Side Effects of desloratadine: A Synthesis of Findings from 21 Studies

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Original Abstract of the Article

Main Research Findings

Desloratadine is a second-generation H1-type antihistamine widely prescribed for various conditions including allergic rhinitis and urticaria. 17 reported a case of recurrent fixed drug eruption induced by desloratadine, suggesting the potential for skin side effects. 2 showed that desloratadine inhibits muscarinic receptor-mediated slowing of the heart. However, other second-generation H1-receptor antagonists, such as cetirizine and fexofenadine, did not show this effect on heart rate. 10 demonstrated that desloratadine brain penetration is limited by P-glycoprotein. This suggests that desloratadine is less likely to affect the central nervous system. 5 suggested that desloratadine could mitigate cisplatin-induced renal and testicular toxicity. Moreover, 9 showed that desloratadine can inhibit SARS-CoV-2 entry into cells.

Reasons for Side Effects

Side effects of desloratadine are thought to arise from the drug's mechanism of action and its effects on the body. Desloratadine inhibits the action of histamine on H1 receptors, thereby suppressing allergic symptoms. However, it can also affect other tissues and organs. For example, the effect on heart rate is thought to be caused by desloratadine's action on muscarinic receptors. Also, skin side effects such as fixed drug eruption are thought to be caused by the potential for desloratadine to affect the immune system.

Common Side Effects

Drowsiness

Desloratadine is considered non-sedating, with fewer side effects such as drowsiness compared to other second-generation H1-receptor antagonists. 10 However, 20 pointed out that drowsiness could occur when desloratadine is prescribed at higher than recommended doses. 3 showed that HRH1 gene rs901865 polymorphism was associated with the severity of sedation side effect after desloratadine therapy. Patients with the rs901865 G/G genotype were found to experience more serious sedation side effects than those with the rs901865 G/A genotype.

Gastrointestinal Symptoms

19 showed that desloratadine could reduce skin and gastrointestinal symptoms associated with peanut oral immunotherapy. However, it was also suggested that neuropsychiatric side effects could increase. 8 indicated that long-term desloratadine use could lead to mesenteric lymphatic vessel dysfunction, increasing the risk of obesity and metabolic syndrome. This lymphatic dysfunction is considered one of the causes of gastrointestinal symptoms.

Skin Side Effects

One case report found a connection between desloratadine and recurrent fixed drug eruption. 17 This side effect is not usually associated with desloratadine, but it's essential to be aware of potential skin reactions.

Other Side Effects

18 reported the potential for desloratadine to cause depression. 13 reported a case of acute urticaria following Mirena insertion, suggesting a possible association with desloratadine. 2 showed that desloratadine can affect the heart, potentially leading to side effects like dry mouth, tachycardia, and thickening of mucus. 15 suggests that high-dosage antihistamine therapy, including desloratadine, can be used to treat chronic pruritus. However, this treatment strategy may require careful monitoring and dose adjustment.

Countermeasures for Side Effects

Drowsiness

If drowsiness occurs, consulting a doctor is important. 20 recommends using non-sedating medications such as cetirizine or fexofenadine if drowsiness is a concern.

Gastrointestinal Symptoms

If gastrointestinal symptoms arise, it's important to review your diet or consult a doctor. 8 suggests the need for regular exercise and dietary adjustments to prevent lymphatic dysfunction when taking desloratadine long-term. Additionally, 19 indicated that taking desloratadine beforehand could potentially reduce gastrointestinal side effects during peanut oral immunotherapy. However, neuropsychiatric side effects could increase, so it's essential to discuss appropriate use with your doctor.

Skin Side Effects

If you notice any unusual skin reactions after taking desloratadine, discontinue use and consult your doctor immediately. 17

Comparison Between Studies

Common Points

Multiple studies have suggested that desloratadine, compared to other second-generation H1-receptor antagonists, has fewer side effects, including drowsiness, and is considered non-sedating. 10 20 However, not all studies have reached a unanimous conclusion regarding the safety of desloratadine. For example, 8 indicated that long-term desloratadine use could lead to lymphatic dysfunction, increasing the risk of obesity and metabolic syndrome. This study did not conclude that desloratadine is safe.

Different Points

Research on desloratadine side effects varies in results due to differences in research subjects and methods. For instance, 3 showed that HRH1 gene rs901865 polymorphism was associated with the severity of sedation side effects after desloratadine therapy. However, this study should consider the potential influence of other genetic and environmental factors on side effects. 19 suggested that desloratadine could reduce side effects from peanut oral immunotherapy. Nevertheless, this study didn't investigate how desloratadine might affect side effects in other allergic diseases.

Precautions for Real-Life Application

Desloratadine is an effective medication for treating allergic conditions such as allergic rhinitis and urticaria. 21 However, it can cause side effects like drowsiness. 20 3 Therefore, consulting a doctor to determine the appropriate dosage and method of administration is crucial before taking desloratadine. Additionally, caution is advised when performing tasks requiring concentration and alertness, such as driving or operating machinery. 16 Furthermore, desloratadine can interact with other medications. 11 Therefore, it is important to consult a doctor if you are taking other medications. 1 12 15 Also, long-term use of desloratadine could increase the risk of lymphatic dysfunction, obesity, and other related conditions. 8 Therefore, it is important to consult a doctor regularly and monitor your health status. 6 4

Limitations of Current Research

Research on desloratadine side effects is still insufficient. More research is needed, particularly regarding long-term effects, side effects in specific populations, and the mechanisms of action of side effects. Additionally, research into preventing or mitigating desloratadine side effects is also necessary.

Future Research Directions

Further research on desloratadine side effects is required. It is crucial to conduct studies investigating long-term side effects, side effects in specific populations, and the mechanisms by which side effects occur. Research on methods for preventing or reducing desloratadine side effects is also essential.

Conclusion

Desloratadine is an effective medication for treating allergic conditions such as allergic rhinitis and urticaria. However, it can cause side effects like drowsiness. 20 3 Therefore, it is important to consult a doctor to determine the appropriate dosage and method of administration before taking desloratadine. Additionally, caution is advised when performing tasks requiring concentration and alertness, such as driving or operating machinery. 16 Furthermore, desloratadine can interact with other medications. 11 Therefore, it is important to consult a doctor if you are taking other medications. 1 12 15 Also, long-term use of desloratadine could increase the risk of lymphatic dysfunction, obesity, and other related conditions. 8 Therefore, it is important to consult a doctor regularly and monitor your health status. 6 4

Literature analysis of 21 papers
Positive Content
15
Neutral Content
2
Negative Content
4
Article Type
4
0
0
3
20
1.

Low-dose short-term cyclosporine versus etretinate in psoriasis: improvement of skin, nail, and joint involvement.

Author: MahrleG, SchulzeH J, FärberL, WeidingerG, SteiglederG K

Nail and joint improvement
Psoriasis treatment
Cyclosporine side effects
Relapse risk

Low-dose short-term cyclosporine therapy was highly effective and well tolerated for psoriasis, compared to etretinate. Remission was better preserved by tapering the drug than by discontinuing treatment abruptly.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

2.

Antimuscarinic actions of antihistamines on the heart.

Author: LiuHuiling, ZhengQi, FarleyJerry M

Antihistamine treatment
Dry mouth
Sedation
Tachycardia
Thickening of mucus

This study examined the interaction of four antihistamines with muscarinic receptors. Fexofenadine and cetirizine had little or no interaction with muscarinic receptors.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

Human H1 receptor (HRH1) gene polymorphism is associated with the severity of side effects after desloratadine treatment in Chinese patients with chronic spontaneous uticaria.

Author: LiJuan, ChenWangqing, PengCong, ZhuWu, LiuZhaoqian, ZhangWei, SuJuan, LiJie, ChenXiang

Sedation side effect

Desloratadine is an antihistamine used to treat chronic spontaneous urticaria (CSU). This study investigated the association between the HRH1 gene rs901865 polymorphism and the severity of sedation side effects following desloratadine treatment. Results showed that the G/G genotype was associated with severe sedation side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Premedication with montelukast reduces local reactions of allergen immunotherapy.

Author: WöhrlStefan, GamperSimon, HemmerWolfgang, HeinzeGeorg, StinglGeorg, KinaciyanTamar

Allergy treatment

This study investigated the effectiveness of montelukast and desloratadine in preventing local reactions (LRs) to specific immunotherapy with allergens. The study found that montelukast, a leukotriene antagonist, was more effective in preventing LRs than desloratadine, an antihistamine.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Establishing the place in therapy of bilastine in the treatment of allergic rhinitis according to ARIA: evidence review.

Author: BousquetJean, AnsóteguiIgnacio, CanonicaG Walter, ZuberbierTorsten, Baena-CagnaniCarlos E, BachertClaus, CruzAlvaro A, GonzálezSandra N, KunaPiotr, Morais-AlmeidaMario, MullolJoaquim, RyanDermot P, Sánchez-BorgesMario, ValienteRomán, ChurchMartin K

Allergic rhinitis treatment

Oral H(1)-antihistamines should meet certain criteria in terms of their pharmacological, and clinical efficacy and safety profiles.

Evaluation StudyResearch that systematically evaluates the effectiveness of a particular program or policy. It measures its outcomes and provides important information for future decision-making.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

8.

Prolonged intake of desloratadine: mesenteric lymphatic vessel dysfunction and development of obesity/metabolic syndrome.

Author: GashevaOlga Y, Tsoy NizamutdinovaIrina, HargroveLaura, GobbellCassidy, Troyanova-WoodMaria, AlpiniSally F, PalSarit, DuChristina, HittAngie R, YakovlevVlad V, Newell-RogersM Karen, ZawiejaDavid C, MeiningerCynthia J, AlpiniGianfranco D, FrancisHeather, GashevAnatoliy A

Metabolic syndrome
Obesity

Prolonged intake of desloratadine, a common antihistamine, induced obesity and metabolic syndrome in rats. These effects were linked to dysfunction of mesenteric lymphatic vessels, suggesting that antihistamines may have underevaluated lymphatic-related side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.

Language : English

9.

Desloratadine, an FDA-approved cationic amphiphilic drug, inhibits SARS-CoV-2 infection in cell culture and primary human nasal epithelial cells by blocking viral entry.

Author: Morin-DewaeleMargot, BartierSophie, BerryFrançois, BrilletRozenn, López-MolinaDennis Salomón, NguyễnCông Trung, MaillePascale, SerenoKevin, NeversQuentin, SofticLaurent, VaugeoisJean-Marie, LouisBruno, BequignonEmilie, BruscellaPatrice, CosteAndré, PawlotskyJean-Michel, JamainStéphane, Ahmed-BelkacemAbdelhakim

Antiviral activity
Unknown

This study assessed the anti-SARS-CoV-2 effectiveness of 8 FDA-approved cationic amphiphilic drugs (CADs). Desloratadine, a commonly used antiallergic, potently reduced the production of SARS-CoV-2 RNA in Vero-E6 cells and showed broad-spectrum anti-coronavirus activity.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

P-glycoprotein limits the brain penetration of nonsedating but not sedating H1-antagonists.

Author: ChenCuiping, HansonElizabeth, WatsonJohn W, LeeJae S

Reduced CNS side effects

This study found that sedating H1-antagonists (diphenhydramine, hydroxyzine, and triprolidine) are not substrates for P-gp, while nonsedating H1-antagonists (cetirizine, loratadine, and desloratadine) are. This suggests that the lack of central nervous system side effects of modern H1-antagonists may be due to their affinity for P-gp at the blood-brain barrier.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

11.

Identification and Mechanistic Investigation of Drug-Drug Interactions Associated With Myopathy: A Translational Approach.

Author: HanX, QuinneyS K, WangZ, ZhangP, DukeJ, DestaZ, ElmendorfJ S, FlockhartD A, LiL

Myopathy

This study identifies drug-drug interactions (DDIs) that increase the risk of myopathy, a group of muscle diseases. The study found that loratadine and promethazine were involved in DDIs with several other drugs, and the interaction between loratadine and simvastatin was confirmed epidemiologically.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

13.

Acute urticaria as a side effect of the Mirena® (levonorgestrel-releasing intrauterine system): a case report.

Author: ChenXiangjuan, WuXueqing, ZhuHaiyan

Urticaria

A 27-year-old woman developed acute urticaria 2 hours after Mirena® implantation, which resolved after the device was removed. This case highlights the potential for allergic reactions to Mirena® implantation.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

14.

Comparative Efficacy and Safety of Ebastine 20 mg, Ebastine 10 mg and Levocetirizine 5 mg in Acute Urticaria.

Author: GoyalVippan, GuptaAnu, GuptaOnam, LalDhruvendra, GillManharan

Urticaria treatment

Second-generation non-sedating H1 antihistamines are often used as first-line treatment for acute and chronic urticaria.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

15.

[Antipruritic efficacy of a high-dosage antihistamine therapy. Results of a retrospectively analysed case series].

Author: SchulzS, MetzM, SiepmannD, LugerT A, MaurerM, StänderS

Symptom relief
Not effective at standard doses

High-dosage antihistamines can be effective and safe for treating chronic pruritus of different origins.

Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : German

16.

Characterization of anti-inflammatory properties and evidence for no sedation liability for the novel antihistamine SUN-1334H.

Author: MandhaneSanjay N, ShahJigar H, BahekarPrashant C, MehetreSameer V, PawarChandrashekhar A, BagadAshish S, ChidrewarGajanan U, RaoChitturi Trinadha, RajamannarThennati

Anti-inflammatory effects
CNS side effects

This study compared the anti-inflammatory effects, sedation potential, and interaction with alcohol of SUN-1334H, a new potential antihistamine, with other antihistamines.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

17.

A Case of Recurrent Fixed Drug Eruption Secondary to Desloratadine.

Author: AlmukhadebEman

Fixed drug eruption

This case report describes a patient who experienced recurrent fixed drug eruption (FDE) after exposure to desloratadine, a second-generation H1-type antihistamine. This case highlights the potential for desloratadine to induce FDE, despite its generally good tolerance and lack of known cutaneous side effects.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

19.

Peanut Oral Immunotherapy With or Without H<sub>1</sub> and H<sub>2</sub> Antihistamine Premedication for Peanut Allergy (PISCES): A Placebo-Controlled Randomized Clinical Trial.

Author: ChuDerek K, FreitagTosha, MarrinAndrea, WalkerTina D, AvillaErnie, FreitagAndeas, SpillPaul, FosterGary A, ThabaneLehana, JordanaManel, WasermanSusan

Desensitization
Improved quality of life
Adverse reactions
Neuropsychiatric side effects

Peanut oral immunotherapy (OIT) with antihistamines modestly reduces the skin and gastrointestinal components of adverse reactions during OIT.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

20.

Review of H1 antihistamines in the treatment of chronic idiopathic urticaria.

Author: MonroeEugene

CIU treatment efficacy

Newer-generation H1 antihistamines like fexofenadine, loratadine, and desloratadine are preferred over older-generation antihistamines for treating chronic idiopathic urticaria due to their nonsedating properties.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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