Version July 2025
Cold and allergy symptoms: Oral:
Loratadine 5 mg/pseudoephedrine 120 mg per tablet: One tablet every 12 hours (maximum: 2 tablets/day)
Loratadine 10 mg/pseudoephedrine 240 mg per tablet: One tablet daily (maximum: 1 tablet/day)
Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
Altered kidney function:
CrCl ≥30 mL/minute: No dosage adjustment necessary (Ref).
CrCl <30 mL/minute:
Loratadine 5 mg/pseudoephedrine 120 mg per tablet: One tablet every 24 hours (Ref).
Loratadine 10 mg/pseudoephedrine 240 mg per tablet: One tablet every other day (Ref).
There are no dosage adjustments provided in manufacturer's labeling; however, hepatic impairment increases loratadine systemic exposure; use with caution and dosage adjustment should be considered. Previous FDA approved labeling recommended to avoid use in patients with hepatic impairment (Ref).
Refer to adult dosing.
(For additional information see "Loratadine and pseudoephedrine: Pediatric drug information")
Allergic rhinitis, seasonal/nasal decongestion: Children ≥12 years and Adolescents:
12-hour formulation (loratadine 5 mg and pseudoephedrine 120 mg/tablet): Oral: 1 tablet every 12 hours.
24-hour formulation (loratadine 10 mg and pseudoephedrine 240 mg/tablet): Oral: 1 tablet once daily.
Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
Altered kidney function (Ref):
Children ≥12 years and Adolescents:
CrCl ≥30 mL/minute: No adjustment necessary.
CrCl <30 mL/minute:
12-hour formulation: 1 tablet every 24 hours.
24-hour formulation: 1 tablet every other day.
There are no dosage adjustments provided in manufacturer's labeling; however, hepatic impairment increases loratadine systemic exposure; use with caution and dosage adjustment should be considered. Previous FDA approved labeling recommended to avoid use in patients with hepatic impairment (Ref).
See individual agents.
OTC labeling: When used for self-medication, do not use if you are sensitive to loratadine, pseudoephedrine, or any component of the formulation; during or within 14 days of monoamine oxidase inhibitor therapy; severe hypertension or coronary heart disease.
Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
Other warnings/precautions:
• Self-medication (OTC use): When used for self-medication (OTC), notify health care provider prior to use if you have diabetes, difficulty urinating due to an enlarged prostate, heart disease, hypertension, kidney disease, liver disease, or thyroid disease. Do not exceed the recommended doses; discontinue use and contact health care provider if symptoms do not improve within 7 days or are accompanied by fever; if nervousness, dizziness, or sleeplessness occur; or if an allergic reaction to the formulation occurs.
Safety and efficacy for the use of cough and cold products in pediatric patients <4 years of age is limited; the AAP warns against the use of these products for respiratory illnesses in young children. Serious adverse effects including death have been reported (in some cases, high blood concentrations of pseudoephedrine were found). Many of these products contain multiple active ingredients, increasing the risk of accidental overdose when used with other products. The FDA does not recommend OTC uses for these products in pediatric patients <2 years of age and recommends to use with caution in pediatric patients ≥2 years of age. Health care providers are reminded to ask caregivers about the use of OTC cough and cold products in order to avoid exposure to multiple medications containing the same ingredient (AAP 2018; CDC 2007; FDA 2017; FDA 2018).
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Tablet, extended release:
Alavert Allergy and Sinus: Loratadine 5 mg and pseudoephedrine sulfate 120 mg [DSC]
Alavert D-12 Hour Allergy and Congestion: Loratadine 5 mg and pseudoephedrine sulfate 120 mg
Allergy Relief-D: Loratadine 10 mg and pseudoephedrine sulfate 240 mg
Claritin-D 12 Hour Allergy & Congestion: Loratadine 5 mg and pseudoephedrine sulfate 120 mg [contains calcium 30 mg/tablet]
Claritin-D 24 Hour Allergy & Congestion: Loratadine 10 mg and pseudoephedrine sulfate 240 mg [contains calcium 25 mg/tablet]
Loratadine-D 12 Hour: Loratadine 5 mg and pseudoephedrine sulfate 120 mg
Loratadine-D 24 Hour: Loratadine 10 mg and pseudoephedrine sulfate 240 mg
Generic: Loratadine 5 mg and pseudoephedrine sulfate 120 mg; Loratadine 10 mg and pseudoephedrine sulfate 240 mg
Yes
Tablet, 12-hour (Claritin-D 12 Hour Oral)
5-120 mg (per each): $1.23
Tablet, 24-hour (Claritin-D 24 Hour Oral)
10-240 mg (per each): $1.62
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
Oral: Do not divide, chew, crush, or dissolve tablets.
Bariatric surgery: Tablet, extended release: Some institutions may have specific protocols that conflict with these recommendations; refer to institutional protocols as appropriate. Switch to IR separate components.
Oral: Administer without regard to meals. Swallow extended-release tablets whole; do not chew or crush; administer with a full glass of water.
Cold, allergy symptoms: Temporary relief of sinus and nasal congestion, runny nose, sneezing, itching of nose or throat and itchy, watery eyes due to common cold, hay fever (allergic rhinitis), or other upper respiratory allergies or sinusitis
Claritin-D may be confused with Claritin-D 24
Claritin-D 24 may be confused with Claritin-D
Refer to individual components.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.
Alpha1-Blockers: May decrease therapeutic effects of Alpha-/Beta-Agonists. Risk C: Monitor
Amezinium: Antihistamines may increase stimulatory effects of Amezinium. Risk C: Monitor
Amiodarone: May increase serum concentration of Loratadine. Management: Due to reported QT interval prolongation and Torsades de Pointes with this combination, consider an alternative to loratadine when possible. If concomitant use cannot be avoided, monitor QT interval and for signs of dyshythmias (eg, syncope). Risk D: Consider Therapy Modification
Atomoxetine: May increase hypertensive effects of Sympathomimetics. Atomoxetine may increase tachycardic effects of Sympathomimetics. Risk C: Monitor
Benzylpenicilloyl Polylysine: Coadministration of Alpha-/Beta-Agonists and Benzylpenicilloyl Polylysine may alter diagnostic results. Management: Consider use of a histamine skin test as a positive control to assess a patient's ability to mount a wheal and flare response. Risk D: Consider Therapy Modification
Benzylpenicilloyl Polylysine: Coadministration of Antihistamines and Benzylpenicilloyl Polylysine may alter diagnostic results. Management: Suspend systemic H1 antagonists for benzylpenicilloyl-polylysine skin testing and delay testing until systemic antihistaminic effects have dissipated. A histamine skin test may be used to assess persistent antihistaminic effects. Risk D: Consider Therapy Modification
Betahistine: Antihistamines may decrease therapeutic effects of Betahistine. Betahistine may decrease therapeutic effects of Antihistamines. Risk C: Monitor
Bornaprine: Sympathomimetics may increase anticholinergic effects of Bornaprine. Risk C: Monitor
Bromocriptine: May increase hypertensive effects of Alpha-/Beta-Agonists. Management: Consider alternatives to this combination when possible. If combined, monitor for hypertension and tachycardia, and do not coadminister these agents for more than 10 days. Risk D: Consider Therapy Modification
Cannabinoid-Containing Products: May increase tachycardic effects of Sympathomimetics. Risk C: Monitor
Certoparin: Antihistamines may increase therapeutic effects of Certoparin. Risk C: Monitor
Chloroprocaine (Systemic): May increase hypertensive effects of Alpha-/Beta-Agonists. Risk C: Monitor
Cocaine (Topical): May increase hypertensive effects of Sympathomimetics. Management: Consider alternatives to use of this combination when possible. Monitor closely for substantially increased blood pressure or heart rate and for any evidence of myocardial ischemia with concurrent use. Risk D: Consider Therapy Modification
Dihydralazine: Sympathomimetics may decrease therapeutic effects of Dihydralazine. Risk C: Monitor
Doxofylline: Sympathomimetics may increase adverse/toxic effects of Doxofylline. Risk C: Monitor
Ergot Derivatives (Vasoconstrictive CYP3A4 Substrates): May increase vasoconstricting effects of Alpha-/Beta-Agonists. Risk X: Avoid
Esketamine (Injection): May increase adverse/toxic effects of Sympathomimetics. Specifically, the risk for elevated heart rate, hypertension, and arrhythmias may be increased. Risk C: Monitor
FentaNYL: Decongestants may decrease serum concentration of FentaNYL. Risk C: Monitor
Guanethidine: May increase hypertensive effects of Sympathomimetics. Guanethidine may increase arrhythmogenic effects of Sympathomimetics. Risk C: Monitor
Haloperidol: QT-prolonging Agents (Indeterminate Risk - Caution) may increase QTc-prolonging effects of Haloperidol. Risk C: Monitor
Hexoprenaline: May increase adverse/toxic effects of Alpha-/Beta-Agonists. Risk X: Avoid
Hyaluronidase: Antihistamines may decrease therapeutic effects of Hyaluronidase. Risk C: Monitor
Iobenguane Radiopharmaceutical Products: Alpha-/Beta-Agonists (Indirect-Acting) may decrease therapeutic effects of Iobenguane Radiopharmaceutical Products. Management: Discontinue all drugs that may inhibit or interfere with catecholamine transport or uptake for at least 5 biological half-lives before iobenguane administration. Do not administer these drugs until at least 7 days after each iobenguane dose. Risk X: Avoid
Ketoconazole (Systemic): May increase serum concentration of Loratadine. Risk C: Monitor
Kratom: May increase adverse/toxic effects of Sympathomimetics. Risk X: Avoid
Landiolol: Sympathomimetics may decrease therapeutic effects of Landiolol. Risk C: Monitor
Levothyroxine: May increase therapeutic effects of Sympathomimetics. Sympathomimetics may increase therapeutic effects of Levothyroxine. Levothyroxine may increase adverse/toxic effects of Sympathomimetics. Specifically, the risk of coronary insufficiency may be increased in patients with coronary artery disease. Risk C: Monitor
Linezolid: May increase hypertensive effects of Sympathomimetics. Management: Consider initial dose reductions of sympathomimetic agents, and closely monitor for enhanced blood pressure elevations, in patients receiving linezolid. Risk D: Consider Therapy Modification
Lisuride: May increase hypertensive effects of Alpha-/Beta-Agonists. Risk X: Avoid
Metergoline: May increase adverse/toxic effects of Alpha-/Beta-Agonists (Indirect-Acting). Risk C: Monitor
Monoamine Oxidase Inhibitors: May increase hypertensive effects of Alpha-/Beta-Agonists (Indirect-Acting). While linezolid is expected to interact via this mechanism, management recommendations differ from other monoamine oxidase inhibitors. Refer to linezolid specific monographs for details. Risk X: Avoid
Pergolide: May increase hypertensive effects of Alpha-/Beta-Agonists. Risk C: Monitor
Pitolisant: Antihistamines may decrease therapeutic effects of Pitolisant. Risk X: Avoid
QT-prolonging Agents (Highest Risk): QT-prolonging Agents (Indeterminate Risk - Caution) may increase QTc-prolonging effects of QT-prolonging Agents (Highest Risk). Management: Monitor for QTc interval prolongation and ventricular arrhythmias when these agents are combined. Patients with additional risk factors for QTc prolongation may be at even higher risk. Risk C: Monitor
Reserpine: May decrease therapeutic effects of Alpha-/Beta-Agonists (Indirect-Acting). Risk C: Monitor
Serotonin/Norepinephrine Reuptake Inhibitor: May increase tachycardic effects of Alpha-/Beta-Agonists. Serotonin/Norepinephrine Reuptake Inhibitor may increase vasopressor effects of Alpha-/Beta-Agonists. Management: If possible, avoid coadministration of direct-acting alpha-/beta-agonists and serotonin/norepinephrine reuptake inhibitors. If coadministered, monitor for increased sympathomimetic effects (eg, increased blood pressure, chest pain, headache). Risk D: Consider Therapy Modification
Solriamfetol: Sympathomimetics may increase hypertensive effects of Solriamfetol. Sympathomimetics may increase tachycardic effects of Solriamfetol. Risk C: Monitor
Spironolactone: May decrease vasoconstricting effects of Alpha-/Beta-Agonists. Risk C: Monitor
Sympathomimetics: May increase adverse/toxic effects of Sympathomimetics. Risk C: Monitor
Tedizolid: May increase adverse/toxic effects of Sympathomimetics. Specifically, the risk for increased blood pressure and heart rate may be increased. Risk C: Monitor
Tranylcypromine: May increase hypertensive effects of Alpha-/Beta-Agonists (Indirect-Acting). Risk X: Avoid
Tricyclic Antidepressants: May increase vasopressor effects of Alpha-/Beta-Agonists. Management: Avoid, if possible, the use of alpha-/beta-agonists in patients receiving tricyclic antidepressants. If combined, monitor for evidence of increased pressor effects and consider reductions in initial dosages of the alpha-/beta-agonist. Risk D: Consider Therapy Modification
See individual agents.
Refer to individual monographs.
Refer to individual monographs.
See individual agents.
