аллергический ринит (облегчение или устранение чихания, заложенности носа, выделения слизи из носа, зуда в носу, зуда неба, покраснения и зуда глаз, слезотечения);
крапивница (уменьшение или устранение кожного зуда, сыпи).
Противопоказания
повышенная чувствительность к дезлоратадину, лоратадину или какому-либо другому компоненту препарата;
беременность;
период грудного вскармливания;
возраст до 1 года (для данной лекарственной формы);
Дезлоратадин - антагонист гистамина длительного действия. Является первичным активным метаболитом лоратадина. Ингибирует целый каскад реакций аллергического воспаления, в т.ч. - высвобождение провоспалительных цитокинов, таких как интерлейкины ИЛ-4, ИЛ-6, ИЛ-8 и ИЛ-13, высвобождение провоспалительных хемокинов (RANTES), продукцию супероксидных анионов активированными полиморфноядерными нейтрофилами, хемотаксис и адгезию эозинофилов, выделение молекул адгезии, таких как Р-селектин, IgE-зависимое высвобождение гистамина, простагландина D2 и лейкотриена С4. Таким образом, дезлоратадин предупреждает развитие и облегчает течение аллергических реакций, а также обладает противозудным и противоэкссудативным действием, уменьшает проницаемость капилляров, предупреждает развитие отека тканей и спазма гладкой мускулатуры.
Препарат не оказывает воздействия на ЦНС, практически не обладает седативным действием (не вызывает сонливости) и не влияет на скорость психомоторных реакций. В клинико-фармакологических исследованиях применения дезлоратадина в рекомендуемой терапевтической дозе не отмечалось удлинения интервала QT на ЭКГ.
Действие дезлоратадина начинается в течение 30 мин после приема внутрь и продолжается в течение 24 ч.
Фармакокинетика
Всасывание
Дезлоратадин хорошо всасывается в ЖКТ. Определяется в плазме крови через 30 мин после приема внутрь. Cmax в плазме крови достигается, в среднем, через 3 ч после приема.
Распределение
Не проникает через ГЭБ. Связывание с белками плазмы составляет 83-87%. При применении у взрослых и подростков в течение 14 дней в дозе от 5 мг до 20 мг 1 раз/сут клинически значимой кумуляции препарата не отмечалось. Одновременный прием пищи или грейпфрутового сока не влиял на распределение дезлоратадина при применении в дозе 7.5 мг 1 раз/сут.
Метаболизм
Дезлоратадин не является ингибитором изоферментов CYP3A4 и CYP2D6 и не является субстратом или ингибитором Р-гликопротеина. Интенсивно метаболизируется в печени путем гидроксилирования с образованием 3-ОH-дезлоратадина глюкуронида.
Выведение
Лишь небольшая часть принятой внутрь дозы выводится в неизменном виде почками (<2%) и через кишечник (<7%). T1/2 составляет 20-30 ч (в среднем - 27 ч).
Показания к применению
аллергический ринит (облегчение или устранение чихания, заложенности носа, выделения слизи из носа, зуда в носу, зуда неба, покраснения и зуда глаз, слезотечения);
крапивница (уменьшение или устранение кожного зуда, сыпи).
Противопоказания
повышенная чувствительность к дезлоратадину, лоратадину или какому-либо другому компоненту препарата;
беременность;
период грудного вскармливания;
возраст до 1 года (для данной лекарственной формы);
наследственно передаваемые нарушения - непереносимость или нарушение всасывания сорбитола, недостаточность сорбитолдегидрогеназы (Лордестин® сироп 0.5 мг/мл содержит сорбитол; непереносимость или нарушение всасывания сорбитола часто сопровождается непереносимостью других сахаров, например, фруктозы).
С осторожностью
Тяжелая почечная недостаточность, судороги в анамнезе.
Применение при беременности и в период грудного вскармливания
Применение препарата у беременных противопоказано в связи с отсутствием клинических данных о безопасности применения Лордестин® сиропа 0.5 мг/мл во время беременности.
Дезлоратадин выделяется с грудным молоком, поэтому применять Лордестин® сироп 0.5 мг/мл в период грудного вскармливания противопоказано.
Способ применения и дозы
Внутрь. Сироп следует принимать независимо от приема пищи, запивая небольшим количеством воды.
Детям в возрасте от 1 года до 5 лет: по 1.25 мг (2.5 мл сиропа) 1 раз/сут.
Детям в возрасте от 6 до 11 лет: по 2.5 мг (5 мл сиропа) 1 раз/сут.
Взрослым и подросткам от 12 лет: по 5 мг (10 мл сиропа) 1 раз/сут.
Для правильного дозирования следует использовать прилагаемый пластиковый дозирующий стаканчик, градуированный от 2.5 мл до 20 мл.
Если после лечения улучшения не наступает или симптомы усугубляются, или появляются новые симптомы, необходимо проконсультироваться с врачом.
Препарат следует применять только согласно тем показаниям, тому способу применения и в тех дозах, которые указаны в инструкции.
Побочное действие
У детей в возрасте от 6 до 23 месяцев отмечались следующие побочные эффекты, частота которых была несколько выше, чем при применении плацебо: диарея (в 3.7% случаев), повышение температуры тела (2.3%), бессонница (2.3%).
У детей в возрасте от 2 до 11 лет при применении дезлоратадина сироп частота побочных эффектов была такой же, как при применении плацебо.
По результатам клинических исследований у детей в возрасте от 6 до 11 лет при приеме дезлоратадина сиропа в рекомендуемых дозах (2.5 мг/сут) побочных эффектов выявлено не было.
У детей в возрасте 12-17 лет по результатам клинических исследований наиболее часто встречающийся побочный эффект - головная боль (5.9%), частота которой была не выше, чем при приеме плацебо (6.9%).
У взрослых и подростков (12 лет и старше) по результатам клинических исследований побочные эффекты были зафиксированы у 3% пациентов по сравнению с группой, применявших плацебо, из них чаще всего отмечались: повышенная утомляемость (1.2%), сухость во рту (0.8%), головная боль (0.6%).
Информация о побочных эффектах представлена по результатам клинических исследований и наблюдений пострегистрационного периода.
По данным ВОЗ побочные эффекты классифицированы в соответствии с их частотой развития следующим образом: очень часто (≥1/10), часто (от ≥1/100 до <1/10), нечасто (от ≥1/1000 до <1/100), редко (от ≥1/10 000 до <1/1000), очень редко (<1/10 000); частота неизвестна - по имеющимся данным установить частоту возникновения не представлялось возможным.
Со стороны психики: очень редко - галлюцинации; частота неизвестна - аномальное поведение, агрессия.
Со стороны нервной системы: часто - головная боль, бессонница (у детей до 2 лет); очень редко - головокружение, сонливость, бессонница, психомоторная гиперактивность, судороги.
Со стороны печени и желчевыводящих путей: очень редко - повышение активности ферментов печени, повышение концентрации билирубина, гепатит; частота неизвестна - желтуха.
Со стороны пищеварительной системы: часто - сухость во рту, диарея (у детей до 2 лет); очень редко - боль в животе, тошнота, рвота, диспепсия, диарея.
Со стороны сердечно-сосудистой системы: очень редко - тахикардия, сердцебиение; частота неизвестна - удлинение интервала QT.
Со стороны костно-мышечной системы: очень редко - миалгия.
Со стороны кожи и подкожных тканей: частота неизвестна - фотосенсибилизация.
Общие расстройства: часто - повышенная утомляемость, лихорадка (у детей до 2 лет); очень редко - анафилаксия, ангионевротический отек, одышка, зуд, сыпь, в т.ч. крапивница; частота неизвестна - астения.
Если любые из указанных в инструкции побочных эффектов усугубляются, или пациент заметил любые другие побочные эффекты, не указанные в инструкции, он должен сообщить об этом врачу.
Передозировка
Симптомы: прием дозы, превышающей рекомендуемую в 5 раз, не приводит к появлению каких-либо симптомов. В ходе клинических исследований ежедневное применение дезлоратадина у взрослых и подростков в дозе до 20 мг в течение 14 дней не сопровождалось статистически или клинически значимыми изменениями со стороны сердечно-сосудистой системы. В клинико-фармакологическом исследовании применение дезлоратадина в дозе 45 мг/сут (в 9 раз выше рекомендуемой) в течение 10 дней не вызывало удлинения интервала QT и не сопровождалось возникновением серьезных побочных эффектов.
Лечение: при случайном приеме внутрь большого количества препарата необходимо незамедлительно обратиться к врачу. Рекомендуется промывание желудка, прием активированного угля; при необходимости - симптоматическая терапия. Дезлоратадин не выводится при гемодиализе, эффективность перитонеального диализа не установлена.
Взаимодействие с другими лекарственными средствами
При изучении лекарственного взаимодействия при многократном совместном применении дезлоратадина с кетоконазолом, эритромицином, азитромицином, флуоксетином и циметидином клинически значимых изменений концентрации дезлоратадина в плазме не выявлено.
Одновременный прием пищи или употребление грейпфрутового сока не оказывает влияния па эффективность препарата.
Лордестин® сироп 0.5 мг/мл не усиливает действие алкоголя на ЦНС. Тем не менее, во время пострегистрационного применения были зарегистрированы случаи непереносимости алкоголя и алкогольного опьянения. Поэтому дезлоратадин одновременно с алкоголем следует применять с осторожностью.
Особые указания
Срок годности препарата после первого вскрытия флакона составляет 28 дней.
Применение у детей
Эффективность и безопасность применения препарата Лордестин® сироп у детей в возрасте до 1 года не установлена.
Исследований эффективности дезлоратадина при ринитах инфекционной этиологии не проводилось.
Тяжелая почечная недостаточность
У пациентов с тяжелой почечной недостаточностью или находящихся на гемодиализе происходит повышение концентрации дезлоратадина в плазме крови в 1.7 и 2.5 раза, соответственно. Было выявлено минимальное изменение концентрации 3-гидроксидезлоратадина. Дезлоратадин и 3-гидроксидезлоратадин плохо выводятся при диализе. Нарушение функции почек не оказывает влияния на связывание дезлоратадина и 3-гидроксидезлоратадина с белками плазмы крови. Основываясь на фармакокинетике сиропа Лордестин® 0.5 мг/мл, следует соблюдать осторожность при применении препарата у пациентов с почечной недостаточностью.
Судороги в анамнезе
Необходимо соблюдать осторожность при применении дезлоратадина у пациентов с судорогами в анамнезе, особенно у пациентов детского возраста. В случае развития судорог следует прекратить применение дезлоратадина.
Влияние на способность управлять автомобилем и движущимися механизмами
Следует принимать во внимание потенциальную возможность развития таких побочных эффектов, как головокружение и сонливость. При появлении описанных нежелательных явлений следует воздержаться от выполнения указанных видов деятельности.
Условия хранения
Препарат следует хранить в недоступном для детей, защищенном от света месте при температуре не выше 25°С.
Срок годности
2 года. Не применять по истечении срока годности, указанного на упаковке.
Условия отпуска
Без рецепта.
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Является первичным активным метаболитом лоратадина. Ингибирует целый каскад реакций аллергического воспаления, в т.ч. - высвобождение провоспалительных цитокинов, таких как интерлейкины ИЛ-4, ИЛ-6, ИЛ-8 и ИЛ-13, высвобождение провоспалительных хемокинов (RANTES), продукцию супероксидных анионов активированными полиморфноядерными нейтрофилами, хемотаксис и адгезию эозинофилов, выделение молекул адгезии, таких как Р-селектин, IgE-зависимое высвобождение гистамина, простагландина D2 и лейкотриена С4. Таким образом, дезлоратадин предупреждает развитие и облегчает течение аллергических реакций, а также обладает противозудным и противоэкссудативным действием, уменьшает проницаемость капилляров, предупреждает развитие отека тканей и спазма гладкой мускулатуры."}},{"type":"paragraph","data":{"text":"Препарат не оказывает воздействия на ЦНС, практически не обладает седативным действием (не вызывает сонливости) и не влияет на скорость психомоторных реакций. В клинико-фармакологических исследованиях применения дезлоратадина в рекомендуемой терапевтической дозе не отмечалось удлинения интервала QT на ЭКГ."}},{"type":"paragraph","data":{"text":"Действие дезлоратадина начинается в течение 30 мин после приема внутрь и продолжается в течение 24 ч."}},{"type":"header","data":{"text":"Фармакокинетика","level":4}},{"type":"paragraph","data":{"text":"\u003ci\u003eВсасывание\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Дезлоратадин хорошо всасывается в ЖКТ. Определяется в плазме крови через 30 мин после приема внутрь. C\u003csub\u003emax \u003c/sub\u003eв плазме крови достигается, в среднем, через 3 ч после приема."}},{"type":"paragraph","data":{"text":"\u003ci\u003eРаспределение\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Не проникает через ГЭБ. Связывание с белками плазмы составляет 83-87%. При применении у взрослых и подростков в течение 14 дней в дозе от 5 мг до 20 мг 1 раз/сут клинически значимой кумуляции препарата не отмечалось. Одновременный прием пищи или грейпфрутового сока не влиял на распределение дезлоратадина при применении в дозе 7.5 мг 1 раз/сут."}},{"type":"paragraph","data":{"text":"\u003ci\u003eМетаболизм\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Дезлоратадин не является ингибитором изоферментов CYP3A4 и CYP2D6 и не является субстратом или ингибитором Р-гликопротеина. Интенсивно метаболизируется в печени путем гидроксилирования с образованием 3-ОH-дезлоратадина глюкуронида."}},{"type":"paragraph","data":{"text":"\u003ci\u003eВыведение\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Лишь небольшая часть принятой внутрь дозы выводится в неизменном виде почками (<2%) и через кишечник (<7%). T\u003csub\u003e1/2 \u003c/sub\u003eсоставляет 20-30 ч (в среднем - 27 ч)."}}]},{"id":7,"name":"Показания к применению","slug":"indications","body":[{"type":"list","data":{"style":"ordered","items":["аллергический ринит (облегчение или устранение чихания, заложенности носа, выделения слизи из носа, зуда в носу, зуда неба, покраснения и зуда глаз, слезотечения);","крапивница (уменьшение или устранение кожного зуда, сыпи)."]}}]},{"id":8,"name":"Противопоказания","slug":"contraindications","body":[{"type":"list","data":{"style":"ordered","items":["повышенная чувствительность к дезлоратадину, лоратадину или какому-либо другому компоненту препарата;","беременность;","период грудного вскармливания;","возраст до 1 года (для данной лекарственной формы);","наследственно передаваемые нарушения - непереносимость или нарушение всасывания сорбитола, недостаточность сорбитолдегидрогеназы (Лордестин\u003csup\u003e®\u003c/sup\u003e сироп 0.5 мг/мл содержит сорбитол; непереносимость или нарушение всасывания сорбитола часто сопровождается непереносимостью других сахаров, например, фруктозы)."]}}]},{"id":9,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"Тяжелая почечная недостаточность, судороги в анамнезе."}}]},{"id":10,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Применение препарата у беременных противопоказано в связи с отсутствием клинических данных о безопасности применения Лордестин\u003csup\u003e®\u003c/sup\u003e сиропа 0.5 мг/мл во время беременности."}},{"type":"paragraph","data":{"text":"Дезлоратадин выделяется с грудным молоком, поэтому применять Лордестин\u003csup\u003e®\u003c/sup\u003e сироп 0.5 мг/мл в период грудного вскармливания противопоказано."}}]},{"id":11,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Внутрь. Сироп следует принимать независимо от приема пищи, запивая небольшим количеством воды."}},{"type":"paragraph","data":{"text":"\u003cb\u003eДетям в возрасте от 1 года до 5 лет:\u003c/b\u003e по 1.25 мг (2.5 мл сиропа) 1 раз/сут."}},{"type":"paragraph","data":{"text":"\u003cb\u003eДетям в возрасте от 6 до 11 лет:\u003c/b\u003e по 2.5 мг (5 мл сиропа) 1 раз/сут."}},{"type":"paragraph","data":{"text":"\u003cb\u003eВзрослым и подросткам от 12 лет:\u003c/b\u003e по 5 мг (10 мл сиропа) 1 раз/сут."}},{"type":"paragraph","data":{"text":"Для правильного дозирования следует использовать прилагаемый пластиковый дозирующий стаканчик, градуированный от 2.5 мл до 20 мл."}},{"type":"paragraph","data":{"text":"Если после лечения улучшения не наступает или симптомы усугубляются, или появляются новые симптомы, необходимо проконсультироваться с врачом."}},{"type":"paragraph","data":{"text":"Препарат следует применять только согласно тем показаниям, тому способу применения и в тех дозах, которые указаны в инструкции."}}]},{"id":12,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"У детей в возрасте от 6 до 23 месяцев отмечались следующие побочные эффекты, частота которых была несколько выше, чем при применении плацебо: диарея (в 3.7% случаев), повышение температуры тела (2.3%), бессонница (2.3%)."}},{"type":"paragraph","data":{"text":"У детей в возрасте от 2 до 11 лет при применении дезлоратадина сироп частота побочных эффектов была такой же, как при применении плацебо."}},{"type":"paragraph","data":{"text":"По результатам клинических исследований у детей в возрасте от 6 до 11 лет при приеме дезлоратадина сиропа в рекомендуемых дозах (2.5 мг/сут) побочных эффектов выявлено не было."}},{"type":"paragraph","data":{"text":"У детей в возрасте 12-17 лет по результатам клинических исследований наиболее часто встречающийся побочный эффект - головная боль (5.9%), частота которой была не выше, чем при приеме плацебо (6.9%)."}},{"type":"paragraph","data":{"text":"У взрослых и подростков (12 лет и старше) по результатам клинических исследований побочные эффекты были зафиксированы у 3% пациентов по сравнению с группой, применявших плацебо, из них чаще всего отмечались: повышенная утомляемость (1.2%), сухость во рту (0.8%), головная боль (0.6%)."}},{"type":"paragraph","data":{"text":"Информация о побочных эффектах представлена по результатам клинических исследований и наблюдений пострегистрационного периода."}},{"type":"paragraph","data":{"text":"По данным ВОЗ побочные эффекты классифицированы в соответствии с их частотой развития следующим образом: очень часто (≥1/10), часто (от ≥1/100 до <1/10), нечасто (от ≥1/1000 до <1/100), редко (от ≥1/10 000 до <1/1000), очень редко (<1/10 000); частота неизвестна - по имеющимся данным установить частоту возникновения не представлялось возможным."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны психики:\u003c/i\u003e очень редко - галлюцинации; частота неизвестна - аномальное поведение, агрессия."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны нервной системы: \u003c/i\u003eчасто - головная боль, бессонница (у детей до 2 лет); очень редко - головокружение, сонливость, бессонница, психомоторная гиперактивность, судороги."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны печени и желчевыводящих путей:\u003c/i\u003e очень редко - повышение активности ферментов печени, повышение концентрации билирубина, гепатит; частота неизвестна - желтуха."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны пищеварительной системы: \u003c/i\u003eчасто - сухость во рту, диарея (у детей до 2 лет); очень редко - боль в животе, тошнота, рвота, диспепсия, диарея."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны сердечно-сосудистой системы:\u003c/i\u003e очень редко - тахикардия, сердцебиение; частота неизвестна - удлинение интервала QT."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны костно-мышечной системы:\u003c/i\u003e очень редко - миалгия."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны кожи и подкожных тканей:\u003c/i\u003e частота неизвестна - фотосенсибилизация."}},{"type":"paragraph","data":{"text":"\u003ci\u003eОбщие расстройства:\u003c/i\u003e часто - повышенная утомляемость, лихорадка (у детей до 2 лет); очень редко - анафилаксия, ангионевротический отек, одышка, зуд, сыпь, в т.ч. крапивница; частота неизвестна - астения."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПострегистрационный период\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eДети:\u003c/i\u003e частота неизвестна - удлинение интервала QT, аритмия, брадикардия, аномальное поведение, агрессия."}},{"type":"paragraph","data":{"text":"Если любые из указанных в инструкции побочных эффектов усугубляются, или пациент заметил любые другие побочные эффекты, не указанные в инструкции, он должен сообщить об этом врачу."}}]},{"id":13,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eСимптомы: \u003c/i\u003eприем дозы, превышающей рекомендуемую в 5 раз, не приводит к появлению каких-либо симптомов. В ходе клинических исследований ежедневное применение дезлоратадина у взрослых и подростков в дозе до 20 мг в течение 14 дней не сопровождалось статистически или клинически значимыми изменениями со стороны сердечно-сосудистой системы. В клинико-фармакологическом исследовании применение дезлоратадина в дозе 45 мг/сут (в 9 раз выше рекомендуемой) в течение 10 дней не вызывало удлинения интервала QT и не сопровождалось возникновением серьезных побочных эффектов."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛечение: \u003c/i\u003eпри случайном приеме внутрь большого количества препарата необходимо незамедлительно обратиться к врачу. Рекомендуется промывание желудка, прием активированного угля; при необходимости - симптоматическая терапия. Дезлоратадин не выводится при гемодиализе, эффективность перитонеального диализа не установлена."}}]},{"id":14,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"При изучении лекарственного взаимодействия при многократном совместном применении дезлоратадина с кетоконазолом, эритромицином, азитромицином, флуоксетином и циметидином клинически значимых изменений концентрации дезлоратадина в плазме не выявлено."}},{"type":"paragraph","data":{"text":"Одновременный прием пищи или употребление грейпфрутового сока не оказывает влияния па эффективность препарата."}},{"type":"paragraph","data":{"text":"Лордестин\u003csup\u003e®\u003c/sup\u003e сироп 0.5 мг/мл не усиливает действие алкоголя на ЦНС. Тем не менее, во время пострегистрационного применения были зарегистрированы случаи непереносимости алкоголя и алкогольного опьянения. Поэтому дезлоратадин одновременно с алкоголем следует применять с осторожностью."}}]},{"id":15,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Срок годности препарата после первого вскрытия флакона составляет 28 дней."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПрименение у детей\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Эффективность и безопасность применения препарата Лордестин\u003csup\u003e®\u003c/sup\u003e сироп у детей в возрасте до 1 года не установлена."}},{"type":"paragraph","data":{"text":"Исследований эффективности дезлоратадина при ринитах инфекционной этиологии не проводилось."}},{"type":"paragraph","data":{"text":"\u003ci\u003eТяжелая почечная недостаточность\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"У пациентов с тяжелой почечной недостаточностью или находящихся на гемодиализе происходит повышение концентрации дезлоратадина в плазме крови в 1.7 и 2.5 раза, соответственно. Было выявлено минимальное изменение концентрации 3-гидроксидезлоратадина. Дезлоратадин и 3-гидроксидезлоратадин плохо выводятся при диализе. Нарушение функции почек не оказывает влияния на связывание дезлоратадина и 3-гидроксидезлоратадина с белками плазмы крови. Основываясь на фармакокинетике сиропа Лордестин\u003csup\u003e®\u003c/sup\u003e 0.5 мг/мл, следует соблюдать осторожность при применении препарата у пациентов с почечной недостаточностью."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСудороги в анамнезе\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Необходимо соблюдать осторожность при применении дезлоратадина у пациентов с судорогами в анамнезе, особенно у пациентов детского возраста. В случае развития судорог следует прекратить применение дезлоратадина."}}]},{"id":16,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Следует принимать во внимание потенциальную возможность развития таких побочных эффектов, как головокружение и сонливость. При появлении описанных нежелательных явлений следует воздержаться от выполнения указанных видов деятельности."}}]},{"id":18,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"Препарат следует хранить в недоступном для детей, защищенном от света месте при температуре не выше 25°С."}}]},{"id":19,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"2 года. Не применять по истечении срока годности, указанного на упаковке."}}]},{"id":20,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Без рецепта."}}]}],"source":null},"description_toggle":false,"short_description":"Дезлоратадин - антагонист гистамина длительного действия. Является первичным активным метаболитом лоратадина. Ингибирует целый каскад реакций аллергического воспаления, в т.ч. - высвобождение провоспалительных цитокинов, таких как интерлейкины ИЛ-4, ИЛ-6, ИЛ-8 и ИЛ-13, высвобождение провоспалительных хемокинов (RANTES), продукцию супероксидных анионов активированными полиморфноядерными нейтрофилами, хемотаксис и адгезию эозинофилов, выделение молекул адгезии, таких как Р-селектин, IgE-зависимое высвобождение гистамина, простагландина D2 и лейкотриена С4. Таким образом, дезлоратадин предупреждает развитие и облегчает течение аллергических реакций, а также обладает противозудным и противоэкссудативным действием, уменьшает проницаемость капилляров, предупреждает развитие отека тканей и спазма гладкой мускулатуры. Препарат не оказывает воздействия на ЦНС, практически не обладает седативным действием (не вызывает сонливости) и не влияет на скорость психомоторных реакций. В клинико-фармакологических исследованиях применения дезлоратадина в рекомендуемой терапевтической дозе не отмечалось удлинения интервала QT на ЭКГ. Действие дезлоратадина начинается в течение 30 мин после приема внутрь и продолжается в течение 24 ч.ВсасываниеДезлоратадин хорошо всасывается в ЖКТ. Определяется в плазме крови через 30 мин после приема внутрь. Cmaxв плазме крови достигается, в среднем, через 3 ч после приема.РаспределениеНе проникает через ГЭБ. Связывание с белками плазмы составляет 83-87%. При применении у взрослых и подростков в течение 14 дней в дозе от 5 мг до 20 мг 1 раз/сут клинически значимой кумуляции препарата не отмечалось. Одновременный прием пищи или грейпфрутового сока не влиял на распределение дезлоратадина при применении в дозе 7.5 мг 1 раз/сут.МетаболизмДезлоратадин не является ингибитором изоферментов CYP3A4 и CYP2D6 и не является субстратом или ингибитором Р-гликопротеина. Интенсивно метаболизируется в печени путем гидроксилирования с образованием 3-ОH-дезлоратадина глюкуронида.ВыведениеЛишь небольшая часть принятой внутрь дозы выводится в неизменном виде почками (\u003c2%) и через кишечник (\u003c7%). T1/2составляет 20-30 ч (в среднем - 27 ч).","substance":[{"id":230,"title":"Дезлоратадин","title_latin":"Desloratadinum","slug":"dezloratadin_230"}],"branding":null,"valid_for_quick_buy":false,"is_available_to_delivery":false,"comments":null,"image_alt":"Лордестин - фото упаковки","image_share":{"isTouch":{"default":"https://vseapteki.ru/cropping/thumbnails/101/224278/share_default/"},"isFromTablet":{"default":"https://vseapteki.ru/cropping/thumbnails/101/224278/share_default/"}},"diseases":[{"id":"789","title":"Острый назофарингит","slug":"789-ostryy_nazofaringit"},{"id":"811","title":"Вазомоторный и аллергический ринит","slug":"811-vazomotornyy_i_allergicheskiy_rinit"},{"id":"813","title":"Аллергический ринит, вызванный пыльцой растений","slug":"813-allergicheskiy_rinit_vyzvannyy_pyltsoy_rasteniy"},{"id":"814","title":"Другие аллергические риниты (круглогодичный аллергический 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