LORATADINE BETAMETHASONE: WHAT IT IS FOR, EFFECTS AND DOSAGE - MEDICINE - 2025

The combination loratadine betamethasone brings together a drug that provides immediate relief to symptoms associated with allergies (loratadine) with another that blocks the inflammatory component of the reaction (betamethasone), which ultimately results in a more potent therapeutic effect and a higher rate lower number of recurrences.

This composition has become a very popular therapeutic option since its introduction on the market. While most mild allergic reactions can be managed with loratadine alone, in severe or recurrent allergic reactions the best option is to use the combination loratadine-betamethasone.

This is so because, in addition to treating the symptoms derived from the release of histamine with loratadine, the inflammatory component will also be blocked with betamethasone; thus achieving a higher success rate with a lower recurrence.

Mechanism of action

The mechanism of action of the combination loratadine betamethasone is based on the synergy of both drugs.

Action of loratadine

First of all, loratadine is a very powerful selective H1 blocker, without sedative effect, that very quickly inhibits the effects of histamine at the peripheral level. This helps to quickly reduce itching (itching) and redness.

However, when loratadine is administered alone, histamine continues to circulate, so symptoms may reappear when the drug is no longer effective.

And that is precisely where betamethasone comes in, as this drug from the group of corticosteroids has a powerful anti-inflammatory effect.

Action of betamethasone

Since the basis of allergic reactions is inflammation, betamethasone goes to the root of the problem, blocking the release of inflammatory mediators at the cellular level as well as the chemical interactions between these and their receptors.

Through this mechanism, betamethasone ultimately blocks the release of histamine, controlling the allergic reaction from its source.

However, since this mechanism takes longer and the histamine secreted prior to drug administration will continue to produce symptoms, concomitant administration of loratadine is necessary for faster initial relief of symptoms.

What is it for?

Although most mild allergic reactions can be treated with loratadine alone, those cases of severe or recurrent allergy benefit from the use of the combination loratadine betamethasone, particularly those associated with chronic inflammatory conditions such as asthma.

In this sense, the most common indications for the use of this combination are:

- Atopic dermatitis.

- Bronchial asthma.

- Seasonal allergic rhinitis.

- Perennial allergic rhinitis.

- Allergic reactions to medicines.

- Food allergies.

- Insect bites.

The above are only the most common, although in general any allergic reaction associated with inflammation can be treated with this combination as long as its severity does not require the use of parenteral treatments, as in the case of anaphylactic shock.

Contraindications

- The combination of loratadine and betamethasone is contraindicated when it is known that the patient is sensitive to any of the components of the formulation.

- It is contraindicated in the case of fungal infections (as it could aggravate them), bile duct obstruction and urinary obstruction, especially when this is due to prostatic hypertrophy.

- Its use should be avoided in patients with hypokalemia (low potassium in the blood).

- It should be used with caution when administered to patients undergoing treatment with MAOIs (mono amino oxidase inhibitors).

- It should be used with caution in patients with renal or hepatic insufficiency. Sometimes it is even necessary to adjust the dose according to kidney or liver function.

- During pregnancy and lactation, its use should be limited only to those cases where there is no other therapeutic option and the benefit for the patient far outweighs the risks.

Side effects

- Most of the side effects noted by the patient (symptomatic) tend to appear at the systemic level and in the digestive tract, the most frequent being asthenia (tiredness), drowsiness, a sensation of dry mouth, nausea and vomiting.

- In some patients, paradoxical allergic reactions characterized by rash and urticaria may occur after the administration of this combination of drugs.

- Other side effects may occur that, although they go unnoticed by the patient (they are asymptomatic), can put their life at risk. Such is the case of hypokalemia (decreased levels of calcium in the blood), fluid and electrolyte imbalances, increased sodium levels and fluid retention.

- In cases where it is administered for very long and uninterrupted periods of time, Cushing's Syndrome and adrenal insufficiency may appear as late side effects.

Despite its potential side effects (the above being only the most frequent), it is a very safe drug that should not cause any inconvenience if administered under strict medical supervision.

Recommended dosage

The combination loratadine betamethasone is administered orally, either as a solid (tablet) or liquid (syrup). The most common concentration in these presentations is 5 mg of loratadine and 0.25 mg of betamethasone.

In adults and children over 12 years of age, the recommended standard dose is 1 tablet every 12 hours for a period of no more than 5 days. However, each patient must be individualized, since there may be particular conditions that require an adjustment of the dose in more or less.

Likewise, a treatment may be indicated for a period greater than 5 days, although this should always be under strict medical supervision.

In children under 12 years of age, the calculation of the dose per kilogram of body weight should be performed. In these cases, the ideal is to consult with the pediatrician so that, based on the child's weight, not only the total dose to be administered can be calculated but also how it will be divided throughout the day during the duration of the treatment.

References

1. Snyman, JR, Potter, PC, Groenewald, M., & Levin, J. (2004). Effect of Betamethasone-Loratadine Combination Therapy on Severe Exacerbations of Allergic Rhinitis. Clinical drug investigation, 24 (5), 265-274.
2. de Morales, TM, & Sánchez, F. (2009). Clinical efficacy and safety of a combined loratadine-betamethasone oral solution in the treatment of severe pediatric perennial allergic rhinitis. World Allergy Organization Journal, 2 (4), 49.
3. Juniper, EF (1998). Rhinitis management: the patient's perspective. Clinical and Experimental Allergy, 28 (6), 34-38.
4. Okubo, K., Kurono, Y., Fujieda, S., Ogino, S., Uchio, E., Odajima, H.,… & Baba, K. (2011). Japanese guideline for allergic rhinitis. Allergology International, 60 (2), 171-189.
5. Leung, DY, Nicklas, RA, Li, JT, Bernstein, IL, Blessing-Moore, J., Boguniewicz, M.,… & Portnoy, JM (2004). Disease management of atopic dermatitis: an updated practice parameter. Annals of Allergy, Asthma & Immunology, 93 (3), S1-S21.
6. Angier, E., Willington, J., Scadding, G., Holmes, S., & Walker, S. (2010). Management of allergic and non-allergic rhinitis: a primary care summary of the BSACI guideline. Primary Care Respiratory Journal, 19 (3), 217.
7. Greaves, MW (1995). Chronic urticaria. New England Journal of Medicine, 332 (26), 1767-1772.