LORATADINE CRISTERS 10 mg Cpr Plq/15

Loratadine.......................................................................................................................................................10 mg

Excipient(s) with known effect: each tablet contains 75 mg of lactose monohydrate.

LORATADINE CRISTERS 10 mg, tablet is indicated for the symptomatic treatment of allergic rhinitis and chronic idiopathic urticaria.

Dosage

Adults: 10 mg once a day, i.e. one tablet once a day.

Paediatric population

Children aged 6 years and older: body weight of more than 30 kg: 10 mg once a day.

Children under 6 years of age or weighing 30 kg or less: other, more suitable pharmaceutical forms exist.

Children under 2 years: The efficacy and safety of LORATADINE CRISTERS have not been established.

Patients with hepatic impairment

In patients with severe hepatic impairment, the initial dose should be reduced due to a risk of reduced clearance of loratadine. An initial dose of 10 mg every two days is recommended for adults and children weighing more than 30 kg.

Elderly patients or patients with renal impairment

No dose adjustment is necessary in elderly patients or patients with renal impairment.

Method of administration

The tablet may be taken regardless of meals.

LORATADINE CRISTERS is contraindicated in cases of hypersensitivity to loratadine or to any of the excipients mentioned in section Composition.

LORATADINE CRISTERS should be used with caution in patients with severe hepatic impairment (see section .Dosage and administration).

Administration of LORATADINE CRISTERS must be discontinued at least 48 hours before skin tests are performed for the diagnosis of allergy, because antihistamines may inhibit or reduce the skin response.

This medicinal product contains lactose. Its use is not recommended in patients with galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption syndrome (rare hereditary disorders).

Psychomotor performance studies have not shown potentiation of the effects of LORATADINE CRISTERS when administered simultaneously with alcohol.

The risk of interactions with inhibitors of cytochromes CYP3A4 or CYP2D6 leading to increased plasma concentrations of loratadine may increase the risk of occurrence of adverse effects. (see section Pharmacokinetics).

Pregnancy

Animal studies have not revealed any teratogenic effect of loratadine. The safety of loratadine during pregnancy has not been established. Consequently, the use of LORATADINE CRISTERS during pregnancy is not recommended.

Breast-feeding

Loratadine is excreted in breast milk. Consequently, administration of loratadine during breastfeeding is not recommended.

In clinical studies evaluating the ability to drive vehicles, no deleterious effect was observed in patients receiving loratadine. However, patients must be informed that very rarely in certain people somnolence has been described which could affect their ability to drive vehicles or use machines.

In clinical studies conducted in the paediatric population, in children aged 2 to 12 years, the frequent adverse effects reported with a higher frequency than under placebo were: headache (2,7%), nervousness (2,3%) and fatigue (1%).

In clinical studies conducted in adults and adolescents in the indications allergic rhinitis and chronic idiopathic urticaria, at the recommended dose of 10 mg, adverse effects with loratadine were reported in 2% more patients than those treated with placebo. The adverse effects most frequently reported with a higher frequency than under placebo were: somnolence (1,2%), headache (0,6%), increased appetite (0,5%) and insomnia (0,1%).

Other adverse effects very rarely reported since marketing are listed in the following table:

Reporting of suspected adverse reactions

Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the national reporting system: National Agency for the Safety of Medicines and Health Products (ANSM) and the network of Regional Pharmacovigilance Centres - Website:www.ansm.sante.fr.

Overdose of loratadine increases the occurrence of anticholinergic symptoms. Somnolence, tachycardia and headache have been reported in cases of overdose.

In case of overdose, symptomatic treatment and maintenance of vital functions are recommended. Activated charcoal suspended in water may possibly be administered. Gastric lavage may be considered. Loratadine is not eliminated by haemodialysis and it is not known whether peritoneal dialysis eliminates it. The patient must remain under medical supervision after emergency treatment.

Pharmacotherapeutic class: ANTIHISTAMINES FOR SYSTEMIC USE, ATC code: R06AX13.

Loratadine, the active ingredient of LORATADINE CRISTERS, is a tricyclic antihistamine acting selectively on peripheral H1 receptors.

Loratadine does not exert a significant sedative or anticholinergic effect in the majority of the population when used at the recommended dose.

During long-term treatment, no clinically significant changes in vital functions, biological parameters, clinical examination or electrocardiographic tracings have been observed.

Loratadine has no significant action at H2 receptors. It does not inhibit noradrenaline reuptake and has practically no influence on cardiovascular functions or on intrinsic pacemaker activity.

After oral administration, loratadine is rapidly and well absorbed and undergoes a significant first-pass hepatic effect, being essentially metabolised by CYP3A4 and CYP2D6. The main metabolite, desloratadine, is pharmacologically active and largely responsible for the clinical effect. Maximum plasma concentrations of loratadine and desloratadine are reached (Tmax) between 1-1,5 hours and 1,5-3,7 hours, respectively, after administration.

In controlled clinical studies, an increase in plasma concentrations of loratadine has been reported when administered concomitantly with ketoconazole, erythromycin or cimetidine, but without significant clinical consequence (no change in ECG tracings).

The binding of loratadine to circulating proteins is high (97% to 99%), whereas that of the metabolite is more moderate (73% to 76%).

In healthy volunteers, the distribution half-lives of loratadine and its active metabolite are approximately 1 and 2 hours respectively. The main elimination half-life in healthy volunteers was 8,4 hours (range 3 to 20 hours) for loratadine and 28 hours (range 8,8 to 92 hours) for the main active metabolite.

Approximately 40% of the dose is excreted in the urine and 42% in the feces over a period of 10 days, mainly as conjugated metabolites. Approximately 27% of the dose is eliminated in the urine during the first 24 hours. Less than 1% of the active substance is excreted in the unchanged active form, loratadine or desloratadine.

The bioavailability of loratadine and its active metabolite is dose-dependent.

The pharmacokinetic profile of loratadine and its metabolites is comparable in healthy adult and elderly volunteers.

Concomitant food intake may cause a slight delay in the absorption of loratadine, without consequence for the clinical effect.

In patients with chronic renal failure, the AUC and peak plasma concentrations (Cmax) of loratadine and its metabolite were higher than the AUC and peak plasma concentrations (Cmax) observed in patients with normal renal function. The mean elimination half-lives of loratadine and its metabolite were not significantly different from those observed in normal subjects. Hemodialysis has no effect on the pharmacokinetics of loratadine and its active metabolite in patients with chronic renal failure.

In patients with chronic hepatic impairment of alcoholic origin, the observed AUC and peak plasma concentrations (Cmax) of loratadine were doubled, whereas the pharmacokinetic profile of the active metabolite was not significantly modified compared with patients with normal hepatic function. The elimination half-lives of loratadine and its metabolite were 24 hours and 37 hours, respectively, and they increased in parallel with the severity of hepatic impairment.

Loratadine and its active metabolite are excreted in breast milk in breastfeeding women.

Preclinical data reveal no specific risk for humans in the light of conventional safety, pharmacology, repeated-dose toxicity, genotoxicity or carcinogenicity studies.

Studies of reproductive function revealed no teratogenic effect in animals. However, prolonged parturition and reduced viability of offspring were observed in rats exposed to plasma levels (AUC) 10 times higher than those achieved with the doses used clinically.

3 years.

No special precautions for storage.

No particular requirements