Second-generation antihistamine
ATC code: R06AX27 (Desloratadine)
Brand names
Aerius, Neoclarityn, Clarinex
An active metabolite of loratadine. A selective peripheral H1-antagonist with a long half-life (27 hours). Minimal blood-brain barrier penetration – sedation is close to placebo. Metabolized primarily by 3-hydroxylation; data on specific CYP isoenzymes are limited and drug interactions are minimal.
First line
First-line for seasonal and perennial allergic rhinitis under ARIA 2020 and 2022 alongside other second-generation antihistamines. Standard dose 5 mg once daily. Children 1–5 years: 1.25 mg (2.5 mL syrup) once daily. Tolerability and sedation comparable to and .
First line
First-line for chronic spontaneous urticaria under /GA²LEN/EDF/ 2022 at 5 mg once daily. With insufficient response, up-dosing to 20 mg/day is acceptable (off-label, EAACI consensus). When symptoms persist at quadruple dose, add omalizumab.
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
Desloratadine is a second-generation antihistamine and the active metabolite of loratadine. It is prescribed for seasonal and perennial allergic rhinitis and urticaria ( 2024, AEMPS Ficha Técnica). Desloratadine is recommended for viral runny nose and for general immunity, conflating the common cold with allergic rhinitis. The Cochrane review by De Sutter 2015 in people with ordinary colds did not confirm significant effect of antihistamines as monotherapy. If desloratadine was prescribed for a cold without confirmed allergic rhinitis, consider seeking a second opinion.
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FDA category C. Limited pregnancy data. Loratadine or cetirizine with more pregnancy data are preferred in pregnancy.
Fully compatible. Hale L1. RID 0.04%, same as loratadine. Drug of choice for nursing mothers with allergic rhinitis or chronic urticaria.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Desloratadine is evaluated for the following indications with varying evidence strength: Allergic rhinitis (evidence tier A), Chronic urticaria (evidence tier A), Immune support and respiratory infection care (evidence tier F). See the full indication matrix with dosing and citations above on this page.
Common side effects of Desloratadine (≥ 1 in 100): Fatigue, Dry mouth, Headache, Drowsiness (~2%, placebo-level). See the Safety section for uncommon and serious reactions.
FDA category C. FDA category C. Limited pregnancy data. Loratadine or cetirizine with more pregnancy data are preferred in pregnancy.
Fully compatible. Hale L1. RID 0.04%, same as loratadine. Drug of choice for nursing mothers with allergic rhinitis or chronic urticaria.
Desloratadine is contraindicated in: Hypersensitivity to desloratadine, loratadine, or excipients; Age under 6 months. Full list in the Safety section.