Cezera

The drug Ceser refers to antiallergic drugs, in particular, to blockers of H1-histamine receptors.

[1]

Indications Cezera

• Symptomatic therapy of permanent or recurrent allergic rhinitis or inflammation of the conjunctiva, which are accompanied by itching, discharge from the nasal cavity, reddening of the mucous membranes.
• Treatment of pollinosis, or seasonal allergic rhinoconjunctivitis.
• Allergic rashes by the type of urticaria.
• Other allergic manifestations.

[2]

Release form

The cesium is produced in tablet form, each tablet has a film coating. The weight of the tablet is 5 mg.

The composition of the tablet is represented by the active ingredient levocetirizine hydrochloride, as well as additional substances: lactose, microcrystalline cellulose, silicon dioxide, magnesium stearate. The film coating consists of hypromellose, titanium dioxide, lactose, triacetin and macrogol.

Contoured cell packaging can hold 10 tablets. The carton pack can contain 10 tablets, 30 tablets, 60 tablets or 90 tablets. In each cardboard package is enclosed instructions for the use of Ceser.

The drug is produced in Slovenia, Novo mesto.

Pharmacodynamics

Medication Ceser exhibits an effect opposite to histamine, blocking distal H¹-histamine receptors. Similarity in the main properties of receptors and levocetirizine is higher than in cetirizine.

The drug affects the histamine-dependent stage of the allergic process, reduces the degree of cellular movement of eosinophils, prevents the release of the liquid part of the blood into surrounding tissues, keeps the release of mediators (mediators) of the inflammatory reaction.

The active ingredient of Cesar can prevent the onset and smooth out the symptoms of the allergic process, manifests an anti-edema and soothing effect. The drug does not block the action of cholinergic receptors and serotonin receptors.

The standard dosages of the drug have almost no sedative effect.

[3]

Pharmacokinetics

The active substance of the preparation is perfectly absorbed when taken internally. The peak level in plasma is observed after 50-55 minutes after the use of Cezer. The stable level is established after two days. The limiting concentration can be 270 ng / ml after a single use of the drug, or 308 ng / ml with regular administration of 5 mg once a day. The degree of absorption is dependent only on the dosage of the drug, but can not vary with the time of eating. However, in this case, the peak level can be somewhat lower and is revealed later.

Binding to plasma proteins - up to 90%. Biological availability of the drug is up to 100%.

Less than 14% of the obtained amount of the drug passes the metabolic stages in the liver by the aromatase oxidation process, N- and O-dealkylation and taurine compound.

The biological half-life can be about 8 hours (an error of 2 hours). The rate of cleansing plasma blood on average can be 0.63 ml per minute per kilogram. The active component and its metabolites leave the body mostly through renal filtration (more than 85% of the amount consumed). The yield with caloric masses can reach 12-13%.

The facts of penetration of the drug into breast milk are documented.

Patients with kidney pathologies should lower the dosage of the drug, given the clearance of creatinine. If there are problems with urination (urinary retention), the rate of cleansing of the blood plasma is reduced by approximately 80%. Up to 10% of the active ingredient is eliminated in the usual four-hour hemodialysis session.

[4], [5]

Dosing and administration

Cesera is intended for oral use, regardless of the time of eating. The drug should be washed down with water. Chew and grind the tablet is unacceptable.

Adult patients and children from 6 years of age are prescribed an average daily dosage in the amount of 1 tablet (5 mg).

For elderly patients with satisfactory renal function, the daily amount of the drug remains the same.

In the disorder of the kidney function, the dosage and the frequency of taking the drug are selected individually, given the creatinine clearance:

• 30-49 ml per minute - 1 tablet once in 48 hours;
• 10-29 mo per minute - 1 tablet once in 96 hours;
• less than 10 ml per minute - Cesar's treatment is contraindicated.

The creatinine clearance is calculated according to the following scheme: 140 minus the number of patient's years multiplied by the number of kilograms of body weight and divided by 72. The resulting score should be multiplied not by serum creatinine (multiplying by 0.85 for female patients).

With a separate violation of the hepatic function, there is no need to adjust the dosage.

The duration of treatment for pollinosis is 7-42 days. Chronic pathologies (chronic allergic rhinitis, atopic form of dermatitis) require a longer treatment - up to a year and a half.

Use Cezera during pregnancy

Cesera medication is not used by pregnant or lactating women.

The proven facts of penetration of the drug into breast milk do not allow the use of the drug when breastfeeding. If there is an acute need for the use of the drug by a nursing woman, then the infant should be temporarily stopped, with the possibility of its renewal after the treatment course of Cesar.

Contraindications

Contraindications to the use of Cesera

• Propensity to develop an allergic reaction to any of the components of the drug.
• Severe or complicated course of functional kidney failure (with creatinine clearance less than 10 ml per minute).
• Patients who use hemodialysis.
• Children up to 6 years of age.
• Period of gestation and breastfeeding.
• Disturbance of metabolism of galactose, lactase deficiency (glucose-galactose impairment of absorption).

The drug should be taken under the supervision of a specialist, especially if the renal function is of moderate severity (creatinine clearance less than 60 ml per minute) and in old age (there is a high probability of a decrease in renal filtration).

[6], [7], [8], [9]

Side effects Cezera

There are the following side effects of Cezer:

• Pain in the head, sleep disorders, general and muscle weakness.
• Dryness of the oral mucosa, thirst, epigastric pain, dyspeptic phenomena, attacks of nausea.
• Tachycardia.
• Change in visual acuity.
• Labored breathing.
• Allergic process: skin itchy rashes, redness, swelling Quincke.
• Transient activation of liver enzymes.
• Obesity.

[10], [11], [12], [13], [14]

Overdose

Symptoms of a Cesar overdose: adult patients may experience drowsiness, and children, on the contrary, are overexcited, capricious and restless behavior, which then goes into a drowsy state.

Measures in case of overdose: elimination of symptoms and strengthening of the body, purification of the stomach (you can induce vomiting and take sorbent preparations, such as activated carbon or sorbex).

A special agent that stops or weakens the effect of Ceser's drug on the body has not been developed.

The procedure does not detect hemodialysis.

[15], [16]

Interactions with other drugs

There were no clinical trials of Ceser's interaction with drugs such as diazepam, erythromycin, pseudoephedrine, glipizide, cimetidine, azithromycin, and cimetidine.

Reduction of the overall rate of cleansing of blood plasma from the active component can be observed with the regular administration of theophylline (0.4 g once a day), while the pharmacokinetic properties of theophylline when combined with Ceser were not amenable to changes.

The use of food does not reduce the degree of absorption of the active substance, but reduces the rate of absorption.

In sensitive patients, a combination of Ceser with ethyl alcohol and depressants can affect the function of the central nervous system. The effect of alcohol is not increased.

[17], [18], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28]

Storage conditions

The cesium is kept in a stable temperature regime of no more than 30 ° C. Children should be prevented from reaching the storage sites of the preparation.

[29], [30]

Shelf life

Shelf life - up to 3 years, after which the drug is not recommended.

[31], [32]