Home Drug Guide Desloratadine and Pseudoephedrine Sulfate

Drug Guide

Generic Name

Desloratadine and Pseudoephedrine Sulfate

Brand Names Clarinex-D 12 Hour, Clarinex D 24 Hour, Desloratadine and Pseudoephedrine Sulfate 24 Hour

Classification

Therapeutic: Nasal decongestant, antihistamine combination

Pharmacological: Antihistamine (Desloratadine), Sympathomimetic (Pseudoephedrine)

FDA Approved Indications

Relief of nasal congestion, sneezing, runny nose, and itchy or watery eyes due to allergies or hay fever.
Temporary relief of nasal congestion associated with sinusitis or common cold.

Mechanism of Action

Desloratadine is a selective peripheral H1 antihistamine that inhibits the effects of histamine. Pseudoephedrine is a sympathomimetic agent that constricts blood vessels in the nasal passages, leading to decreased swelling and congestion.

Dosage and Administration

Adult: Clarinex-D 12 Hour: 1 tablet every 12 hours; Clarinex D 24 Hour: 1 tablet every 24 hours; Desloratadine and Pseudoephedrine Sulfate 24 Hour: 1 tablet every 24 hours.

Pediatric: Use only if directed; generally, not recommended for children under 12 without medical advice.

Geriatric: Caution advised; consider renal and hepatic function.

Renal Impairment: Adjust dosage as needed; consult specific product guidelines.

Hepatic Impairment: Hepatic impairment may prolong drug effects; adjust accordingly.

Pharmacokinetics

Absorption: Rapidly absorbed after oral administration.

Distribution: Widely distributed; crosses the blood-brain barrier minimally.

Metabolism: Desloratadine undergoes hepatic metabolism; pseudoephedrine undergoes minimal metabolism.

Excretion: Primarily via urine; pseudoephedrine also excreted in urine unchanged.

Half Life: Desloratadine: approximately 27 hours; Pseudoephedrine: about 6 hours.

Contraindications

Hypersensitivity to desloratadine, pseudoephedrine, or any component of the formulation.
Use with monoamine oxidase inhibitors (MAOIs).

Precautions

Use with caution in patients with hypertension, cardiovascular disease, or prostatic hypertrophy. Monitor blood pressure during therapy. Avoid excessive doses.

Adverse Reactions - Common

Insomnia, headache, dry mouth, dizziness (Common)
Nervousness, restlessness (Common)

Adverse Reactions - Serious

Elevated blood pressure, tachycardia, arrhythmias (Less common)
Allergic reactions including rash, anaphylaxis (Rare)

Drug-Drug Interactions

MAOIs (risk of hypertensive crisis), other adrenergic agents, SSRIs, tricyclic antidepressants.

Drug-Food Interactions

Avoid tyramine-rich foods with pseudoephedrine in large doses.

Drug-Herb Interactions

Potential interactions with herbal sympathomimetics or stimulants.

Nursing Implications

Assessment: Monitor blood pressure, heart rate, and for adverse effects like insomnia or restlessness.

Diagnoses:

Ineffective airway clearance due to nasal congestion.
Risk for hypertension or cardiovascular effects.

Implementation: Administer with food if gastrointestinal upset occurs. Counsel on proper timing and dosage.

Evaluation: Assess symptom relief, monitor for adverse reactions, and evaluate blood pressure and heart rate regularly.

Patient/Family Teaching

Take medication exactly as prescribed.
Do not exceed recommended dose.
Report signs of increased blood pressure or allergic reactions.
Avoid alcohol and CNS depressants.

Special Considerations

Black Box Warnings:

Pseudoephedrine may increase blood pressure; use with caution in hypertensive patients.

Genetic Factors: No specific pharmacogenetic testing recommended.

Lab Test Interference: None noted.

Overdose Management

Signs/Symptoms: Severe hypertension, dizziness, rapid heartbeat, CNS stimulation.

Treatment: Seek emergency medical care; manage symptoms with supportive care. Do not induce vomiting unless directed.

Storage and Handling

Storage: Store at room temperature away from moisture and heat.

Stability: Stable as per manufacturer guidelines, usually at least 24 months.