Desloratadine

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Desloratadine
Desloratadine.svg
Desloratadine2.png
Systematic (IUPAC) name
8-chloro-6,11-dihydro-11-(4-piperdinylidene)- 5H-benzo[5,6]cyclohepta[1,2-b]pyridine
Clinical data
Trade names Clarinex
AHFS/Drugs.com monograph
MedlinePlus a602002
Licence data EMA:Link, US FDA:link
Pregnancy cat. B1 (AU) C (US)
Legal status POM (UK) -only (US)
Routes oral
Pharmacokinetic data
Bioavailability Rapidly absorbed
Protein binding 85%
Metabolism Liver
Half-life 27 hours
Excretion 40% as conjugated metabolites into urine
Similar amount into the feces
Identifiers
CAS number 100643-71-8 YesY
ATC code R06AX27
PubChem CID 124087
DrugBank DB00967
ChemSpider 110575 YesY
UNII FVF865388R YesY
KEGG D03693 YesY
ChEBI CHEBI:291342 YesY
ChEMBL CHEMBL1172 YesY
Chemical data
Formula C19H19ClN2 
Mol. mass 310.82
 YesY (what is this?)  (verify)

Desloratadine is a drug used to treat allergies. It is marketed under several trade names such as NeoClarityn, Claramax, Clarinex, Larinex, Aerius, Dazit, Azomyr, Deselex and Delot. It is an active metabolite of loratadine, which is also on the market.

Available forms[edit]

Desloratadine is available as tablets (including orally disintegrating and extended release) and as syrup.[1] In Colombia (South America) it is marketed under Dexio from Laboratorios Bussié, as tablets and as syrup to children. In Nepal and India it is widely available under the trade name Daziti and Dazit.

Mechanism of action[edit]

Desloratadine is a tricyclic antihistamine, which has a selective and peripheral H1-antagonist action. It is an antagonist at histamine H1 receptors, and an antagonist at all subtypes of the muscarinic acetylcholine receptor. It has a long-lasting effect and in moderate and low doses, does not cause drowsiness because it does not readily enter the central nervous system.[2] Unlike other antihistamines, desloratadine is also effective in relieving nasal congestion, particularly in patients with allergic rhinitis. [3]

Side effects[edit]

Most common side-effects are fatigue, dry mouth, headache, and gastrointestinal disturbances.

Desloratadine vs. loratadine[edit]

Desloratadine is the major metabolite of loratadine. There are no head-to-head randomised controlled trials of the two drugs. A survey of patients dissatisfied with loratadine published in August 2003 reported equal or better satisfaction with desloratadine,[4] concluding:

When severity of disease was controlled for in the analysis, a pattern emerged suggesting greater levels of satisfaction amongst loratadine dissatisfied patients who converted to desloratadine. Point estimates suggest a consistent pattern favoring desloratadine patient satisfaction, with statistically significant results reported for sum of adverse effects, nighttime awakening due to symptoms, symptom severity just prior to the next dose, and overall satisfaction (p < 0.05).

A November 2003 article published in the journal American Family Physician about the safety, tolerability, effectiveness, price, and simplicity of desloratadine concluded the following:[5]

Desloratadine is similar in effectiveness to fexofenadine and would be expected to produce results similar to loratadine and other nonsedating antihistamines. There is no clinical advantage to switching a patient from loratadine to desloratadine. However, it may be an option for patients whose medical insurance no longer covers loratadine if the co-pay is less than the cost of the over-the-counter product.

In Canada and Denmark, desloratadine is available as a generic, without a prescription, and prices are comparable to those of loratadine. In Russia and Belarus, desloratadine is also available without a prescription (Aerius by Schering-Plough; Desloratadine-Teva by Teva). However prices in these markets are much higher if compared to those of loratadine.

Synthesis[edit]

Desloratadine synthesis:[6]

References[edit]

  1. ^ FDA Electronic Orange Book http://www.fda.gov/cder/ob/default.htm.
  2. ^ Mann R, Pearce G, Dunn N, Shakir S (2000). "Sedation with "non-sedating" antihistamines: four prescription-event monitoring studies in general practice". BMJ 320 (7243): 1184–6. doi:10.1136/bmj.320.7243.1184. PMC 27362. PMID 10784544. 
  3. ^ Horak F, Stübner UP, Zieglmayer R, Harris AG (June 2002). "Effect of desloratadine versus placebo on nasal airflow and subjective measures of nasal obstruction in subjects with grass pollen-induced allergic rhinitis in an allergen-exposure unit". J. Allergy Clin. Immunol. 109 (6): 956–61. doi:10.1067/mai.2002.124657. PMID 12063524. 
  4. ^ Glass D, Harper A (August 13, 2003). "Assessing satisfaction with desloratadine and fexofenadine in allergy patients who report dissatisfaction with loratadine". BMC Fam Pract 4: 10. doi:10.1186/1471-2296-4-10. PMC 194638. PMID 12917016. 
  5. ^ See S (2003). "Desloratadine for allergic rhinitis". Am Fam Physician 68 (10): 2015–6. PMID 14655812. 
  6. ^ "Contemporary Drug Synthesis; Jie Jack Li, Douglas S. Johnson, Drago R. Sliskovic, Bruce D. Roth". John Wiley & Sons. 2004. Retrieved 2014-07-22.