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Amlodipine and allergy medicine. "I was doing all they told me to do and was never tested," he says.
"It was quite a shock," Dr O'Connor says. "I was in a very, very bad state. "People are used to people coming in with severe allergies all the time and they have a very specific idea of what causes these kinds reactions, and that wasn't right. I would never have thought for a second that drug could cause asthma attacks like that."
It appears some people may benefit from the drug. An early case report in Nature Medicine, 2006, found that patients prescribed loratadine experienced fewer acute exacerbations following their first dose but more recurrences over the next seven years, a higher rate than those taking a placebo (8 versus 7 re-exposures) (doi:10.1038/nm.3133). An analysis of the study, which involved a randomised controlled trial, found the drug was successful in reducing the severity of asthma exacerbations, albeit for only about 12 days (doi:10.1038/nm.3133 and 10.1038/nm.3310).
But for patients with severe allergies, the evidence to date does not support using loratadine to treat their symptoms. "There's a lot of good data, but it isn't that robust," says Dr O'Leary.
One drugstore coupon hair recent study, performed on a small number of children with severe asthma, found that children who were given loratadine more likely to achieve remission at eight weeks than those who were given the placebo (doi:10.1038/nm.3135). But in a larger study, published The Lancet, a separate group of children was given the same drug and found that it produced no further remission over an eight-week period, compared with placebo (doi:10.1016/S0140-6736(02)00162-4).
The evidence remains controversial: "There's been quite a lot of controversy," says Dr O'Connor. "Some studies have found loratadine is effective with these patients but other studies have not. And that's because of the way those trials are done; the people who participate in these studies don't look at the drug from patient's perspective. They do their statistical work, and then they compare the people who took drug to those did not. They may well have got a more extreme result if they'd actually"
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