Hi! For the pharmaceutical history: I'd like to know more about the history of loratadine. (If that one's boring, I'm sorry - I'm just really curious about allergy medicine history) Hope you're doing good!
Loratadine (Claritin, approved in 1988) was not the first nonsedating (second generation) antihistamine, but it wanted to be. Terfenadine (Seldane, from a competing manufacturer, approved in 1985) was the first. And because terfenadine got to the FDA just ahead of loratadine, loratadine was put on the FDA's backburner, delaying it's entrance to the market by over 3 years.
Loratadine made up for this by marketing the absolute sh*t out of their drug. If you were watching TV or reading magazines in the late 80s or early 90s, you probably remember. Loratadine was prescription only at the time. But direct-to-consumer advertising still had rules. By the early 1990's you couldn't have an ad that was selling a drug without a list of the side effects. And when you're trying to sell a non-drowsy antihistamine on the merit that it was non-drowsy, having to list the fact that the #1 side effect was still drowsiness didn't go over so well. This wasn't an issue in print so much- you could make the print about the side effects as small as you wanted, and who was going to read 3-pt font? But you couldn't do the same in a TV spot.
This was a problem for the company selling Claritin. So instead of making TV ads for the DRUG Claritin, they decided to sell the BRAND Claritin instead. So the ads just never said that Claritin was a drug, or what it did. They just said things like "Claritin is the non-drowsy brand" and "ask your doctor about Claritin" and the ever popular "live Claritin clear."
"But Ross," you might be asking yourself, "whatever did Claritin do to sell to the previously untapped market of children as drug consumers? I simply must know!" Well, you're in luck, because in 1998, and this is real, they released a 12-page Batman comic centered around Tim Drake having allergies that interfered with his crimefighting career. All other antihistamines made him too drowsy, so thank goodness he went to his doctor to get a prescription for Claritin!
You might also be wondering how insurance companies felt about having to pay for on-patent allergy medication (spoiler alert, they hated it, just like they hate paying for everything). Well, also in 1998, Anthem (the insurance company) petitioned the FDA to approve Claritin as an over-the-counter medication. If a medication was over the counter, they wouldn't have to pay for the medication, nor would they have to pay for the associated doctor's visits to get prescriptions for the medication. The FDA approved the petition, but it wasn't until 2002, when the patent had expired, that the company that made Claritin finally released an over the counter version. Even today, though, over the counter loratadine is so much more expensive than other second generation antihistamines. I couldn't figure out why this is, or why people keep buying brand name Claritin when there's like 5 other cheaper non-drowsy antihistamines to choose from.
Finally, I'll wrap up by telling you about the fate of terfenadine. See, turns out terfenadine is super cardiotoxic, especially when combined with certain antibiotics. It got taken off the market in 1997 after quite a few people died. It was replaced with fexofenadine, a metabolite of terfenadine without the cardiotoxic properties.
