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desloratadine + pseudoephedrine (Clarinex D / Aerinaze)

✓ Approved

Merck & Co. · HRH1 · Small Molecule

What is desloratadine + pseudoephedrine?

desloratadine + pseudoephedrine is a small molecule developed by Merck & Co.. It is approved for therapeutic indications via oral (po).

Drug Profile

Brand NamesClarinex D, Aerinaze
CompanyMerck & Co.
Drug ClassSmall Molecule
Molecular TargetHRH1
RouteOral (PO)
StatusApproved

Mechanism of Action

Molecular Targets

desloratadine + pseudoephedrine acts on 1 molecular target:

HRH1histamine receptor H1 (HH1R, H1R)
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Therapeutic Indications

desloratadine + pseudoephedrine is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Immune system disordersSeasonal allergy✓ Approved

Related Research Articles

PubMedJournal of pharmaceutical sciences2026-07-25

Efficacy of ultraviolet irradiation of pharmaceutical excipients in mitigating N-nitrosamine generation.

Minamioka Saki S, Matsuzawa Shun S, Yoshihara Naoki N, Oikawa Michinori M et al.

The generation of N-nitrosamine compounds (NOCs) in drugs presents a critical regulatory challenge owing to their potential mutagenicity and exceptionally strict acceptable intake limits required for patient safety. These impurities arise primarily from the reaction between amine-containing active pharmaceutical ingredients and trace amounts of nitrosating agents (reactive NOx), which contribute to N-nitrosation. Reactive NOx species are frequently found in pharmaceutical excipients. Therefore, efficiently reducing reactive NOx is essential for robust management of the risk posed by NOCs. In this study, we employed ultraviolet (UV) irradiation of excipients as a novel preemptive strategy to reduce reactive NOx levels. Desloratadine was used as a secondary amine model to evaluate the generation of N-nitrosamine in physical mixtures with various excipients. The excipients were exposed to different UV wavelengths (248, 313, and 365 nm), and N-nitrosodesloratadine (NDLRT) generation was quantified after storage under stress conditions. We found that 365 nm UV irradiation was the most effective in reducing reactive NOx under all conditions. In a formulation study, 365 nm UV irradiation successfully reduced NDLRT generation in the tablet by 54-68% compared with the control. Overall, the novel strategy described herein should be useful for reducing NOCs without affecting the quality of drugs.

PubMedEuropean journal of clinical pharmacology2026-07-22

The incidence of sleepiness in newer-generation antihistamine users: a systematic review and network meta-analysis.

Leelakanok Nattawut N, Pongpun Anchana A, Sapapsap Bannawich B, Jirathawonkul Nattanich N et al.

This systematic review and meta-analysis aimed to summarize the incidence of sleepiness in patients who used newer-generation antihistamines. CINAHL Complete, Medline, Scopus, ScienceDirect, and Google Scholar were systematically searched from inception to July 2025. The pairwise meta-analysis of the sleepiness incidence was conducted using a binary random-effects model. The network meta-analysis was performed using a random-effects model in a frequentist framework. Heterogeneity was evaluated using the I2 statistic. One hundred and sixty-three studies were included in the systematic review and meta-analysis. We found that 1.3% (95% CI: 1.0-1.6%, I2 = 40.45) of those taking a placebo reported sleepiness. The least-sedating antihistamine in adults was bilastine 20 mg (prevalence = 1.6%; 95% CI: 0.7-2.5%, I2 = 47.83). Data from network meta-analysis also supported that bilastine 20 mg has the least sedative effect (relative risk = 1.06; 95%CI: 0.67-1.69). At their usual therapeutic dose, bepotastine 20 mg, bilastine 20 mg, desloratadine 5 mg, and fexofenadine 120 mg-180 mg had a prevalence of sleepiness of less than 10% and not significantly different from placebos (p > 0.05). All nonsedating antihistamines administered at their usual doses have a higher prevalence of sleepiness compared to the placebo. However, most of the prevalence values are not statistically different from those of the placebo.

PubMedJournal of chemical information and modeling2026-07-14

Discovery and Mechanism of Action of a Novel Desloratadine Derivative Inhibiting Mycobacterium tuberculosis 3-Dehydroquinate Synthase.

Belachew Aweke Mulu AM, Li Haizhou H, Tian Xirong X, Liu Zhiyong Z et al.

Mycobacterium tuberculosis, the etiological agent of tuberculosis (TB), remains a leading cause of mortality from infectious disease worldwide. The continued emergence of multidrug-resistant strains highlights the urgent need for new therapeutic agents with novel mechanisms of action. Here, we report the discovery and comprehensive characterization of DL25, a synthetic desloratadine-derived small molecule exhibiting potent antimycobacterial activity (minimum inhibitory concentration (MIC) 2-4 μg/mL against multiple mycobacterial species). Using a supra-inhibitory DL25 selection strategy, we isolated and characterized spontaneous resistant mutants. Whole-genome sequencing identified recurrent mutations in aroB, which encodes 3-dehydroquinate synthase (DHQS), an essential enzyme of the shikimate pathway. Consistent with target involvement, aroB overexpression reduced susceptibility to DL25, while DL25 decreased DHQS-associated biochemical activity in vitro with an apparent IC50 of approximately 5.0 μg/mL. In addition, DL25 exhibited concentration- and time-dependent bactericidal activity and showed partial synergy with several established antitubercular agents. Structural modeling, molecular docking, and 100 ns molecular dynamics simulations supported stable binding of DL25 within the DHQS active site and identified interactions with residues implicated in substrate recognition and catalysis. Collectively, the genetic, biochemical, and computational findings support DHQS as a biologically relevant target associated with DL25 activity and establish DL25 as a promising lead-like scaffold for the development of future shikimate pathway-directed antimycobacterial agents. More broadly, this study demonstrates the value of integrating genetic, biochemical, and computational approaches for mechanism-guided antituberculosis drug discovery.

PubMedCells2026-07-13

Plant-Derived Diamine Oxidase Modulation of Histamine-Induced Ca2+ Release in Intestinal Caco-2 Cells: A Cellular System to Evaluate Its Histaminase Efficacy.

Neree Armelle Tchoumi AT, Jumarie Catherine C, Marcocci Lucia L, Pietrangeli Paola P et al.

Histamine accumulation is associated with allergic reactions and intestinal dysfunction through activation of H1R Receptors (H1Rs) and subsequent intracellular Ca2+ mobilization. Although antihistamines such as desloratadine block H1Rs to alleviate symptoms, they may induce adverse effects (dizziness, nausea, neurological disorders). Diamine oxidases (DAOs) catalyze the oxidative deamination of histamine to imidazole acetaldehyde with consumption of oxygen and concomitant production of hydrogen peroxide and ammonia. Instead of blocking H1R, we have proposed vegetal diamine oxidase (vDAO) as an enzymatic approach to decompose histamine. This study investigated whether vDAO, by degrading histamine, could modulate histamine-induced Ca2+ mobilization compared with desloratadine. Using intestinal Caco-2 cultured cells loaded with the fluorescent Ca2+ indicator Fluo-4 AM, intracellular calcium (Ca2+) dynamics were analyzed by confocal microscopy following histamine stimulation. vDAO significantly downregulated histamine-induced Ca2+ mobilization. Notably, at a fixed histamine concentration sufficient to trigger Ca2+ release, vDAO achieved the same level of calcium mobility inhibition at a concentration three-fold lower than that of desloratadine, suggesting a high efficiency of DAO. These findings indicate that histamine degradation with orally administrable DAO may reduce Ca2+ signaling in intestinal epithelial cells, providing a promising approach to reduce histamine-related damage or a reinforcement of current antihistamine anti-inflammatory medication based on histamine receptor blockade.

PubMedThe World Allergy Organization journal2026-07-12

Forecasting seasonal allergic rhinitis through integrated analysis of social media and online drug sales data.

Tong Xunliang X, Fang Chuangsen C, Jiang Xiaowei X, Liu Lan L et al.

Allergic rhinitis (AR) is a highly prevalent, seasonally variable disease that poses a growing public health challenge. Conventional surveillance based on clinic visits and surveys is slow and may miss self-medicating patients. Integrating environmental monitoring with digital traces such as search queries and online drug purchases may provide more timely insight into allergen exposure, symptom awareness, and medication demand. We analyzed daily data for urban Beijing from March 1, 2022 to October 15, 2024, including pollen concentration (grains per 1000 mm3), the Baidu search index for "allergic rhinitis," and online purchase rates of 4 oral second-generation H1-antihistamines (loratadine, desloratadine, cetirizine, levocetirizine) from the Meituan platform, standardized per 100,000 population. Cross-correlation functions were computed on pre-whitened series to assess lead-lag relationships. A single-mediator regression framework applied to pre-whitened data and estimated with Newey-West heteroskedasticity- and autocorrelation-consistent standard errors quantified the mediating role of the Baidu Index between pollen and antihistamine purchases. ARIMAX (1,1,1) models with different exogenous inputs (pollen only, Baidu Index only, both combined) and a naïve random-walk benchmark were used to forecast 1-, 2-, 3-, and 7-day demand; performance was evaluated using RMSE, MAPE, and Pearson correlation (PCC). All 3 series exhibited pronounced and recurrent seasonal patterns, with Baidu search activity rising in close temporal alignment with pollen peaks and antihistamine purchases typically lagging by 1-2 days. Pre-whitened cross-correlations remained moderate and statistically significant around lag 0, indicating genuine contemporaneous associations after removing the shared seasonal component. Mediation analysis showed that pollen concentration had a significant total effect on antihistamine purchase rates (β = 0.34, 95% CI [0.13, 0.54]), of which approximately 47% was transmitted indirectly via the Baidu Index (indirect β = 0.16, 95% CI [0.08, 0.25]). The ARIMAX (1,1,1) model integrating both pollen and Baidu Index achieved the best forecasting performance (1-day RMSE = 3.80, MAPE = 7.68%, PCC = 0.89) and consistently outperformed single-predictor models and the random-walk benchmark across all horizons. Pollen exposure influences antihistamine demand both directly and indirectly through public information-seeking behavior captured by the Baidu Index, and integrating environmental and digital data enables timely surveillance of seasonal allergic-rhinitis-related medication use.

PubMedPharmacological reports : PR2026-07-11

The onset of posterior reversible encephalopathy syndrome (PRES) and reversible cerebral vasoconstriction syndrome (RCVS) with the use of decongestant agents: a European pharmacovigilance analysis.

Anatriello Antonietta A, Cantone Andrea A, Pentella Ciro C, Vastarella Maria Giovanna MG et al.

On December 1st, 2023, the Pharmacovigilance Risk Assessment Committee (PRAC) published a safety warning against using pseudoephedrine in patients with severe or uncontrolled hypertension and severe acute or chronic kidney disease for the risk of developing posterior reversible encephalopathy syndrome (PRES) or reversible cerebral vasoconstriction syndrome (RCVS). Based on this consideration and the availability of other decongestants with the same mechanism of action as pseudoephedrine in the European market, we decided to conduct a safety study to evaluate cases of RCVS or PRES reported with other decongestants. A European, retrospective, post-marketing surveillance study was conducted to describe individual case safety reports (ICSRs) of RCVS and PRES reported with decongestants and to compare the likelihood of reporting these events among decongestants. Data were retrieved from the EudraVigilance database from January 1st, 2001, to December 31st, 2025. A total of 65 ICSRs reported PRES or RCVS with decongestants, most of which referred to female patients aged 18-64 years. A disproportionate reporting of RCVS was found for xylometazoline (reporting odds ratio, ROR: 3.39; 95% confidence interval, CI: 1.94-5.93) and phenylephrine (ROR: 2.00; 95% CI: 1.11-3.61), and a disproportionate reporting of PRES for ephedrine (ROR: 6.44; 95% CI: 1.80-23.10) and phenylephrine (ROR: 3.47; 95% CI: 1.22-9.88) compared to all other decongestants. Our results suggest that all decongestants should be used with caution, and attention should be paid to signs and symptoms of PRES and RCVS when taking these medicines.

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