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loratadine has stopped working for me
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loratadine has stopped working for me

Hello Doctor,


Is it possible that I have built up a tolerence to loratadine after using it so many years?  I have the usual allergy symptoms: sneezing, itchiness, runny nose and hive breakouts.  I'm allegic to dust, pollen and grass, no food or medicinal allergies that I know of. I usually take 10mg of generic Claritin once a day and I'm fine (about 4years now) but yesterday I broke out in Hives and the claritin hasnt helped.  I took 20mg last night and 20mg this morning.  Ive always been able to control them with meds but now they're driving me crazy!  

I had my first hives breakout when I was 12 and apparently developed an allergy to grass.  Benadryl didnt work on me at all for my hives or sneeziness and what not, I started on Chlor-Trimeton and that worked great but then that stopped working after 10 years and so i switched to Claritin.  I'm not sre what i should take now.  Help!

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242588_tn?1224275300
Not necessarily a tolerance to loratidine, but equally possible that the nature and/or intensity of your allergies has worsened.  Hives (Urticaria) in the recurrent form, is a very common condition.  Numerous causes of hives have been described.  The following is a partial list of a great variety of precipitating agents.  Despite this knowledge, it is estimated that the cause of 1/3 to 1/2  of the cases is never determined.  Note also that, in some instances, hives can be a manifestation of a serious underlying disease, however, the overwhelming majority of episodes of hives are unrelated to serious disease.

The major causes of urticaria and angioedema (HIVES) that should be considered when any patient is being evaluated are as follows
  
1. Drug reactions
2. Foods or food additives
3. Inhalation, ingestion of, or contact with antigens
4. Transfusion reactions
5. Infections: bacterial, fungal, viral, and helminthic
6. Insects (papular urticaria)
7. Collagen vascular diseases
       a.Cutaneous vasculitis
       b.Serum sickness
8. Malignancy: angioedema
9. Physical urticarias
       a.Cold urticaria
       b.Cholinergic urticaria
       c.Dermographism
       d.Pressure urticaria (angioedema)
       e.Vibratory angioedema
       f.Solar urticarial
       g.Aquagenic urticaria
10. Urticaria pigmentosa: systemic mastocytosis
11. Hereditary diseases
       a.Hereditary angioedema
       b.Familial cold urticaria
       c.C3b inactivator deficiency
       d.Amyloidosis with deafness and urticaria (Muckle-Wells syndrome)
12. Chronic autoimmune urticaria and angioedema
13. Chronic idiopathic urticaria and angioedema
14. Idiopathic angioedema

SUMMARY OF IMPORTANT CONCEPTS

Acute urticaria occurs in up to 20% of the population, and is often associated with drug, food, or other allergy, or with infection

Urticaria should be treated with elimination of trigger factors, where identified, and with H1antihistamines, preferably non-sedating

In some patients with chronic urticaria, low-dose daily or alternate-day corticosteroids or other immunomodulators may be needed
    
C1 inhibitor deficiency is treated with C1 inhibitor concentrate, where available, and with fresh frozen plasma, androgenic agents, or antifibrinolytic agents

Acute urticaria is extremely common, possibly affecting as many as 10–20% of the population at some time in their lives. It is most frequently a self-limited disorder caused by an allergic reaction to a food or drug. When the urticaria is present for more than 6 weeks, it rather arbitrarily is designated chronic.

A suspected drug reaction may be tested by eliminating the agent. If the diagnosis is correct, gradual resolution of the urticaria is anticipated. All medications including aspirin, vitamins, cold tablets, hemorrhoid suppositories, birth control tablets, and herbal preparations should be considered to be a potential cause of urticaria or angioedema, and eliminated if possible. When a medication is required for treatment of a true illness, a change to an alternative drug may be attempted.

I suggest that you take a careful inventory of everything that you might have been exposed to prior to the most recent recurrence of hives, especially things you seldom encounter in your usual everyday life. Keep in mind that the recent episode, fairly unresponsive to your usual meds, may have been an aberration and that your hives may again become responsive to the medication that has worked so well for you.   If the Claritin continues not to help, you may have to switch to another non-sedating antihistamine, such as Zyrtec, on a trial basis.

Good luck
6 Comments
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746512_tn?1388811180
Another one that is similar to claritin is aerius, you could try that.  Or be like me and have to rely on allergy shots helping because none of the antihistamines work any more
:(
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Avatar_f_tn
I was afraid that I'd have to start getting shots. . . I dont have health insurance :(

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746512_tn?1388811180
I don't have insurance coverage at this point but the shots only cost roughly $140 a year which is less than the cost of antihistamines for the same period.  

I would suggest getting an allergist appointment and asking about the pricing of shots
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Avatar_f_tn
I notice that certain drugs work better for me with certain allergies. Claritin works well for me for dust and mild pet dander, but Zyrtec helps with more vigorous pet dander (horses) and for cottonwood and dogwood. Really only Benadryl works for pine bladders. My doctor gave me some samples of some other medications: Zyzal (sp?) and Singulaire, which also help with the more daily stuff, including some food allergies, that Claritin can't handle.

Really I take a moment and figure out what allergen I have been exposed to. I check the pollen count in my area (see if you have a local count), and medicate accordingly. With a little forethought I manage quite well and very rarely have to take more than one medication.
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Avatar_n_tn
Im just sick and tired of my lips swelling to abnormal sizes. Help whats going on?
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