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Medline ® Abstract for Reference 99

of 'Pharmacotherapy of allergic rhinitis'

Loratadine in the high performance aerospace environment.
Hansen GR
Aviat Space Environ Med. 1999 Sep;70(9):919-24.
BACKGROUND: Authors have unanimously reported that 10 mg of loratadine does not produce sedation. A small risk of sedation may exist and may not have been discovered by those studies due to their small sample size.
HYPOTHESIS: Using combined data, there is no increased risk of sedation over placebo for patients using 10 mg of loratadine daily.
METHODS: Literature search and meta-analysis of published data was performed.
RESULTS: Pooled data showed sedation in 25 of 517 patients given 10 mg of loratadine, and 24 of 510 patients given placebo. The relative risk was 1.03, with a confidence interval from 0.59 to 1.77. Sleepiness was objectively studied using the multiple sleep latency test. Patients treated with 10 mg of loratadine did not have excess sleepiness induced; patients treated with 40 mg of loratadine did. Using 10 different methods, 20 studies did not find performance impairment in subjects given 10 mg of loratadine. Two performance studies, digit substitution and driving, showed impairment with 20 mg and 40 mg of loratadine, respectively. Physiologic studies using restingEEG had conflicting reports. There was no impairment detected in altitude studies or vestibular studies. No centrifuge or color vision data were found.
CONCLUSION: Ingesting 10 mg of loratadine daily does not have sedative effects or impair cognitive-motor performance. Higher doses have demonstrated impairment. Aviation concerns that have not been addressed include centrifuge studies and color vision studies. It would be reasonable to employ loratadine in the high performance aerospace environment if these latter tests prove to be negative.
Air Force Residency in Aerospace Medicine, Brooks AFB, TX, USA.