Claritin and Flonase

Can you take Claritin and Flonase together

What is Claritin

Claritin is a Brand name for antihistamine drug that contains loratadine as an active ingredient. Loratadine is second generation, long-acting, non-sedating antihistamine drug that reduces the effects of natural histamine during allergic reactions in the body.

It is used for relieving the symptoms of hives, skin rash, itching, sneezing, runny nose, watery eyes and other allergy or cold symptoms. Claritin can be also used for the treatment of chronic skin hives and itching.

Claritin is available in following dosage forms and strengths: solution (5mg/5ml), syrup (1mg), tablet (10mg), chewable tablet (5mg), orally disintegrated tablet (5 and 10mg), capsule and liquid filled capsule (10mg).

Other products on the market containing loratadine are: Alavert, Claritin Reditab, Clear-Atadine, Dimetapp ND, ohm Allergy Relief, QlearQuil All Day & Night, Tavist ND, Wal-itin.


What is Flonase

Flonase is a Brand name for a nasal spray formulation containing fluticasone as an active ingredient. Fluticasone is a synthetic corticosteroid drug that prevents the release of body substances that can cause inflammation and pruritic symptoms of psoriasis and dermatoses.

Flonase Nasal Spray is used for the treatment and relieving nasal symptoms of seasonal and recurrent nonallergic and allergic rhinitis in adults and pediatric patients of 4 years of age and older.

There are no relevant and established studies and data of Flonase safety and effectiveness in children below 4 years of age. The recommended initial dosage in adults is 2 sprays in each nostril once a day.

Patients who are not adequately responding may use 2 sprays in each nostril two times a day which is the maximum total daily dose. Flonase is available only in the form of spray in dose of 50 ug/1.

Other products on the market containing fluticasone are: Seretide, Nasofan, Flixotide, Flixonase, Pirinase, Flunase and Flovent.


How does Claritin and Flonase work in the body

Loratadine is a long acting second generation antihistamine. Loratadine has similar pharmacology effects to other antihistamines, but unlike other H1-antagonists, loratidine has more competitive, specific, and selective antagonism properties for H1 receptors.

Exact mechanism of prolonged antihistamine effects is unknown, but it may be because of drug’s slow dissociation from the H1 receptor or because of the formation of its active metabolite desloratidine.

Loratadine does not penetrate blood-brain barrier effectively and has a low affinity for H1-receptors in CNS than other antihistamine drugs. Studies showed that loratadine has a low affinity for cholinergic receptors and does not have any significant alpha-adrenergic antagonist in-vitro activity.

Loratadine can also suppress the release of histamine and leukotrienes mastocytes in animals, and the release of leukotrienes, however the clinical importance of this is still unknown.

Fluticasone is a very potent vasoconstrictor and anti-inflammatory substance. Its effectiveness is the best in inhaled dosage forms due to its direct local effects. Fluticasone acts by binding to the glucocorticoid receptors.

Unbound corticosteroids molecules can cross the cells membranes of eosinophils and mastocytes, and then bind with high affinity to glucocorticoid receptors.

The results of drug-receptor interaction are: transcription alteration and protein synthesis, a reduced release of enzyme called leukocytic acid hydrolases, leukocyte adhesion to the capillary wall interference, reduction of collagen deposition, reduction of the proliferation of fibroblasts, prevention of macrophage accumulation into the sites of  inflammation, reduction of capillary membrane permeability and edema, decrease of complement components, inhibition of proinflammatory substances such as  histamine and kinin release, and interference with scar tissue formation.

Can patients take Claritin and Flonase together

Since there are no significant interaction between Claritin and Flonase nasal spray, patients can use them together for a treatment of allergies, but they always need to consult their doctor or pharmacist first.

These drugs work pretty well together in treating symptoms associated with allergic rhinitis and this indication usually requires antihistamine drug and topical nasal steroid.

Claritin is also second generation antihistamine and has less side effects compared to older antihistamines. However, patients need to see an allergist first for more definitive treatment options.

The table below shows side effects after Claritin and Flonase administration in recommendable doses. The incidence can be significantly increased if these drugs are overdosed or taken together.

Very common side effects >10% Headache (17%), Upper Respiratory Infection (15%)
Common side effects 1-10% Pharyngitis (6-8%), Nasal congestion (8%), Drowsiness (8%) Somnolence (8%), Asthma symptoms (3-7%), Nervousness (4%), Dysphonia (4%), Cough (3-4%), Dry mouth (3%), Hyperkinesia (3%), Fatigue (3-4%), Fever (1-5%), Aches and pains (1-3%), Flu-like syndrome (1-3%), Bronchitis (1-3%), Abdominal pain (1-3%), Diarrhea (1-3%), Nasal discharge (1-3%), Conjunctivitis (2%), Malaise (2%), Nasal ulcer (1%),
Frequency Not Defined Loss of taste, Arthralgia, myalgia, hypotension, supraventricular tachyarrhythmias, palpitations, syncope, tachycardia
Postmarketing Reports Rhinalgia, nasal discomfort , nasal dryness, and nasal septal perforation

Special precautions and warnings during Claritin and Flonase administration:

  • Patients should tell their doctor and pharmacist if they are allergic to loratadine or fluticasone, or any other medications, or any of the ingredients in Claritin products or Flonase nasal spray.
  • Patients should tell their doctor and pharmacist what prescription and nonprescription medicines, nutritional supplements, herbal products or vitamins, they are taking or plan to take. Patients should mention to their doctor if they are using some of following drugs: an antifungal drugs such as ketoconazole (Nizoral, Extina, Xolegel) and HIV protease inhibitor drugs such as ritonavir (Kaletra, Norvir). They should also tell their doctor and pharmacist if they are using steroid medicines such as: methylprednisolone, dexamethasone, and prednisone. Doctor may need to change the doses of medicines or monitor you carefully for side effects.
  • Patients need to tell their doctor if they have recently had nose surgery or nose injury, if they have nose sores, or if they have or have ever had cataracts eye glaucoma, asthma or any type of infection. Also they need to tell their doctor if they have measles, chicken pox or tuberculosis.
  • Women should tell the doctor if they are pregnant, plan to become pregnant, or are breastfeeding. These drugs shouldn’t be used during pregnancy and breastfeeding.
  • Patients should tell their doctor if they have or have ever had some liver or kidney disease.
  • If patients have phenylketonuriathey should know that some orally disintegrated products may contain aspartame that forms phenylalanine in the body.

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