Decoding the role of loratadine in optimally managing and in alleviating the burden of allergic rhinitis

Abstract

Despite an alarmingly rise in prevalence of allergic rhinitis in the last 2 decades, yet till date it remains underdiagnosed, undertreated, or mistreated in India. The distinguishing features of allergic rhinitis are commonly misinterpreted with the common cold and thus early detection of allergic rhinitis is often delayed in primary care. Poorly controlled allergic rhinitis adversely impairs overall long-term productivity at work or school, quality of life (QoL) and can also trigger underlying comorbidities like asthma. Thus, early diagnosis and timely referral is the need of the hour for more effective management which will reduce the overall burden of allergic rhinitis in India. As allergic rhinitis needs long-term management, it is also paramount to prescribe highly efficacious, cost-effective treatment with minimal side effects like drowsiness to prevent disruption of patient’s QoL. However, current therapies including intranasal corticosteroids have adverse long-term complications and antihistamines like cetirizine, levocetirizine, and fexofenadine have varying degrees of sedation.With these concerns, a management algorithm was developed to aid for early diagnosis in primary care which provides cost effective option of right medication for a proper duration of time to optimize overall patient care. After a thorough discussion of key opinion leaders and evidence-based recommendations, it was highlighted that loratadine deserves to be considered as a first-line antihistamine therapy due to its rapid and long-lasting symptom relief, non drowsy, and low complication rate for long-term management of allergic rhinitis.