Desloratadine is the orally active major metabolite of the nonsedating H1-antihistamine loratadine. The drug had no adverse cardiovascular effects in various animal models or when administered at 9 times the recommended adult dosage for 10 days in volunteers. Therapeutic dosages had no effects on wakefulness or psychomotor performance in healthy volunteers. No clinically significant interactions have been reported between desloratadine and drugs that inhibit the cytochrome P450 system, nor does the drug potentiate the adverse psychomotor effects of alcohol. Oral desloratadine 5 mg once daily for up to 4 weeks in patients with seasonal allergic rhinitis (SAR) significantly reduced nasal (including congestion) and non-nasal symptoms and improved health-related quality of life compared with placebo. Similar beneficial effects were observed in patients with SAR and coexisting asthma (in whom asthma symptoms and use of beta2-agonists were reduced). Desloratadine 5 mg once daily for 6 weeks significantly improved pruritus and reduced the number of hives compared with placebo in patients with chronic idiopathic urticaria (CIU). Sleep and daytime performance also improved. Desloratadine was well tolerated in clinical trials and had an adverse event profile similar to that of placebo in patients with SAR (with or without asthma) or CIU.

Assessing satisfaction with desloratadine and fexofenadine in allergy patients who report dissatisfaction with loratadine - BACKGROUND: The FDA recently moved loratadine (Claritin) from prescription only status to over-the-counter (OTC). In response to the availability of an OTC non-sedating antihistamine, many managed care organizations are reevaluating which if any prescription antihistamines should remain on formulary. From a managed care perspective, determining which of the remaining prescription antihistamines results in the greatest patient satisfaction with allergy treatment would be informative. METHODS: We report on a weighted cross sectional survey (n = 10,023) delivered online to a sample of allergy sufferers in the U.S. during the month of December 2002. Two segments were identified for analysis: patient who were dissatisfied with loratadine and converted to desloratadine (Clarinex; n = 61), and patients who were dissatisfied with loratadine and converted to fexofenadine (Allegra; n = 211). The two segments were compared along a series of measures that the literature suggests are related to treatment satisfaction. RESULTS: The survey found that two of the satisfaction measures differentiated desloratadine converters from fexofenadine converters (p <.05): mean sum of self-reported adverse events and nighttime awakening due to allergy symptoms. For the remainder of satisfaction measures though, patients who were dissatisfied with loratadine reported equal duration of coverage and satisfaction with desloratadine as fexofenadine. 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). CONCLUSIONS: On average, patients who were dissatisfied with loratadine reported equal or better satisfaction with desloratadine as fexofenadine. Patients with severe allergic rhinitis reported greater satisfaction when converted from loratadine to desloratadine than fexofenadine for select satisfaction measures. These results suggest that if managed care intends to position prescription antihistamines as second line for OTC loratadine treatment dissatisfaction, desloratadine is a useful treatment alternative. These findings, while informative to formulary decision-makers, must be interpreted with caution. Only through head-to-head controlled clinical trials can differences in efficacy and safety be established.

Assessing patient satisfaction with desloratadine after conversion from loratadine, fexofenadine, or cetirizine - A number of prescription and nonprescription nonsedating antihistamines are available for the treatment of allergic rhinitis. From a managed care perspective, determining the extent to which a medication conversion to desloratadine from loratadine, fexofenadine, or cetirizine results in maintained or increased patient satisfaction with allergy care would be informative for formulary decision makers and other budget holders. To that end, a survey was undertaken of patient medication assessments after a switch in antihistamines. On average, patients who converted to desloratadine from loratadine, fexofenadine, or cetirizine reported increased satisfaction with desloratadine treatment.

Pollen grains from trees, grasses and weeds can float through the air in spring, summer or fall. But along with staying on mission to fertilize plants and tree flowers, pollen particles often end up in our noses, eyes, ears and mouths. The result can be sneezing spells, watery eyes, congestion and an itchy throat. Pollen allergy, commonly known as hay fever, affects about 1 out of 10 Americans, according to the National Institute of Allergy and Infectious Diseases (NIAID). For some, symptoms can be controlled with occasional over-the-counter (OTC) medicine. Others have reactions that may more seriously disrupt the quality of their lives. Allergies can trigger or worsen asthma and lead to other health problems such as sinusitis and ear infections in children. You can distinguish allergy symptoms from a cold because a cold tends to be short-lived, results in thicker nasal secretions, and is usually associated with sore throat, hoarseness, malaise, and fever. Many people with seasonal allergic rhinitis notice a seasonal pattern with their symptoms, but others may need a doctor's help to find out for sure that pollen is the source of their misery. If these symptoms crop up year-round, dust mites, pet dander or another indoor allergen could be the culprit. This is known as perennial allergic rhinitis. Once you know you have seasonal allergies, probably the most important step you can take is to avoid pollen as much as possible. Try to stay indoors when pollen levels are highest. In the fall ragweed pollen season, pollen levels are highest in the morning. During the grass pollen season in the spring and summer, pollen levels are highest in the evening. Pollen counts measure how much pollen is in the air and are expressed in grains of pollen per square meter of air collected during a 24-hour period. It may also help to keep windows closed in your house and car and to run the air conditioner. If possible, avoid mowing grass and other yard work.