Description
Levocetirizine-Vertex Pharmacodynamics
Levocetirizine is the R-enantiomer of cetirizine, a potent and selective histamine antagonist that blocks H1-histamine receptors.
Levocetirizine affects the histamine-dependent stage of allergic reactions, as well as reduces the migration of eosinophils, reduces vascular permeability, limits the release of inflammatory mediators.
Levocetirizine prevents the development and facilitates the course of allergic reactions, it has antiexudative, antipruritic action, it has practically no anticholinergic and antiserotonin action. In therapeutic doses it has practically no sedative effect.
Indications
Treatment of symptoms of year-round (persistent) and seasonal (intermittent) allergic rhinitis and allergic conjunctivitis, such as itching, sneezing, nasal congestion, rhinorrhea, lacrimation, conjunctival hyperemia;
Pollinosis (hay fever);
urticaria;
Other allergic dermatoses, accompanied by itching and rashes.
Contraindications
Hypersensitivity to the active substance, cetirizine, hydroxyzine, any piperazine derivative or any other excipient of the drug;
lactase deficiency, lactose intolerance, glucose-galactose malabsorption;
terminal stage of renal failure (creatinine clearance ? 10 ml/min);
children under 6 years of age (because of the limited data on safety and efficacy).
With caution
Chronic renal insufficiency (dosage adjustment is required);
Elderly (with age-related decrease in glomerular filtration);
patients with spinal cord injury, prostatic hyperplasia, and in the presence of other predisposing factors to urinary retention, since levocetirizine may increase the risk of urinary retention;
concomitant use with alcohol;
pregnant women and during breastfeeding.
Dosage and administration
- Film-coated tablets are taken orally, swallowed as a whole during or on an empty stomach with a small amount of water.
- Adults and children over 6 years of age: daily dose is 5 mg (1 tablet) once.
- Administration in special groups of patients
As levocetirizine is excreted by kidneys in patients with renal insufficiency and elderly patients the dose should be adjusted according to the degree of renal insufficiency. - Patients with mild renal impairment (CKD 50-79 ml/min) do not require dose adjustment.
- In patients with moderate renal impairment (CKD 30-49 ml/min) the recommended dose is 5 mg every other day.
- In patients with severe renal failure (CKD less than 30 ml/min) the recommended dose is 5 mg once every 3 days.
- In patients with renal and hepatic impairment the dosing is carried out according to the above scheme.
- No dosage adjustment is required for patients with liver function abnormality only.
- Duration of drug administration
- In treatment of seasonal (intermittent) rhinitis (presence of symptoms of less than 4 days per week or their total duration of less than 4 weeks per year) the treatment duration depends on the duration of symptoms; the treatment may be stopped when symptoms disappear or be resumed when symptoms appear.
- When treating year-round (persistent) allergic rhinitis (presence of symptoms lasting more than 4 days per week and their total duration of more than 4 weeks per year), treatment may continue for the duration of allergen exposure.
- There is clinical experience with continuous use of levocetirizine in adult patients for up to 6 months.
- If you are taking (or have recently taken) other medicines, including over-the-counter medicines, tell your doctor.
- If you forget to take your medicine, do not take a double dose to make up for a missed dose; take the next dose at the usual time.
