Cetirizine and Levocetirizine

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Cetirizine belongs to the group of medicines known as long lasting antihistamines and treat various skin conditions. It is used mainly in the treatment of rhinitis the medical term describing irritation and inflammation of some internal areas of the nose (more commonly known as a runny nose). Examples of allergies would be, hay fever, angioedema, (a sudden, severe swelling of the skin in a particular area). and commonly affects eyes, nose, tounge, lips, hands or bowel. some types of angioedema are know as idiopathic (which in laymans terms means the doctors do not know why some individuals get it) and urticaria (sometimes called hives).

For some individuals exposure to pet fur, pollen, house dust mites or an insect bite can cause the body to produce histamine. When this happens the histamine produced causes an allergic reaction such as those mentioned above including rashes, sneezing, watery eyes and a blocked nose. The purpose of antihistamines is to stop the effects of the histamine reducing the discomfort and help to-ward recovery.

Cetirizine was at one time prescription-only in the US and Canada, It is now freely available over-the-counter in both countries as Zyrtec and Reactine respectively. Zyrtec is also available over-the-counter in pharmacies and here in the UK cetirizine can be sold off-the-shelf in any outlet and is often available in supermarkets.

Levocetirizine (as levocetirizine dihydrochloride) is a third-generation non-sedative antihistamine, developed from the second-generation antihistamine cetirizine, and like cetirizine it is a long lasting antihistamine covering the same area of allergy disorders and blocks the action of histamine reliving discomfort and promoting recovery. The difference between these two drugs and traditional antihistamines such as chlorphenamine (chlorpheniramine) is a less sedating effect on the central nervous system making it ideal for those individual who need to avoid sleepiness for example: hazardous work, lorry driver, taxi driver ect. However, some individuals may suffer some degree of drowsiness so you need to be aware of how this drug affects your performance of skilled tasks (e.g. driving); excess alcohol should be avoided.

Quick Guide

• Antihistamine with danger of overdosing – MEDIUM.
• Dependancy is said to be – LOW.
• Prescription only drug – Yes.(in part) (generic drugs, short: generics) is a drug which is produced and distributed without patent protection.
• Available as generic – YES.(Australia)
• Alcohol avoidance – YES.
• Alcohol keep consumption to a minimum. May cause increased drowsiness and lack of co-ordination.

Side Effects

You may if prescribed Cetirizine or levocetirizine suffer one or more of these side effects, in the initial stages. However, you may find you do not suffer any at all, as it does not follow that being on this medication will cause unwanted side effects.

Common: Considered mild, well tolerated and dissappear with use. Dizziness, Drowsiness, Dry mouth, Stomach upset and Digestive disorders.

Rare: Allergic skin reactions and Fits, Shortness of breath, Nausea, weight gain, Agitation or aggression, Visual disturbances, Palpitations, Liver problems, Stomach pain.

Allergic skin reactions commonly affects the: eyes, lips, nose, tongue, voice box (larynx), hands, or bowel.

The side effects listed here are the most common and rare problems reported by patients using Cetirizine or levocetirizine. It may not include all of the side effects reported by the drug’s manufacturer. If common side effects persist you need to inform your doctor. Notify your doctor if you suffer any of the rare or some other side effects not listed here. For total peace of mind, seek information from your doctor or chemist.

Prolonged Use

There would be no special problems attached to prolonged use of these drugs.

Driving, Hazardous/Skilled Work & Alcohol

Cetirizine crosses the blood-brain barrier only slightly, eliminating the sedative side-effect common with older antihistamines. Although drowsiness is rare, in non-sedating antihistamines such as cetirizine, desloratadine (an active metabolite of loratadine), fexofenadine (an active metabolite of terfenadine), levocetirizine (an isomer of cetirizine), loratadine. You should avoid this category until you know how cetirizine affects you. It has been known for some individuals to experience drowsiness. Alcohol should be taken in moderation or avoided altogether while taking these tablets. The effects of alcohol may be the cause of increased drowsiness and co-ordination problems.

Pregnancy and Breast-Feeding

Do not take cetirizine or levocetirizine without the advice of your doctor. Safety in pregnancy has not been established. The drug also passes into the breast milk. If you are breast feeding you should switch to bottle feed. Discuss both of these issues with your doctor or pharmacist.

Cetirizine and Levocetirizine are classified as a Pregnancy Category B Medicine. Category B… Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.

Tell Your Doctor or Pharmacist

You should tell your doctor if you have a current health problem. For example: heart disease, kidney problems, if you are pregnant or you intend to become pregnant, or if you think you may be at risk from drug treatment for any other reason. Some types of medication can cause serious adverse effects when taken side by side so it is important to tell your doctor of any other medication you are already taking. This should also include any over-the-counter medication. For example: Painkillers, cold remedies, herbal and complimentary/alternative medication.

Over 60’s & Children

There would be no problems expected for the over sixties. Both Cetirizine and Levocetirizine are not recommended for children under 2 years of age and for children between 2 and 6 years your doctor would advise.

Overdose

Take Cetirizine or Levocetirizine exactly as directed by your doctor. An extra unintentional extra dose should not cause a problem. However, large overdoses may cause unusual drowsiness, nausea and could have adverse effects on the heart. Notify your Doctor at once or Go to your nearest accident and emergency department of your local hospital taking the container with you. Even if it is empty.

Other Medication Reactions

The anticholinergic effects of both cetirizine and levocetirizine may be increased by all drugs that have antcholinergic effects, including antipsychotics and tricyclic antidepressants. Cetirizine and levocetirizine may increase the effects of anti-anxiety drugs, sleeping tablets, antidepressants and antipsychotic medication.

Missed A Dose

Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue the regular dosing schedule. Do not take a double dose to make up for a missed one, and leave at the very least a 24 hour gap between doses.

Reducing or Stopping Medication

This medication can be safely stopped when it is nolonger required.

Effect Of Medication (from one dose)

the effects of the medication can usually be felt within 1 to 3 hours. However, some effects may not be felt for 2 to 3 days. The duration of this medication can be felt for up to 24 hours.

Storage and Safety

• Never take more than the original dosage prescribed by your doctor.
• If your due to have treatment like an operation or dental work tell the person carrying out the treatment which medicines you are taking.
• When you buy any medicines over-the-counter check with the pharmacist that they are safe to take with your other medicines.
• Never take cetirizine or levocetirizine if it has past the expiry date shown on the box or container.
• Do not store medication above a temperature of 25°C or above a working area where high condensation may exits.
• Keep cetirizine or levocetirizine in their original container, in a cool dry place, away from the reach and eye sight of children.
• Always read the printed information leaflet that comes with your medicine.
• Do not discard old or unwanted drugs into your trash, sink or toilet.
• Return all unused or old medicines/drugs to your pharmacist. who will dispose of them safely.

If one of these medicines has been prescribed for you never allow anyone else to use it, even if you know or others feel their symptom are similar to your own.

Do not leave your doctors surgery until you have a clear understanding of what the drug your doctor has prescribed for you does, and why you have been prescribed it. It is common for people who do not understand the reason behind there treatment to take their medication correctly.