Moderate
Diazepam × Loratadine
Anxiolytics. Benzodiazepine derivatives×Second-generation antihistamines
Mechanism
Loratadine rarely causes sedation at standard doses. With diazepam, mild additive CNS depression is possible, especially in older patients.
Symptoms
Sedation, fatigue, slowed reactions, impaired coordination. In older patients: fall and fracture risk. Driving and operating machinery: accident risk.
Management
On standard loratadine (10 mg/day) with intermittent diazepam (e.g. for anxiety), no adjustment needed. In older patients and on long-term benzodiazepine therapy, watch for sedation signs. For anxiety disorders, consider alternatives to diazepam: buspirone or CBT.