Suprastinex - instructions for use, reviews, analogs and forms of release (5 mg tablets, drops for ingestion) of a drug for the treatment of urticaria, itching, runny nose and other manifestations of allergies in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Suprastinex. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Suprastinex in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Suprastinex in the presence of existing structural analogues.Use for the treatment of urticaria, itching, runny nose and other manifestations of allergies in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Suprastinex antiallergic agent. Levocetirizine (active ingredient of the preparation Suprastinex) - Cetirizine R-enantiomer, which belongs to the group of competitive histamine antagonists, blocks histamine H1 receptors.

It affects the histamine-dependent stage of allergic reactions, reduces the migration of eosinophils, reduces vascular permeability, and limits the release of inflammatory mediators. Prevents development and facilitates the course of allergic reactions, has antiexudative, antipruritic effect.

Virtually no anticholinergic and antiserotonergic action. In therapeutic doses, it practically does not have a sedative effect.

The drug begins 12 minutes after receiving a single dose in 50% of patients, after 1 hour - in 95% and lasts for 24 hours.

Composition

Levocetirizine dihydrochloride + excipients.

Pharmacokinetics

Pharmacokinetic parameters of levocetirizine vary linearly and practically do not differ from the pharmacokinetics of cetirizine. After oral administration, it is quickly and completely absorbed from the digestive tract. The ingestion of food does not affect the completeness of absorption, but reduces its speed. Bioavailability reaches 100%. Levocetirizine binds to blood plasma proteins by 90%. Less than 14% of the drug is metabolized in the liver by N- and O-dealkylation (as opposed to other histamine H1 receptor antagonists that are metabolized in the liver by the CYP system). Because of the minor metabolism and metabolic potential, the interaction of levocetirizine with other drugs is unlikely. About 85.4% of the accepted dose of the drug is excreted by the kidneys in unchanged form by glomerular filtration and tubular secretion; about 12.9% - through the intestine.

In young children, the elimination half-life is shorter.

Indications

Symptomatic treatment:

• year-round (persistent) and seasonal (intermittent) allergic rhinitis and conjunctivitis (pruritus, sneezing, nasal congestion, rhinorrhea, lacrimation, congestion hyperemia);
• hay fever (hay fever);
• urticaria, incl. chronic idiopathic urticaria (for tablets);
• Edema Quincke (for tablets);
• allergic dermatoses, accompanied by itching and rashes.

Forms of release

The tablets covered with a cover of 5 mg.

Drops for oral administration.

Instructions for use and dosage

The drug should be taken orally during meals or on an empty stomach.

Tablets are taken without chewing, with a small amount of water.

To take the drug in the form of drops should use a teaspoon. If necessary, the dose of the drug can be diluted in a small amount of water immediately before use.

The recommended dose for adults and children over 6 years old, elderly patients (with normal kidney function) is 5 mg (1 tablet or 1 ml drops or 20 drops from a dropper) per day. The maximum daily dose is 5 mg.

For children aged 2 to 6 years, the drug is prescribed in the form of drops for oral administration at 1.25 mg (5 drops) 2 times a day; daily dose of 2.5 mg (10 drops).

Duration of admission depends on the disease.

In the treatment of year-round (persistent) allergic rhinitis (the presence of symptoms more than 4 days a week and their total duration of more than 4 weeks) treatment can continue throughout the exposure period of allergens.

In the treatment of seasonal (intermittent) presence of allergic rhinitis symptoms than 4 days per week or a total duration of less than 4 weeks), the duration of treatment depends on the nature of the disease; Treatment can be stopped if symptoms disappear and are resumed when symptoms appear.

The course of treatment of pollinosis on average is 1-6 weeks.

In chronic diseases (including chronic idiopathic urticaria), the course of treatment can be longer in agreement with the doctor.

There is a clinical experience of continuous use of the drug in adult patients lasting up to 6 months.

Since levocetirizine excreted by the kidneys, when administering the drug to patients with renal failure and patients older dose should be adjusted depending on the creatinine clearance (CC).

QC for males can be calculated from the serum creatinine concentration by the following formula: QC (ml / min) = [140 - age (years)] × weight (kg) / 72 × QC serum (mg / dl).

KK for women can be calculated by multiplying the obtained value by a factor of 0.85.

Patients with a violation of only liver function correction of the dosing regimen is not required.

Side effect

• headache;
• hypersensitivity reactions, including anaphylaxis;
• anxiety;
• aggression;
• excitation;
• insomnia;
• drowsiness;
• hallucinations;
• depression;
• suicidal thoughts;
• convulsions;
• thrombosis of the sinuses of the dura mater;
• paresthesia;
• dizziness;
• fainting;
• tremor;
• vertigo;
• impaired vision;
• blurred vision;
• a feeling of palpitations;
• tachycardia;
• thrombosis of the jugular vein;
• dyspnea;
• increased symptoms of rhinitis;
• increased appetite;
• nausea, vomiting;
• dry mouth;
• asthenia;
• abdominal pain;
• hepatitis;
• change in functional liver samples;
• retention of urine;
• rash;
• itching;
• hypotrichosis;
• cracks;
• angioedema;
• persistent drug erythema;
• hives;
• photosensitization;
• muscle pain;
• peripheral edema;
• increase in body weight;
• cross reactivity.

If any side effects indicated in the manual are aggravated, or other side effects not indicated in the instructions are noted, the patient should be informed of this to the doctor.

Contraindications

• terminal stage of renal failure (QC less than 10 ml / min);
• children under 6 years (for tablets);
• children under 2 years of age (for drops for oral administration - due to lack of clinical data);
• pregnancy;
• lactation period;
• lactose intolerance, hereditary lactase deficiency or glucose-galactose malabsorption syndrome (for tablets);
• hypersensitivity to the active substance (including piperazine derivatives) or any auxiliary component of the drug.

Application in pregnancy and lactation

Preclinical studies did not reveal any direct or indirect adverse effects of Suprastinex on the developing fetus, as well as on development in the postnatal period; the course of pregnancy and childbirth also did not change.

Adequate and strictly controlled clinical trials on the safety of the use of the drug Suprastinex during pregnancy have not been conducted. The use of the drug during pregnancy is contraindicated.

Levocetirizine is excreted in breast milk, so if it is necessary to use the drug during lactation it is recommended to stop breastfeeding.

Use in children

Contraindicated in children under 6 years of age (for tablets); children under 2 years (for drops for oral administration - due to lack of clinical data).

Application in elderly patients

Caution should be given to patients of advanced age (possibly reducing glomerular filtration).

special instructions

Caution should be given to Suprastinex in chronic renal failure (correction of the dosing regimen is necessary), to patients with spinal cord injury, prostatic hyperplasia, and other predisposing factors to urinary retention (levocetirizine may increase the risk of urinary retention), with simultaneous use with alcohol .

The suprastinex tablets contain lactose, so do not prescribe this dosage form to patients with lactose intolerance, hereditary lactase deficiency, or glucose-galactose malabsorption syndrome.

Suprastinex drops can cause allergic reactions (sometimes late), because contain methyl parahydroxybenzoate and propyl parahydroxybenzoate.

Impact on the ability to drive vehicles and manage mechanisms

Levocetirizine can lead to increased drowsiness, and, therefore, can affect the ability to drive a car or work with machinery. During the treatment period, it is necessary to refrain from engaging in potentially dangerous activities that require a high concentration of attention and speed of psychomotor reactions.

Drug Interactions

Studies of the interaction of Suprastinex with other drugs have not been conducted.

When studying the drug interaction of the racemate cetirizine with phenazone, pseudoephedrine, cimetidine, ketoconazole, erythromycin, azithromycin, glipizide and diazepam, no clinically significant undesirable interaction was detected. With simultaneous application with theophylline (400 mg per day), the total clearance of cetirizine is reduced by 16% (theophylline kinetics does not change).

In a study with simultaneous administration of ritonavir (600 mg twice daily) and cetirizine (10 mg per day), it was shown that the exposure of cetirizine increased by 40%, the exposure of ritonavir changed (-10%).

In some cases, while using levocetirizine with ethanol (alcohol) or drugs,having an overwhelming effect on the central nervous system, it is possible to increase their effect on the central nervous system, although it has not been proven that the racemate of cetirizine potentiates the effect of ethanol.

The degree of absorption of levocetirizine does not decrease with simultaneous intake of food, but the rate of absorption decreases.

Analogues of the drug Suprastinex

Structural analogs for the active substance:

• Alersat L;
• Allervay;
• Glencet;
• Zenaro;
• Zodak Express;
• Xizal;
• Levocetirizine;
• Cezer;
• Eltset.

Analogues for the pharmacological group (antihistamines):

• Azelastine hydrochloride;
• Alerza;
• Allegra;
• Allergodyl;
• Allergoferon;
• Astemizole;
• Vibrocil;
• Vizin Alerji;
• Histaglobin;
• Histalong;
• Histafen;
• Gifast;
• Glencet;
• Dezal;
• Desloratadine;
• Diazoline;
• Diphenhydramine;
• Diphenhydramine 1% for injection;
• Diphenhydramine hydrochloride;
• Doxylamine succinate;
• Donormil;
• Dramina;
• Zincet;
• Zirtek;
• Zodak;
• Kestin;
• Claritin;
• Clemastine;
• Xizal;
• Levocetirizine;
• Lomilan;
• Loratadine;
• Lordestin;
• Has occluded;
• Opatanol;
• Parliamentary;
• Pipolphen;
• Primalan;
• Reactin;
• Rivtagil;
• Rupafin;
• Suprastin;
• Tavegil;
• Telfast;
• Fexadine;
• Fexofenadine;
• Femizol;
• Pheniramine maleate;
• Fenistil;
• Fenkarol;
• Fenspiride;
• Chloropyramine;
• Chlorphenamine maleate;
• Cetirizine;
• Cetirinax;
• Cetrin;
• Ezlor;
• Elisei;
• Erolin.

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