counter availability began early this century.
Conclusion
Both loratadine and cetirizine are second-generation antihistamines that have been widely used for the management of allergies. They work by blocking histamine, a substance in your body that triggers allergic symptoms. Both medications are supported by numerous clinical studies demonstrating their efficacy over placebo treatments.
Though they share a common mechanism of action, there is some difference in how these drugs are metabolized which may affect how they are prescribed. Loratadine tends to cause less drowsiness compared to cetirizine due to its minimal penetration into the central nervous system.
Both loratadine and cetirizine can be purchased without a prescription and come in generic forms, providing substantial cost savings especially for those who must pay out-of-pocket for their medication.
The side effects profile between the two drugs is similar; however, as aforementioned cetirizine does tend to cause more drowsiness than loratadine. It's important that patients monitor their reactions when starting either treatment and seek medical help immediately if any severe adverse reaction occurs or if allergy symptoms worsen despite treatment.