Cetirizine Hexal: indications for use, instructions, experience of use. International nonproprietary name

cetirizine (-1-piperazino]ethoxy] acetic acid hydrochloride) - antihistamine, a selective and potent H1 receptor blocker. Cetirizine is a piperazine derivative, which is chemical structure is a carboxylated derivative of hydroxyzine - its main metabolite. Due to its pronounced polarity and strong binding to plasma proteins, as well as low lipophilicity, cetirizine penetrates the BBB much worse than hydroxyzine, as a result of which it has virtually no inhibitory effect on the central nervous system. Cetirizine reduces the effect of mediators allergic reactions(prostaglandin D2 and histamine), and also suppresses eosinophil migration in patients with atopic reactions. Reduces histamine-induced bronchoconstriction in asthma. It has a long-term selective effect on H1 receptors.
Cetirizine dihydrochloride is rapidly absorbed into digestive tract. The maximum concentration in blood plasma is usually achieved 40-60 minutes after oral administration. Maximum therapeutic effect develops after approximately 4-8 hours and lasts up to 24 hours. Approximately 93% of cetirizine is bound to plasma proteins. The volume of distribution of cetirizine is approximately 0.56-0.8 l/kg. About 70% of the administered dose is excreted in the urine, mainly unchanged within 24 hours. In children, only 40% of the drug is excreted within 24 hours. At renal failure elimination of the drug slows down.

Indications for use of the drug Cetirizine hexal

Symptomatic treatment of such allergic diseases as chronic (year-round) allergic rhinitis, seasonal allergic rhinitis, allergic conjunctivitis, chronic idiopathic urticaria, atopic dermatitis.

Use of the drug Cetirizine hexal

Children over 12 years of age and adults are prescribed 10 mg/day, preferably in the evening. The dose for children aged 6-12 years depends on body weight: for body weight less than 30 kg, 5 mg per day is prescribed in the evening (the tablet has a notch on one side, which makes it possible to divide it in half); with a body weight of more than 30 kg - 1 film-coated tablet per day, divided into 2 doses (5 mg in the morning and 5 mg in the evening).
Cetirizine Hexal can be taken regardless of meals. The film-coated tablet should be swallowed without chewing and washed down with liquid.
For ease of dosing of the solution when taken orally, the package contains a measuring spoon. Children over the age of 12 years are prescribed 10 ml (10 mg) (2 scoops) of Cetirizine Hexal solution per day, preferably in the evening. Children aged 2-12 years with a body weight of less than 30 kg are prescribed 5 ml (5 mg, 1 scoop) of Cetirizine Hexal solution; with a body weight of more than 30 kg - 10 ml (10 mg, 2 scoops) of Cetirizine Hexal solution.
In some cases, a double dose of 5 ml (5 mg, 1 measuring spoon) in the morning and evening is possible.
Cetirizine solution Hexal can be taken regardless of meals, preferably in the evening.
The duration of treatment with the drug is determined individually and is usually 2-4 weeks. For seasonal allergic rhinitis - 3-6 weeks, for chronic idiopathic urticaria and chronic allergic rhinitis, the duration of treatment can be up to 1 year.
In patients with renal failure, the recommended dose should be reduced by half.
Patients with liver failure the dose should be adjusted individually, especially in the presence of concomitant renal failure. Elderly patients may be more sensitive to the drug, which requires dose adjustment.

Contraindications to the use of the drug Cetirizine hexal

Increased sensitivity to cetirizine or other components of the drug, severe nephropathy, pregnancy and lactation, age up to 6 years (for tablets) and up to 2 years (for solution).

Side effects of the drug Cetirizine hexal

IN in rare cases possible transient side effects, in particular headache, dizziness, agitation, weakness, xerostomia, skin allergic reactions, increased fatigue, laryngitis, abdominal pain, cough, diarrhea, nosebleeds, bronchospasm, nausea, vomiting, angioedema. Hypersensitivity reactions and hepatotoxicity have been observed in some patients. toxic effect drug (hepatitis, increased transaminase levels).

Special instructions for the use of the drug Cetirizine hexal

1 tablet contains less than 0.01 XE.
Due to the lack of relevant data, the use of Cetirizine Hexal in children under 6 years of age is not recommended. The drug in tablet form is used in children over 6 years of age.
The drug must be discontinued several days before the planned procedure. skin tests with allergens.
Although experimental studies have not revealed teratogenic effect drug, Cetirizine Hexal should not be used during pregnancy, since there are no relevant data on the effect of the drug on the fetus. Since experimental studies have shown that cetirizine passes into breast milk, and excretion with breast milk has not been studied in humans; breastfeeding women should not take Cetirizine Hexal.
Comparative clinical researches found no evidence of impairment in attention, reaction time, or driving ability after taking cetirizine hydrochloride at recommended doses. However, patients who drive a car work with potentially dangerous mechanisms, it is recommended not to exceed the established doses and take into account the likelihood of developing individual reactions(dizziness, drowsiness).
Although it has been established that the effect of alcohol (blood alcohol concentration 80 ml) is not enhanced by Cetirizine Hexal, their combined use is not recommended.
10 ml medicinal solution For oral administration(2 scoops) contain 3.15 g of sorbitol (equivalent to 0.8 g of fructose), which corresponds to 0.26 XE. Caloric content is 8.2 kcal/3.15 g sorbitol.

Drug interactions Cetirizine hexal

Simultaneous administration of cetirizine dihydrochloride at a dose of 20 mg and cimetidine at a dose of 400 mg does not affect the manifestations of the skin reaction caused by the injection of histamine, compared with a similar reaction when taking cetirizine dihydrochloride alone.
Despite the lack of direct evidence of interaction of cetirizine with drugs that depress the central nervous system, caution must be exercised when prescribing them together.
Simultaneous use Use of cetirizine with agents that exhibit ototoxic effects, such as gentamicin, may mask symptoms of ototoxicity such as tinnitus and dizziness. There was a decrease in the elimination of cetirizine from the body when it was used simultaneously with theophylline at a dose of 400 mg.

Overdose of the drug Cetirizine hexal, symptoms and treatment

With a significant overdose (50 mg of cetirizine dihydrochloride once), drowsiness and increased side effects may occur.
In case of significant overdose, standard detoxification measures are carried out, in particular gastric lavage and the administration of enterosorbents. A specific antidote is not known, treatment is symptomatic. Cetirizine dihydrochloride is not excreted during dialysis.

Storage conditions for the drug Cetirizine hexal

At temperatures up to 25 °C.

List of pharmacies where you can buy Cetirizine hexal:

• Saint Petersburg

Previously, Cetirizine Hexal was also produced in the form of tablets and syrup, analogues:

• Zyrtec;
• Cetirizine;
• Suprastinex, syrup.

Price

average price online* 220 rub. (drops)

Where can I buy:

Instructions for use

Indications

• lacrimation and conjunctivitis of an allergic nature;
• hives and itchy skin, provoked by an allergen;
• neurodermatitis;

Directions for use and doses

Cetirizine Hexal is taken regardless of food intake. The duration of treatment ranges from several days to several weeks.

Contraindications

Absolute contraindications to taking Cetirizine Hexal are:

• individual intolerance to the components of the drug;
• severe forms renal and liver failure;
• pregnancy;
• lactation;
• infancy up to 1 year.

Side effects

Side effects When taking Cetirizine Hexal, they are observed rarely, mainly with an overdose of the drug or an unjustifiably long-term use.

• headache and dizziness;
• migraine;
• weakness and fatigue;
• dry mouth;
• allergic skin reactions;
• difficulty breathing due to bronchospasm;
• a sore throat;
• dyspeptic symptoms: nausea, vomiting, upset stomach;
• nose bleed.

All side effects from taking the drug quickly disappear after its discontinuation.

Compound

Cetirizine dihydrochloride – 10 mg per tablet

Excipients: lactose, microcrystalline cellulose, silicon dioxide, titanium dioxide, magnesium stearate

Pharmacokinetics

Regardless of the dosage form used, Cetirizine Hexal is rapidly absorbed from the gastrointestinal tract. At the same time, the rate of absorption is practically not affected by food intake - therefore, taking Cetirizine does not need to be coordinated with the time of the meal.

Within an hour after the drug enters the body, its concentration in the blood reaches its maximum. A pronounced therapeutic effect occurs after a few hours and continues throughout the day.

Active active substance Cetirizine dihydrochloride passes from the blood to the liver, where it breaks down into biologically neutral substances. The medicine does not accumulate either in the liver or in other organs.

The drug is excreted primarily by the kidneys and urine.

Drug interactions

Can't practice simultaneous administration Cetirizine Hexal and alcohol-containing substances, since ethanol can enhance the toxic effect of cetirizine on the body.

Theophylline reduces the effectiveness of Cetirizine - therefore, concomitant use of these two drugs is undesirable.

Miscellaneous

Available without a prescription. Shelf life: 3 years. Store at a temperature not exceeding 25 °C.

Manufacturer: Hexal AG (Geksal AG) Germany

ATC code: R06AE07

Farm group:

Release form: Solid dosage forms. Pills.

General characteristics. Compound:

Active substance: 10 mg cetirizine dihydrochloride.

Excipients: lactose monohydrate, microcrystalline cellulose, colloidal silicon dioxide, magnesium stearate. Shell composition: white opadry dye, consisting of lactose monohydrate, titanium dioxide, hypromellose, macrogol 4000.

Pharmacological properties:

Pharmacodynamics. The drug has a pronounced antiallergic effect. Virtually no sedative effect in pharmacologically active doses, it belongs to the selective antagonists of H1-histamine receptors and has practically no anticholinergic and antiserotonin effects, prevents the development and facilitates the course of allergic reactions. Has antipruritic and antiexudative effect. Affects early stage allergic reactions, and also reduces the migration of inflammatory cells; inhibits the release of mediators involved in a late allergic reaction. Reduces capillary permeability, prevents the development of tissue edema, relieves spasms smooth muscle. Eliminates skin reaction to histamine injection, specific allergens, as well as cooling (for cold urticaria). Cetirizine significantly reduces hyperreactivity bronchial tree, which occurs in response to the release of histamine in patients with bronchial asthma. The therapeutic effect of the drug appears on average 60 minutes after administration. During the course of treatment, tolerance does not develop.

Pharmacokinetics. Absorption: after oral administration, cetirizine is quickly and well absorbed from gastrointestinal tract. The maximum concentration level is determined after approximately 40 - 60 minutes.
Food intake does not have a significant effect on the amount of absorption, but in this case the rate of absorption is slightly reduced.
Distribution: cetirizine is approximately 93% bound to plasma proteins. The volume of distribution (Vd) is low (0.5 l/kg), the drug does not penetrate into the cell.
The drug does not penetrate the blood-brain barrier.
Metabolism: Cetirizine is poorly metabolized in the liver to form an inactive metabolite.
With 10-day use at a dose of 10 mg, no accumulation of the drug is observed.
Excretion: approximately 70% occurs by the kidneys, mainly unchanged.
The systemic clearance is about 54 ml/min.
After a single dose, the half-life is about 10 hours. In children aged 2 to 12 years, the half-life decreases to 5-6 hours.
In case of impaired renal function (creatinine clearance below 11-31 ml/min) and in patients on hemodialysis (creatinine clearance less than 7 ml/min), the half-life increases 3 times, clearance decreases by 70%.
On the background chronic diseases and in elderly patients there is an increase in half-life by 50% and a decrease in clearance by 40%.
Hemodialysis is ineffective.

Indications for use:

Year-round and seasonal allergic rhinitis(symptomatic therapy); , incl. chronic idiopathic; dermatoses that occur with itching (atopic,); .

Important! Get to know the treatment

Directions for use and dosage:

Orally, regardless of food intake, without chewing and drinking sufficient quantity liquids, preferably in the evening.
Children aged 6 to 12 years:

for body weight less than 30 kg: ½ film-coated tablet in the evening
for body weight over 30 kg: 1 film-coated tablet in the evening.

You can take 2 times a day (morning and evening) ½ tablet.
Adults and adolescents over 12 years of age are recommended to take 1 tablet of cetirizine, preferably in the evening.
In case of renal failure, the recommended dose should be reduced by 2 times.
In case of liver dysfunction, it is necessary to select the dose individually, especially with caution in case of simultaneous renal failure.
Elderly patients with normal function renal dose adjustments are not required.
For seasonal allergic rhinitis, the duration of therapy is usually from 3 to 6 weeks, and for short-term exposure to pollen, one week is sufficient.
The duration of therapy for children over 6 years of age is from 2 to 4 weeks, and for short-term exposure to the allergen, 1 week is sufficient.

Features of application:

During the treatment period, it is necessary to refrain from potentially active activities dangerous species activities that require increased concentration and speed of psychomotor reactions.
Not recommended simultaneous use drugs that depress central nervous system, alcohol.

Instructions for patients diabetes mellitus:
1 tablet corresponds to less than 0.01 bread. units

Side effects:

From the outside digestive system: dry mouth, .
- From the central nervous system: drowsiness, fatigue, agitation.
-Allergic reactions: , angioedema, urticaria, .
The drug is usually well tolerated. Side effects occur rarely and are transient.

Interaction with other drugs:

No clinically significant interactions of cetirizine with other drugs have been established.
Sharing with theophylline (400 mg/day) leads to a decrease in the total clearance of cetirizine (theophylline kinetics does not change).

Contraindications:

Hypersensitivity to cetirizine or other components drug; -Heavy.
-Childhood up to 6 years old.
-Pregnancy, lactation period.

Carefully:
Chronic moderate to severe severity (correction of dosage regimen required), elderly age(possibly decreased glomerular filtration rate).

Overdose:

Symptoms: possible drowsiness, lethargy, weakness, headache, increased irritability, urinary retention, fatigue (most often when taking 50 mg of cetirizine per day).
Treatment: carried out symptomatic therapy. A specific antidote has not been identified. ineffective. They do it and prescribe activated carbon.

Storage conditions:

At a temperature not higher than 25°C.
Keep out of the reach of children.

Vacation conditions:

Over the counter

Package:

Film-coated tablets 10 mg, 7 or 10 tablets in a blister pack made of PVC/aluminum foil. 1, 2, 3 or 5 blisters per cardboard box along with instructions for use.

1 tablet contains cetirizine dihydrochloride 10 mg

Excipients: microcrystalline cellulose, hypromellose, lactose, macrogol 4000, magnesium stearate, highly dispersed silicon dioxide, titanium dioxide (E 171).

Release form

Film-coated tablets.

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Pharmacological group

Antihistamines for systemic use.

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Pharmacological properties

Pharmacological. Cetirizine dihydrochloride is an antihistamine, a selective and powerful H1 receptor blocker. Cetirizine is a derivative of piperazine, in its chemical structure it is a carboxylated derivative of hydroxyzine - its main metabolite. Due to its pronounced polarity and strong binding to plasma proteins, cetirizine penetrates the blood-brain barrier much worse than hydroxyzine, which is why it has virtually no inhibitory effect on the central nervous system. This is in to a large extent is a consequence of the low lipophilicity of the drug. Cetirizine reduces the effect of neurotransmitters on allergic reactions (prostaglandin D 2 and histamine), and also exhibits an antagonistic effect on eosinophil migration in patients with atopic reactions. Reduces histamine-induced bronchoconstriction during bronchial asthma. Selective action on H 1 receptors is long-term.

Pharmacokinetics. Cetirizine dihydrochloride is rapidly absorbed from the gastrointestinal tract. Maximum plasma concentrations are usually determined 40 to 60 minutes after administration. The maximum therapeutic effect develops after 4-8 hours and lasts up to 24 hours. Approximately 93% of cetirizine binds to plasma proteins. The volume of distribution of cetirizine is approximately 0.56 - 0.8 L/kg. Approximately 70% of the administered dose is excreted by the kidneys, mainly unchanged within 24 hours. In children, only 40% of the drug is excreted within 24 hours. In renal failure, drug elimination slows down.

Indications

For symptomatic treatment allergic diseases:

• - chronic (year-round) allergic rhinitis
• seasonal allergic rhinitis
• allergic conjunctivitis
• chronic idiopathic urticaria
• allergic dermatitis.

Method of administration and dose. Adolescents over 12 years of age and adults: 1 tablet per day, preferably in the evening.

For ages 6 to 12 years, the dosage depends on their body weight:

• for body weight less than 30 kg, ½ film-coated tablet per day, in the evening (the tablet has a notch on one side, this allows it to be divided in half)
• for body weight more than 30 kg: 1 film-coated tablet per day, divided into 2 doses (1/2 tablet in the morning and 1/2 in the evening), if possible in a particular case.

Cetirizine Hexal ® can be taken regardless of meals. The film-coated tablet should be swallowed without chewing and washed down with liquid.

In patients with hepatic insufficiency, the appropriate dose should be adjusted individually, especially in cases of concomitant renal insufficiency. Elderly patients may be more sensitive to the drug, which requires dose adjustment.

The duration of treatment depends on the nature, duration and dynamics of symptoms and is determined by the doctor.

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Side effect

In rare cases, transient side effects are possible, including headache, confusion, agitation, weakness, xerostomia, allergic skin reactions, fatigue, laryngitis, abdominal pain, cough, diarrhea, nosebleeds, bronchospasm, nausea, vomiting, angioedema .

Some patients experienced hypersensitivity reactions and manifestations of liver dysfunction (hepatitis, increased transaminase levels).

Contraindications

Hypersensitivity to the active ingredient or to any of the inactive ingredients; severe forms of nephropathy; period of pregnancy and lactation, infants and children under 2 years of age.

Overdose

With a significant overdose (50 mg of cetirizine dihydrochloride once), drowsiness and increased side effects may occur.

In cases of significant overdose, standard measures should be used to remove the drug and prevent its further absorption, in particular gastric lavage. The patient's further condition should be monitored. A specific antidote is unknown.

Cetirizine dihydrochloride is NOT dialyzable. SPECIAL.

Features of application

Warning for patients with diabetes: 1 tablet contains less than 0.01 exchangeable units of carbohydrates.

Use in children. Due to the lack of relevant data, the use of Cetirizine Hexal ® in infants and children under 2 years of age is not recommended. The drug in tablet form is used from 6 years of age. The drug must be discontinued several days before the planned skin tests with allergens.

Pregnancy and lactation.

Although animal studies have not revealed any teratogenic effects, Cetirizine Hexal ® should not be used during pregnancy, since there are no relevant data regarding the effect of the drug on the fetus.

Since experimental studies have shown that the active ingredient cetirizine penetrates into mother's milk and excretion into human breast milk has not been studied, breastfeeding women should not take Cetirizine Hexal ® .

Impact on the ability to drive a car and use machinery.

Comparative clinical studies have not revealed any evidence of impairment in attention, reaction time or driving ability after taking cetirizine hydrochloride at recommended doses. However, we recommend that patients who drive a car, work in hazardous conditions or use equipment, exceed the prescribed doses and take into account the possibility of individual reactions (dizziness, drowsiness) to the drug.

Alcohol.

Although studies have found that the effects of alcohol (blood alcohol concentration 80 ml) are not enhanced by Cetirizine Hexal ® tablets, taking them together is not recommended.

Interaction with other drugs

Joint reception Cetirizine dihydrochloride 20 mg and cimetidine 400 mg do not affect the manifestations of the skin reaction caused by another histamine injection compared to a similar reaction when taking cetirizine dihydrochloride itself.

Although there is no direct evidence of interaction between cimetidine and CNS depressants, caution should be exercised when prescribing them together.

Concomitant use of cetirizine with drugs that exhibit an ototoxic effect, such as gentamicin, may mask symptoms of ototoxicity such as tinnitus and dizziness. Reduced elimination of cetirizine from the body was noted when it was used simultaneously with theophylline at a dose of 400 mg.

Storage conditions

Store out of the reach of children at a temperature not exceeding 25 C. Shelf life - 3 years.

"Cetirizine hexal" belongs to the category of anti-allergy drugs. Helps relieve symptoms of initial or chronic rhinitis and get rid of itching.

Photo: Cetirizine hexal instructions for use

Release form

"Cetirizine hexal" (CETIRIZINE HEXAL) is produced in the form of:

• tablets (tablets are packed in 50, 35, 21, 20, 14, 10, 7 pieces);
• drop solution (10 and 20 ml);
• syrup for adults and children (75 and 150 ml).

The medicine "Cetirizine hexal" for children can be purchased in the form of a banana-flavored syrup.

"Cetirizine hexal": composition

1. One tablet consists of: cetirizine dihydrochloride (10 mg), lactose monohydrate, microcrystalline cellulose, colloidal silicon dioxide, magnesium stearate.
2. Drop solution "Cetirizine hexal" contains: 10 mg of cetirizine dihydrochloride, benzoic acid, 85% glycerol, a dose of propylene glycol, distilled water, acetate trihydrate.
3. Cetirizine hexal syrup is made using: cetirizine dihydrochloride (1 mg), 70% sorbitol dose, 85% glycerol dose; propylene glycol concentrate, sodium acetate, methyl parahydroxybenzoate, propyl parahydroxybenzoate, sodium saccharin, 20% acetic acid, banana flavor.

Description of the drug

The medicine contains histamine H1 receptor blockers. It has anti-allergenic properties and does not cause sedative reactions. Has antipruritic and antiexudative effects.

Eliminates early signs A . Prevents the development of tissue edema and reduces spasm reactions in smooth muscles. Reduces the hyperactivity of the bronchial tree in response to the released substance - histamine.
The effect of the drug occurs within 60 minutes of action.

Indications for use

The use of the drug "Cetirizine hexal" is prescribed for both adults and children suffering from conjunctivitis, chronic urticaria And

Mode of application

The drug in the form of tablets “Cetirizine hexal”, the instructions for use are very simple, prescribe to take one tablet daily in evening time(for adults and teenagers from 12 years old).

Children (6-12 years old) take the drug ½ tablet in the evening. But there are certain limitations here. Children weighing up to 30 kg “Cetirizine hexal” tablets should take ½ tablet every day, those weighing more than 30 kg should take 1 tablet.

"Cetirizine hexal" drops are used in the following dosage:
adults and adolescents over 12 years old – 20 drops every day in the evening;

• children 6-12 years old - 5 drops morning and evening;
• children 2-6 years old – 5 drops twice a day (morning and evening);
• children 1-2 years old - 5 drops 1 or 2 times a day.

Adults take 10 ml of “Cetrizine hexal” syrup every day in the evening. Children 2–12 years old take the drug 5 or 10 ml once a day, depending on weight.
It is better to check with your doctor how to use the drug Cetirizine Hexal.

Contraindications

There are contraindications for the use of the drug "Cetrin hexal" for pregnant women.

Use during pregnancy

Contraindications for Cetrizine Hexal apply not only to pregnant women, but also to nursing mothers. In some cases, the doctor prescribes the use of the drug for nursing mothers.

Side effects

Side effects of "Cetrizine Hexal" manifest themselves as:

1. dry mouth;
2. drowsy state;
3. migraine attacks;
4. periodic attacks of fatigue;
5. allergic skin reactions;
6. angioedema.

The drug is well tolerated by patients. Side effects of Cetirizine Hexal can occur in the form of allergic reactions only when individual intolerance drug.

Overdose

If an overdose of Cetrizine Hexal occurs, signs of drowsiness may appear, general weakness, irritability, fatigue, dizziness and discomfort when urinating.

In such situations, the patient is prescribed a course of symptomatic therapy. The stomach is washed with activated carbon.

Analogs

There are analogues of "Cetrizine hexal". Among them medications"Zodak" in tablet form, "Letizen" (table), "Parlazin" (table), "Cetirinax" (table).

Price

On medicine"Cetrizine hexal" price ranges from 60-200 rubles. average cost“Cetrizine hexal” in tablets – 65 rubles. “Cetrizine hexal” in drops costs around 200 rubles.

The drug must be kept in places protected from light and at temperatures from +3 to +25 degrees. The drug can be stored for 2 years.