Issues for surgery
Loss of symptomatic relief of allergic rhinitis, hay fever and urticaria if omitted.
Advice in the perioperative period
Elective and emergency surgery
Continue.
Post-operative advice
If taken regularly, restart post-operatively as soon as next dose is due; otherwise restart when symptoms develop.
Interactions with common anaesthetic agents
QT-Interval Prolongation
There are a few case reports of torsades de pointes in patients taking loratadine. The clinical relevance of these cases is uncertain, but it is recommended that the QT-interval should be monitored if loratadine is given with other drugs that might potentially prolong the QT-interval.
Interactions with other common medicines used in the perioperative period
Macrolides
Clarithromycin and erythromycin are predicted to increase the exposure to loratadine through inhibition of CYP3A4.
Whilst single surgical prophylactic doses should not pose a problem in patients taking loratadine monitor for side effects if a prolonged course is required.
QT-Interval prolongation
There are a few case reports of torsades de pointes in patients taking loratadine. The clinical relevance of these cases is uncertain, but it is recommended that the QT-interval should be monitored if loratadine is given with other drugs that might potentially prolong the QT-interval.
Further information
None relevant.
References
Baxter K, Preston CL (eds), Stockley’s Drug Interactions (online) London: Pharmaceutical Press. http://www.medicinescomplete.com [Accessed on 2nd February 2021]
Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. http://www.medicinescomplete.com [Accessed on 2nd February 2021]
Summary of Product Characteristics – Loratadine 10mg Tablets. Accord-Uk Ltd. Accessed via www.medicines.org.uk 2/2/2021 [date of revision of the text January 2021]