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Loratadine
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=== Pharmacodynamics === Loratadine is a [[tricyclic antihistamine]], which acts as a selective [[inverse agonist]] of peripheral [[histamine]] [[histamine H1 receptor|H<sub>1</sub> receptors]].<ref name="Mutschler" /><ref name=Devillier2008rev>{{cite journal | vauthors = Devillier P, Roche N, Faisy C | title = Clinical pharmacokinetics and pharmacodynamics of desloratadine, fexofenadine, and levocetirizine: a comparative review | journal = Clinical Pharmacokinetics | volume = 47 | issue = 4 | pages = 217β30 | year = 2008 | pmid = 18336052 | doi = 10.2165/00003088-200847040-00001 | s2cid = 9189476 }}</ref> The potency of second generation histamine antagonists is (from strongest to weakest) [[desloratadine]] ([[Dissociation constant|K<sub>i</sub>]] 0.4 nM) > [[levocetirizine]] (K<sub>i</sub> 3 nM) > [[cetirizine]] (K<sub>i</sub> 6 nM) > [[fexofenadine]] (K<sub>i</sub> 10 nM) > terfenadine > loratadine. However, the onset of action varies significantly and clinical efficacy is not always directly related to only the H<sub>1</sub> receptor potency, as the concentration of free drug at the receptor must also be considered.<ref>{{cite journal | vauthors = Church MK, Church DS | title = Pharmacology of antihistamines | journal = Indian Journal of Dermatology | volume = 58 | issue = 3 | pages = 219β24 | date = May 2013 | pmid = 23723474 | pmc = 3667286 | doi = 10.4103/0019-5154.110832 | doi-access = free }}</ref><ref name=Devillier2008rev/> Loratadine also shows anti-inflammatory properties independent of H<sub>1</sub> receptors.<ref name="pmid15631542">{{cite journal | vauthors = Bielory L, Lien KW, Bigelsen S | title = Efficacy and tolerability of newer antihistamines in the treatment of allergic conjunctivitis | journal = Drugs | volume = 65 | issue = 2 | pages = 215β28 | date = 2005 | pmid = 15631542 | doi = 10.2165/00003495-200565020-00004 | s2cid = 46791611 | url = }}</ref><ref name="pmid23268457">{{cite journal | vauthors = Canonica GW, Blaiss M | title = Antihistaminic, anti-inflammatory, and antiallergic properties of the nonsedating second-generation antihistamine desloratadine: a review of the evidence | journal = The World Allergy Organization Journal | volume = 4 | issue = 2 | pages = 47β53 | date = February 2011 | pmid = 23268457 | pmc = 3500039 | doi = 10.1097/WOX.0b013e3182093e19 | url = }}</ref> The effect is exhibited through suppression of the [[NF-ΞΊB]] pathway, and by regulating the release of cytokines and chemokines, thereby regulating the recruitment of inflammatory cells.<ref name="pmid32251678">{{cite journal | vauthors = Hunto ST, Kim HG, Baek KS, Jeong D, Kim E, Kim JH, Cho JY | title = Loratadine, an antihistamine drug, exhibits anti-inflammatory activity through suppression of the NF-kB pathway | journal = Biochemical Pharmacology | volume = 177 | issue = | pages = 113949 | date = July 2020 | pmid = 32251678 | doi = 10.1016/j.bcp.2020.113949| s2cid = 215408324 }}</ref><ref name="pmid15245363">{{cite journal | vauthors = Fumagalli F, Baiardini I, Pasquali M, Compalati E, Guerra L, Massacane P, Canonica GW | title = Antihistamines: do they work? Further well-controlled trials involving larger samples are needed | journal = Allergy | volume = 59 | issue = Suppl 78 | pages = 74β7 | date = August 2004 | pmid = 15245363 | doi = 10.1111/j.1398-9995.2004.00573.x| s2cid = 39936983 }}</ref>
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