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Clarinex-D 12 Hour
desloratadine/ pseudoephedrine
Adult Dosing .
Dosage forms: ER TAB: 2.5 mg/120 mg
allergic rhinitis, seasonal
- [1 tab PO q12h]
- Info: do not cut/crush/chew tab; do not exceed 5 mg/day desloratadine, 240 mg/day pseudoephedrine from all sources
renal dosing
- [see below]
- renal impairment: avoid use
- HD/PD: not defined
hepatic dosing
- [see below]
- hepatic impairment: avoid use
Peds Dosing .
- Dosage forms: ER TAB: 2.5 mg/120 mg
allergic rhinitis, seasonal
- [12 yo and older]
- Dose: 1 tab PO q12h; Info: do not cut/crush/chew tab; do not exceed 5 mg/day desloratadine, 240 mg/day pseudoephedrine from all sources
renal dosing
- [see below]
- renal impairment: avoid use
- HD/PD: not defined
hepatic dosing
- [see below]
- hepatic impairment: avoid use
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- hypersensitivity to loratadine
- MAO inhibitor use within 14 days
- pregnancy 1st trimester
- renal impairment
- urinary retention
- glaucoma, angle-closure
- CAD, severe
- HTN, uncontrolled
- HTN, severe
- caution: pregnancy 2nd trimester
- caution: pregnancy 3rd trimester
- caution: hepatic impairment
- caution: HTN
- caution: cardiovascular disease
- caution: diabetes mellitus
- caution: hyperthyroidism
- caution: prostatic hypertrophy
Drug Interactions .
Overview
desloratadine
antihistamine, 2nd generation
-
None
pseudoephedrine
alpha-1/beta-2 agonist
- hyperglycemic effects
- hypertensive effects
- tachycardia
- urine pH sensitive
- add MAO inhibitor to Interaction Check if recent (14 days) use
Contraindicated
- dihydroergotamine
- ergotamine
- isocarboxazid
- phenelzine
- tranylcypromine
Avoid/Use Alternative
- albuterol
- cocaine
- ephedra
- epinephrine inhaled
- furosemide
- landiolol
- methylergonovine
- midodrine
- ozanimod
- phenylephrine
- procarbazine
- pseudoephedrine
- rasagiline
- safinamide
- selegiline
- selegiline transdermal
- yohimbe
Monitor/Modify Tx
- abiraterone acetate
- acarbose
- acebutolol
- albuterol inhaled
- aliskiren
- almotriptan
- alogliptin
- aluminum hydroxide
- amiloride
- amitriptyline
- amlodipine
- amoxapine
- amphetamine
- angiotensin II
- aprocitentan
- arformoterol inhaled
- armodafinil
- asciminib
- atenolol
- atogepant
- atomoxetine
- atropine ophthalmic
- axitinib
- azilsartan medoxomil
- benazepril
- benzphetamine
- betamethasone
- betaxolol
- bevacizumab
- bexagliflozin
- bismuth subsalicylate
- bisoprolol
- brigatinib
- bromocriptine
- budesonide
- bumetanide
- bupropion
- cabozantinib
- caffeine
- caffeine citrate
- calcium carbonate
- canagliflozin
- candesartan cilexetil
- cannabis
- captopril
- carfilzomib
- carvedilol
- celecoxib
- chlorothiazide
- chlorthalidone
- clevidipine
- clomipramine
- clonidine
- colesevelam
- copanlisib
- corticotropin
- cortisone
- cyclosporine
- danazol
- dapagliflozin
- darbepoetin alfa
- deflazacort
- desipramine
- desmopressin
- desvenlafaxine
- dexamethasone
- dexmethylphenidate
- dextroamphetamine
- dichlorphenamide
- diclofenac
- diclofenac topical
- diethylpropion
- diflunisal
- diltiazem
- dobutamine
- dopamine
- doxapram
- doxazosin
- doxepin
- dronabinol
- droxidopa
- dulaglutide
- eletriptan
- empagliflozin
- enalapril
- enalaprilat
- ephedrine injection
- ephedrine oral
- epinephrine
- eplerenone
- epoetin alfa
- eptinezumab
- erenumab
- ertugliflozin
- esketamine
- esmolol
- estetrol (contraceptive)
- estradiol (contraceptive)
- ethacrynic acid
- ethanol (alcoholic beverage)
- ethinyl estradiol (contraceptive)
- etodolac
- etrasimod
- exenatide
- felodipine
- fenfluramine
- fenoldopam
- fenoprofen
- fingolimod
- fludrocortisone
- flurbiprofen
- formoterol inhaled
- fosinopril
- fostamatinib
- fremanezumab
- frovatriptan
- fruquintinib
- galcanezumab
- glimepiride
- glipizide
- glyburide
- glycopyrrolate
- guanfacine
- hoodia
- hydralazine
- hydrochlorothiazide
- hydrocortisone
- hydroxocobalamin IV
- hyoscyamine
- ibrutinib
- ibuprofen
- imipramine
- indapamide
- indomethacin
- insulin
- irbesartan
- isradipine
- ketamine
- ketoprofen
- ketorolac
- labetalol
- lanreotide
- leflunomide
- lenvatinib
- levalbuterol inhaled
- levomilnacipran
- levothyroxine
- licorice
- lifileucel
- linagliptin
- linezolid
- liothyronine
- liraglutide
- lisdexamfetamine
- lisinopril
- lixisenatide
- lorlatinib
- losartan
- lumacaftor/ivacaftor
- luspatercept
- magnesium carbonate
- magnesium hydroxide
- magnesium salicylate
- meclofenamate
- mefenamic acid
- meloxicam
- metformin
- methamphetamine
- methoxy polyethylene glycol-epoetin beta
- methyldopa
- methylphenidate
- methylprednisolone
- methyltestosterone
- metoclopramide
- metolazone
- metoprolol
- miglitol
- milnacipran
- minoxidil
- mirabegron
- modafinil
- moexipril
- nabumetone
- nadolol
- naproxen
- naratriptan
- nateglinide
- naxitamab
- nebivolol
- nicardipine
- nifedipine
- nimodipine
- niraparib
- nisoldipine
- norepinephrine
- nortriptyline
- obinutuzumab
- olmesartan medoxomil
- olodaterol inhaled
- orphenadrine
- osilodrostat
- oxaprozin
- oxymetazoline nasal
- oxymetazoline ophthalmic
- oxytocin
- pazopanib
- perindopril
- pexidartinib
- phendimetrazine
- phenoxybenzamine
- phentermine
- phentolamine
- phenylephrine injection
- phenylephrine nasal
- phenylephrine ophthalmic
- phenylephrine rectal
- pindolol
- pioglitazone
- piroxicam
- ponatinib
- ponesimod
- pralsetinib
- pramlintide
- prazosin
- prednisolone
- prednisone
- propranolol
- protriptyline
- quetiapine
- quinapril
- ramipril
- ramucirumab
- regorafenib
- repaglinide
- rimegepant
- ripretinib
- rizatriptan
- ropinirole
- rosiglitazone
- rotigotine transdermal
- salmeterol inhaled
- salsalate
- saxagliptin
- selpercatinib
- semaglutide
- siponimod
- sitagliptin
- sodium bicarbonate
- sodium citrate
- solriamfetol
- sorafenib
- spironolactone
- sulindac
- sumatriptan
- sunitinib
- tacrolimus
- tagraxofusp
- telmisartan
- terazosin
- terbutaline
- teriflunomide
- testosterone
- thyroid
- timolol
- tirzepatide
- tivozanib
- tolmetin
- topiramate
- torsemide
- trametinib
- trandolapril
- triamcinolone
- triamterene
- trimipramine
- trospium
- ubrogepant
- vadadustat
- valsartan
- vamorolone
- vandetanib
- vasopressin
- venlafaxine
- verapamil
- vilanterol inhaled
- viloxazine
- voclosporin
- zavegepant
- ziv-aflibercept
- zolmitriptan
Caution Advised
- acetazolamide
- ascorbic acid (vitamin C)
- digoxin
- methazolamide
- potassium acid phosphate
- potassium bicarbonate
- potassium citrate
- zonisamide
Adverse Reactions .
Serious Reactions
- arrhythmia
- HTN
- cardiovascular collapse
- seizures
- hypersensitivity reaction
- anaphylaxis
- skin reaction, severe
- hepatitis
Common Reactions
- xerostomia
- headache
- insomnia
- fatigue
- pharyngitis
- somnolence
- nausea
- dizziness
- hyperactivity
- anorexia
- nervousness
- palpitations
- tachycardia
Safety/Monitoring .
Monitoring Parameters
no routine tests recommended
Pregnancy/Lactation .
Pregnancy
Clinical Summary
desloratadine: may use during pregnancy; no human data available, though risk of fetal harm not expected based on limited human data with loratadine
pseudoephedrine: avoid use in 1st trimester, weigh risk/benefit in 2nd and 3rd trimesters; possible risk of teratogenicity, including gastroschisis, small intestinal atresia, and hemifacial microsomia based on limited human data; risk of vasoconstriction based on animal data and drug's mechanism of action
Lactation
Clinical Summary
desloratadine: may use short-term while breastfeeding, otherwise weigh risk/benefit; no known risk of infant harm based on limited human data with loratadine; inadequate human data available, though theoretical risk of decr. milk production based on decr. prolactin levels
pseudoephedrine: may occasionally use while breastfeeding, though weigh risk/benefit if poor milk production; no known risk of infant harm based on limited human data; decr. milk production based on limited human data
Pharmacology .
Metabolism: for desloratadine: liver extensively; CYP450: unknown; Info: active metabolite; for pseudoephedrine: liver partially; CYP450: unknown; Info: active metabolite
Excretion: for desloratadine: urine, feces; Half-life: 27h; for pseudoephedrine: urine (70-90% unchanged); Half-life: 9-16h; Info: decr. excretion in alkaline urine
Subclass: Antihistamine/Decongestant Combos
Mechanism of Action
for desloratadine: selectively antagonizes peripheral histamine H1 receptors; for pseudoephedrine: stimulates smooth muscle alpha adrenergic receptors, producing vasoconstriction and reducing nasal congestion (sympathomimetic)
Formulary .
No Formulary Selected
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