Cetirizine Geksal: indications for use, instructions, experience of use. International non-proprietary name

cetirizine (-1-piperazino]ethoxy] acetic acid hydrochloride) - antihistamine, a selective and potent H1 receptor blocker. Cetirizine is a derivative of piperazine, which in its chemical structure is a carboxylated derivative of hydroxyzine - its main metabolite. Due to the 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 practically does not show a depressant effect on the central nervous system. Cetirizine reduces the effect of mediators allergic reactions(prostaglandin D2 and histamine), and also inhibits the migration of eosinophils 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 plasma concentration is usually reached 40-60 minutes after ingestion. Maximum therapeutic effect develops after approximately 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. About 70% of the administered dose is excreted in the urine, mostly unchanged within 24 hours. In children, only 40% of the drug is excreted in 24 hours. At kidney failure drug elimination slows down.

Indications for use of the drug Cetirizine hexal

Symptomatic treatment of such allergic diseases like chronic (perennial) allergic rhinitis, seasonal allergic rhinitis, allergic conjunctivitis, chronic idiopathic urticaria, atopic dermatitis.

The use of the drug Cetirizine hexal

Children over the age of 12 and adults are prescribed 10 mg / day, preferably in the evening. The dose for children aged 6-12 years depends on body weight: with a body weight of 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 coated tablet per day, divided into 2 doses (5 mg in the morning and 5 mg in the evening).
Cetirizine Hexal can be taken with or without food. The coated tablet should be swallowed without chewing and washed down with liquid.
For the convenience of dosing the solution when taken orally, the package has a measuring spoon. Children over the age of 12 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 Geksal solution; with a body weight of more than 30 kg - 10 ml (10 mg, 2 measuring spoons) of Cetirizine Geksal solution.
In some cases, a double dose of 5 ml (5 mg, 1 scoop) in the morning and evening is possible.
Solution Cetirizine Hexal can be taken with or without food, preferably in the evening.
The duration of treatment with the drug is determined individually and is usually 2-4 weeks. With seasonal allergic rhinitis - 3-6 weeks, with chronic idiopathic urticaria and chronic allergic rhinitis, the duration of treatment can be up to 1 year.
In patients with renal insufficiency, the recommended dose should be reduced by half.
Patients with liver failure the dose should be selected 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

Hypersensitivity 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 rare cases possible transient side effects, in particular headache, dizziness, agitation, weakness, xerostomia, skin allergic reactions, fatigue, laryngitis, abdominal pain, cough, diarrhea, epistaxis, bronchospasm, nausea, vomiting, angioedema. In some patients, hypersensitivity reactions and hepato toxic effect drug (hepatitis, increased levels of transaminases).

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 appointment of Cetirizine Geksal for children under the age of 6 years is not recommended. The drug in the form of tablets is used in children over the age of 6 years.
The drug must be canceled a few days before the scheduled skin tests with allergens.
Although experimental studies have not identified teratogenic effect drug, Cetirizine Geksal 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 established that cetirizine passes into breast milk, and excretion with breast milk has not been studied in humans, breastfeeding should not take Cetirizine Hexal.
Comparative clinical researches did not find any evidence of impaired attention, reaction time and ability to drive 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 to take into account the likelihood of developing individual reactions(dizziness, drowsiness).
Although it has been established that the effect of alcohol (blood alcohol concentration of 80 ml) is not enhanced by Cetirizine Geksal, their combined use is not recommended.
10 ml medicinal solution For oral intake(2 scoops) contain 3.15 g of sorbitol (equivalent to 0.8 g of fructose), which corresponds to 0.26 XE. Calorie content is 8.2 kcal / 3.15 g of sorbitol.

Interactions of the drug 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 histamine injection, compared with a similar reaction when taking cetirizine dihydrochloride alone.
Despite the lack of direct evidence of the interaction of cetirizine with drugs that depress the central nervous system, care must be taken when they are co-administered.
Simultaneous use 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 with its simultaneous use 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.
With a significant overdose, standard detoxification measures are carried out, in particular, gastric lavage and the appointment of enterosorbents. No specific antidote is known, treatment is symptomatic. Cetirizine dihydrochloride is not excreted during dialysis.

Storage conditions of the drug Cetirizine hexal

At temperatures up to 25 °C.

List of pharmacies where you can buy Cetirizine Hexal:

• Saint Petersburg

Previously, Cetirizine Geksal 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;
• urticaria and pruritus triggered by an allergen;
• neurodermatitis;

Dosage and administration

Cetirizine Hexal is taken with or without food. The duration of treatment ranges from several days to several weeks.

Contraindications

Absolute contraindications to receive Cetirizine Geksal are:

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

Side effects

Side effects when taking Cetirizine, Hexal is rarely observed, mainly with an overdose of the drug or its unreasonably 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, indigestion;
• nose bleed.

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

Compound

Cetirizine dihydrochloride - 10 mg per 1 tablet

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

Pharmacokinetics

Regardless of the dosage form used, Cetirizine Geksal is rapidly absorbed from the gastrointestinal tract. At the same time, the absorption rate is practically not affected by food intake - therefore, the intake of 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 a maximum. A pronounced therapeutic effect occurs after a few hours and lasts for a day.

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

The drug is excreted mainly by the kidneys with urine.

drug interaction

Can't practice simultaneous reception 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, the concomitant use of these two drugs is undesirable.

Miscellaneous

Released 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 ingredient: 10 mg cetirizine dihydrochloride.

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

Pharmacological properties:

Pharmacodynamics. The drug has a pronounced anti-allergic effect. Has practically no sedative effect in pharmacologically active doses, it belongs to selective H1-histamine receptor antagonists and practically does not have anticholinergic and antiserotonin effects, prevents the development and facilitates the course of allergic reactions. It 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 the late allergic reaction. Reduces capillary permeability, prevents the development of tissue edema, relieves spasm smooth muscle. Eliminates skin reaction to the introduction of histamine, specific allergens, as well as for cooling (with cold urticaria). Cetirizine significantly reduces hyperreactivity bronchial tree that 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. Against the background of a course of admission, tolerance does not develop.

Pharmacokinetics. Absorption: After oral administration, cetirizine is rapidly and well absorbed from gastrointestinal tract. The maximum concentration level is determined after about 40 - 60 minutes.
Eating does not have a significant effect on the amount of absorption, however, in this case, the absorption rate 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 an inactive metabolite.
With a 10-day use at a dose of 10 mg, accumulation of the drug is not observed.
Excretion: approximately 70% occurs by the kidneys, mostly unchanged.
The value of systemic clearance is about 54 ml / min.
After a single dose of a single dose, the half-life is about 10 hours. In children aged 2 to 12 years, the half-life is reduced 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 by 3 times, the clearance decreases by 70%.
On the background chronic diseases and in elderly patients, there is an increase in the 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

Dosage and administration:

Inside, regardless of the meal, without chewing and drinking enough liquids, preferably in the evening.
Children aged 6 to 12:

with body weight less than 30 kg: ½ film-coated tablet in the evening
with a body weight of more than 30 kg: 1 film-coated tablet in the evening.

It is possible to take 2 times a day (morning and evening) for 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 insufficiency, the recommended dose should be reduced by 2 times.
In case of impaired liver function, it is necessary to select a dose individually, especially carefully with simultaneous renal failure.
Elderly patients with normal function renal dose adjustment is not required.
With seasonal allergic rhinitis, the duration of therapy is usually from 3 to 6 weeks, and with short-term exposure to pollen, one week is enough.
The duration of therapy for children over the age of 6 years is from 2 to 4 weeks, and with short-term exposure to the allergen, administration for 1 week is sufficient.

Application Features:

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

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

Side effects:

From the side digestive system: dry mouth, .
- From the side of 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.
Joint use with theophylline (400 mg / day) leads to a decrease in the total clearance of cetirizine (the kinetics of theophylline does not change).

Contraindications:

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

Carefully:
Chronic moderate and severe severity (correction of the dosing regimen is 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: carry out symptomatic therapy. No specific antidote has been identified. inefficient. Spend, prescribe activated charcoal.

Storage conditions:

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

Leave conditions:

Over the counter

Package:

Film-coated tablets 10 mg, 7 or 10 tablets in a PVC/aluminum foil blister pack. 1, 2, 3 or 5 blisters in a 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

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 potent 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 the pronounced polarity and strong binding to plasma proteins, cetirizine penetrates the blood-brain barrier much worse than hydroxyzine, which is why it has practically no inhibitory effect on the central nervous system. It's 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 bronchial asthma. selective action on H 1 receptors is long-term.

Pharmacokinetics. Cetirizine dihydrochloride is rapidly absorbed from the gastrointestinal tract. Peak plasma concentrations are usually determined 40 to 60 minutes after ingestion. 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, mostly unchanged within 24 hours. In children, only 40% of the drug is excreted in 24 hours. With renal failure, the elimination of the drug slows down.

Indications

For symptomatic treatment allergic diseases:

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

Method of application and dose. Adolescents from 12 years and adults: 1 tablet per day, preferably in the evening.

At the age of 6 to 12 years, the dosage depends on their body weight:

• with a body weight of less than 30 kg ½ tablet, coated, per day, in the evening (the tablet has a notch on one side, this allows you to divide it in half)
• with a body weight of more than 30 kg: 1 coated tablet per day, divided into 2 doses (1 / 2 tablets in the morning and 1 / 2 in the evening), if possible, in a specific case.

Cetirizine Hexal ® can be taken with or without food. The coated tablet should be swallowed without chewing with liquid.

In patients with hepatic insufficiency, the appropriate dose should be selected individually, especially in cases of concomitant renal insufficiency. Elderly patients may show greater sensitivity to the drug, which requires dose adjustment.

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

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Side effect

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

In some patients, hypersensitivity reactions and manifestations of hepatic dysfunction (hepatitis, elevated transaminase levels) were observed.

Contraindications

Hypersensitivity to the active ingredient or to any of the inactive ingredients; severe forms of nephropathy; 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 taken to remove the drug and prevent its further absorption, in particular gastric lavage. The further condition of the patient should be monitored. The specific antidote is unknown.

Cetirizine dihydrochloride is NOT dialyzable. SPECIAL.

Application features

Warning for diabetics: 1 tablet contains less than 0.01 exchange units of carbohydrates.

Application in children. Due to the lack of relevant data, the use of Cetirizine Geksal ® in infants and children under the age of 2 years is not recommended. The drug in the form of tablets is used from 6 years. The drug must be canceled a few days before the scheduled skin tests with allergens.

Pregnancy and lactation.

Although animal studies have not revealed any teratogenic effect, Cetirizine Geksal ® 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 the active ingredient cetirizine penetrates into mother's milk, and excretion in human milk has not been studied, breast-feeding should not take Cetirizine Geksal ® .

Influence on the ability to drive a car and use mechanisms.

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

Alcohol.

Although studies have shown that the effects of alcohol (blood alcohol concentration of 80 ml) are not enhanced by Cetirizine Geksal ® tablets, their combined use is not recommended.

Interaction with other drugs

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

Despite the lack of direct evidence of the interaction of cimetidine with drugs that depress the central nervous system, care must be taken when they are co-administered.

Co-administration of cetirizine with agents that exhibit an ototoxic effect, such as gentamicin, may mask symptoms of ototoxicity such as tinnitus and dizziness. There was a reduced elimination of cetirizine from the body in the case of its simultaneous use with theophylline at a dose of 400 mg.

Storage conditions

Keep 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-allergic 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) are produced in the form of:

• tablets (tablets are packed in 50, 35, 21, 20, 14, 10, 7 pieces);
• drip 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. The drop solution "Cetirizine hexal" contains: 10 mg of cetirizine dihydrochloride, benzoic acid, 85% glycerol, a dose of propylene glycol, distilled water, acetate sodium trihydrate.
3. Syrup "Cetirizine hexal" is made using: cetirizine dihydrochloride (1 mg), 70% dose of sorbitol, 85% dose of glycerol; propylene glycol concentrate, sodium acetate, methyl parahydroxybenzoate, propyl parahydroxybenzoate, sodium saccharin, 20% acetic acid, banana flavor.

Description of the drug

The medicine contains blockers of histamine H1 receptors. It has anti-allergic properties, and does not cause sedative reactions. It has antipruritic and anti-exudative action.

Eliminates early signs A . They prevent the development of tissue edema and reduce spasmodic reactions in smooth muscles. Reduces the hyperactivity of the bronchial tree in response to the released substance - histamine.
The result of exposure to the drug occurs within a 60-minute 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", instructions for use which is very simple, prescribes to use 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 be taken ½ tablet every day, with a weight of more than 30 kg - 1 tablet.

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

• children 6-12 years old - 5 drops in the 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.

"Cetrizin hexal" syrup adults use 10 ml every day in the evening. Children 2-12 years old use the drug 5 or 10 ml once a day, depending on weight.
How to use the drug "Cetirizine Hexal" is better to check with your doctor.

Contraindications

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

Application during pregnancy

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

Side effects

Side effects of "Cetrizine Hexal" appear as:

1. dryness in the oral cavity;
2. drowsy state;
3. migraine attacks;
4. periodic bouts 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 charcoal.

Analogues

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

Price

On medicine"Cetrizin Hexal" price ranges from 60-200 rubles. average cost"Cetrizin hexal" in tablets - 65 rubles. "Cetrizin 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.