Cetrin

Cetrin is a systemic antihistamine that is a derivative of the piperazine component.

[1],

Indications of the cetrine

It is used to treat nasal manifestations of an allergic rhinitis of chronic or seasonal type (such as sneezing, nasal itching and rhinorrhea) and nasal symptoms developing due to conjunctivitis. In addition, it helps in the treatment of hives of any type (this includes idiopathic) and itching.

[2], [3],

Release form

Release in the form of a syrup in flakonchikah from glass in volume 30 or 60 ml. Inside the pack contains 1 bottle of syrup.

Pharmacodynamics

Cetirizine is a histamine antagonist of a competitive type, a decay product of hydroxyzine, a blocker of histamine H1 ends.

It has antiallergenic and, moreover, antiexudative and antipruritic properties, it prevents the release of inflammatory conductors at a late stage of the allergic response, and at the same time restricts the movement of neutrophils with eosinophils and basophils, and prevents the development of swelling in the tissues.

The medicine removes the reaction of the skin to the introduction of specific specific allergens and histamine, and in addition reduces the bronchoconstriction caused by histamine during moderate or mild bronchial asthma. It also has weak antiserotonin and holinolytic properties.

Pharmacokinetics

The development of exposure to 10 mg of medication begins 20 minutes later (in 5% of people) or after 1 hour (95% of people), and the total duration is 24+ hours. During the course of therapy, patients do not develop tolerance to antihistamine exposure. At the end of the course, the effect of the drug lasts about 3 more days.

The drug is rapidly absorbed from the digestive tract, and the peak value of the substance is observed after about 1 hour. Food does not affect the degree of absorption, but it increases the time to reach the peak level.

The synthesis of the component with the plasma protein is 93%.

Weakly undergoes hepatic metabolism - passes the O-dealkylation process, during which drug-inactive decay products are formed (unlike other H1 terminal blockers that are metabolized inside the liver by the hemoprotein P450 system).

Two thirds of the medication is excreted unchanged through the kidneys, and about 10% of the substance is excreted with feces. The system clearance is 53 ml / minute.

The half-life is within 7-10 hours (adults). In children 2-6 years - 5 hours, 6-12 years - 6 hours.

[4]

Dosing and administration

The syrup is taken orally, regardless of eating.

The size of the dose for the age of 2-6 years: a single use per day 2.5 mg (or 2.5 ml) of the drug. It is allowed to increase the daily dose to 5 mg: take 2.5 mg (or 2.5 ml) every 12 hours, taking into account the effectiveness of the therapy, the severity of the disease and the weight of the patient.

For the age of 6 years, as well as adults, the dose size is a one-time intake of 10 mg (or 10 ml) syrup per day. In view of the severity of symptoms and the effectiveness of therapy, the initial dosage can be reduced to 5 mg (or 5 ml). For a day it is allowed to take no more than 20 mg of medication (adults).

People who have disorders in the work of the kidneys (severe or moderate forms) require an individual determination of the size of the doses:

• normal renal function (CC score is ≥80 ml / minute) - taking 10 mg once a day;
• a mild form of the disorder (level of CC: 50-79 ml / minute) - use 10 mg once a day;
• moderate form of the disorder (QC values within the range of 30-49 ml / minute) - take 5 mg once a day;
• severe form of pathology (level of QC <30 ml / minute) - use 5 mg of medication once every other day;
• at the terminal stage of the disease; In dialysis procedures (CC level is <10 ml / minute), it is forbidden to take the syrup.

For children who have problems with kidney function, the dosages are adjusted separately, taking into account the QC indices, and with it the patient's weights.

The duration of the course is appointed by the doctor, taking into account the effectiveness of treatment.

[10]

Use of the cetrine during pregnancy

In pregnancy, as well as lactation, Zetrin is not used.

Contraindications

The main contraindications:

• the presence in the history of hypersensitivity relative to the elements of the drug, hydroxyzine, and in addition any piperazine derivatives;
• a severe degree of disorder in the kidneys (QC values less than 10 ml / minute);
• intolerance to sucrose-isomaltose with fructose, as well as malabsorption of glucose-galactose or calcium deficiency.

It is forbidden to prescribe to children under 2 years, because there is no information about the use of medication in this age group of patients.

[5], [6]

Side effects of the cetrine

The intake of syrup can cause such adverse reactions:

• systemic disorders: the appearance of edemas, the development of asthenia, fatigue and malaise;
• reactions of the organs of the NS: development of tremors, dyskinesia, dysgeusia, as well as dystonia, the appearance of headaches, seizures, dizziness and paresthesia, and fainting;
• disorders of the gastrointestinal tract: diarrhea, nausea, dry mouth mucous and abdominal pain;
• mental disorders: a sense of aggressiveness, drowsiness, confusion or anxiety, and also the development of tics, depression, insomnia and the appearance of hallucinations;
• manifestations from the respiratory organs: runny nose or pharyngitis;
• test results and analyzes: weight gain;
• disorders in the work of the heart: the appearance of tachycardia;
• lymph and organs of the hematopoietic system: development of thrombocytopenia;
• problems with visual organs: visual fuzziness, accommodation disorder and nystagmus;
• urinary and kidney system: development of enuresis or dysuria;
• reactions of the subcutaneous layers and skin: development of urticaria, Quincke edema, local medicinal eruptions, and also itching;
• immune reactions: hypersensitivity and development of anaphylaxis;
• hepatobiliary system: disorders of the hepatic function (increase in the parameters of alkaline phosphatase, transaminase, bilirubin, and GGT).

[7], [8], [9]

Overdose

An overdose of cetirizine is usually manifested by exposure to the CNS or reactions that can develop due to cholinolytic properties. Disturbances resulting from taking a dosage that is at least five times the standard daily dose include: dizziness, diarrhea, itching, malaise and headaches, and also feelings of anxiety, confusion, fatigue and drowsiness. Urine retention, tachycardia and mydriasis may also develop.

The medicine does not have a specific antidote. Assistance with overdose should be aimed at eliminating violations and maintaining the condition of the victim. At the initial stage of development of an overdose it is required to induce vomiting, and also to make a gastric lavage. In addition, laxatives and activated carbon are prescribed. The dialysis procedure will be ineffective. If severe intoxication is observed, professional medical control over the work of CCC and respiratory organs is required.

[11], [12], [13]

Interactions with other drugs

Studies were carried out aimed at studying the interaction of the drug with antipyrine and erythromycin, as well as with substances ketoconazole, pseudoephedrine and azithromycin. These tests did not reveal the presence of pharmacokinetic interaction of the above drugs with cetirizine.

Combination with theophylline lowers the level of the cleavage factor of cetirizine, so that the substance can accumulate in the body. As a result, an overdose may occur.

Alcoholic drinks or CNS depressants in combination with cetirizine can lead to an additional weakening of vigilance and a worsening of concentration.

[14], [15]

Storage conditions

Cetrin should be kept in a place that is closed from sunlight, and inaccessible to children. Temperature values are a maximum of 25 ° C.

[16],

Shelf life

Cetrin is allowed to be used in the period of 2 years from the moment of making the syrup.

[17], [18], [19]