Side effects causing weight gain in children when taking antiallergic drugs Loratadine, Desloratadine

The article was written by the Clinical Pharmacy Team, Vinmec Times City International General Hospital

Loratadine and desloratadine are commonly used to relieve allergic symptoms such as hives, rash, and runny nose in adults and children. However, the drug can cause weight gain and obesity in children.

Loratadine and its metabolite desloratadine are drugs commonly used for the symptomatic relief of allergic rhinitis or urticaria. These drugs belong to the 2nd generation histamine 1 (H1) receptor antagonists, which are selective, safe and less drowsy than the 1st generation.
In Vietnam, these two active ingredients are circulated. with a number of different brand names such as: Clarityne, Lorastad (active ingredient loratadine), Aerius, Lorastad D (active ingredient desloratadine).

As of November 6, 2016, the World Health Organization's Pharmacovigilance Database VigiBase recorded 159 reports of weight gain associated with desloratadine and loratadine. Of these, 22 were reported in pediatric patients (<12 years). There are cases recorded that children gain 4 - 4.5 kg in 1-2 months of use and recover after stopping the drug.
An analysis of the reports showed that desloratadine was associated with an increased risk of weight gain in children aged 2 to 11 years and was inconclusive with loratadine. However, since loratadine is metabolized in the body to desloratadine, this risk cannot be excluded. The mechanism is thought to be that H1 and H3 histamine receptor antagonists are mediators of energy absorption, increasing appetite, especially in children, causing weight gain and obesity.
Currently, the proportion of children with obesity is on the rise, leading to an increased risk of cardiovascular disease, metabolic disease or musculoskeletal disease in the long term. Furthermore, obesity can also negatively impact a child's psychological and social development.
Therefore, when using loratadine and desloratadine for children, it is necessary to pay attention to the change in appetite as well as the child's weight.

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