Цетиризин Капли, 20 мл, 10 мг/мл, для приема внутрь

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В дополнении к антигистаминному эффекту цетиризин также обладает противовоспалительным эффектом и тем самым оказывает влияние на позднюю фазу аллергической реакции:"}},{"type":"paragraph","data":{"text":"- при дозе 10 мг один или два раза в день ингибирует позднюю фазу агрегации эозинофилов в коже;"}},{"type":"paragraph","data":{"text":"- при дозе 30 мг в день ингибирует выведение эозинофилов в бронхиальную альвеолярную жидкость после вызванного аллергеном бронхиального сужения;"}},{"type":"paragraph","data":{"text":"- ингибирует вызванную калликреином позднюю воспалительную реакцию;"}},{"type":"paragraph","data":{"text":"- подавляет экспрессию маркеров воспаления таких как 1САМ-1 или VCAM-1;"}},{"type":"paragraph","data":{"text":"- ингибирует действие гистаминолибераторов таких как PAF или субстанция Р."}},{"type":"paragraph","data":{"text":"Фармакокинетика:"}},{"type":"paragraph","data":{"text":"Всасывание"}},{"type":"paragraph","data":{"text":"После приема внутрь препарат быстро абсорбируется из желудочно-кишечного тракта. Фармакокинетические параметры цетиризина при его применении в дозах от 5 до 60 мг изменяются линейно. Равновесная концентрация достигается через 3 дня."}},{"type":"paragraph","data":{"text":"Фармакокинетический профиль цетиризина аналогичен у взрослых и детей. У детей после приема цетиризина в дозе 5 мг концентрация активной субстанции в организме такая же как и у взрослых после приема 10 мг. У взрослых после приема цетиризина в дозе 10 мг максимальная концентрация (Сmах) в плазме крови достигается через 1-2 часа и составляет 350 нг/мл. У детей после приема цетиризина в дозе 5 мг Сmах в плазме крови достигается через 1 час и составляет 275 нг/мл."}},{"type":"paragraph","data":{"text":"При приеме цетиризина в форме капель максимальные концентрации в плазме крови достигаются с более высокой скоростью."}},{"type":"paragraph","data":{"text":"Распределение"}},{"type":"paragraph","data":{"text":"Распределение после приема 10 мг составляет 35 литров у взрослых а связывание с белками плазмы крови - 93 %. У детей объем распределения после приема 5 мг составляет примерно 17 литров."}},{"type":"paragraph","data":{"text":"Незначительное количество цетиризина выделяется в грудное молоко."}},{"type":"paragraph","data":{"text":"Метаболизм"}},{"type":"paragraph","data":{"text":"У взрослых 60 % дозы выводится из организма в неизменном виде почками."}},{"type":"paragraph","data":{"text":"Выведение"}},{"type":"paragraph","data":{"text":"После приема 10 мг у взрослых общий клиренс цетиризина составляет 060 мл/мин/кг; период полувыведения (Т1/2) составляет примерно 10 часов. Прием нескольких доз не изменяет фармакокинетические параметры. При приеме препарата в суточной дозе 10 мг в течение 10 дней кумуляции цетиризина не наблюдалось."}},{"type":"paragraph","data":{"text":"После окончания лечения уровень цетиризина в плазме крови быстро падает ниже определяемых пределов. Повторные аллергологические тесты можно возобновить через 3 дня."}},{"type":"paragraph","data":{"text":"Отдельные группы пациентов"}},{"type":"paragraph","data":{"text":"Пожилые пациенты:"}},{"type":"paragraph","data":{"text":"У 16 пожилых лиц при однократном приеме препарата в дозе 10 мг Т1/2 был выше на 50 % а скорость выведения была ниже на 40 % по сравнению с контрольной группой."}},{"type":"paragraph","data":{"text":"Снижение клиренса цетиризина у пожилых пациентов вероятно связано с уменьшением функции почек у этой категории пациентов."}},{"type":"paragraph","data":{"text":"Дети:"}},{"type":"paragraph","data":{"text":"У детей от 6 до 12 лет 70 % дозы выводится из организма в неизменном виде почками."}},{"type":"paragraph","data":{"text":"После приема 5 мг у детей общий клиренс цетиризина составляет 093 мл/мин/кг. Т1/2 у детей от 6 до 12 лет составляет 6 часов от 2 до 6 лет - 5 часов от 6 месяцев до 2 лет - снижено до 31 часа."}},{"type":"paragraph","data":{"text":"Пациенты с почечной недостаточностью:"}},{"type":"paragraph","data":{"text":"У пациентов с почечной недостаточностью легкой степени тяжести (клиренс креатинина (КК) > 50 мл/мин) фармакокинетические параметры аналогичны таковым \\ здоровых добровольцев с нормальной функцией почек."}},{"type":"paragraph","data":{"text":"У пациентов с почечной недостаточностью средней степени тяжести (КК 30-49 мл/мин) Т1/2 удлиняется в 3 раза а общий клиренс снижается на 70 % относительно здоровых добровольцев с нормальной функцией почек."}},{"type":"paragraph","data":{"text":"У пациентов находящихся на гемодиализе (КК < 7 мл/мин) при приеме препарата внутрь в дозе 10 мг общий клиренс снижается приблизительно на 70 % относительно здоровых добровольцев с нормальной функцией почек а Т1/2 удлиняется в 3 раза."}},{"type":"paragraph","data":{"text":"Менее 10 % цетиризина удаляется в ходе стандартной процедуры гемодиализа."}},{"type":"paragraph","data":{"text":"Пациенты с печеночной недостаточностью:"}},{"type":"paragraph","data":{"text":"У пациентов с хроническими заболеваниями печени (гепатоцеллюлярным холестатическим и билиарным циррозом) при однократном приеме препарата в дозе 10 или 20 мг Т1/2 увеличивается примерно на 50 % а клиренс снижается на 40 % по сравнению со здоровыми субъектами."}},{"type":"paragraph","data":{"text":"Коррекция дозы необходима только в случае если у пациента с печеночной недостаточностью имеется также сопутствующая почечная недостаточность."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Препарат показан взрослым и детям с 6месяцев и старше для облегчения:"}},{"type":"paragraph","data":{"text":"- назальных и глазных симптомов круглогодичного (персистирующего) и сезонного (интермиттирующего) аллергического ринита и аллергического конъюнктивита: зуда чиханья заложенности носа ринореи слезотечения гиперемии конъюнктивы;"}},{"type":"paragraph","data":{"text":"- симптомов хронической идиопатической крапивницы."}},{"type":"paragraph","data":{"text":"Применение у детей от 6 до 12 месяцев возможно только по назначению врача и под строгим медицинским контролем."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"- Повышенная чувствительность к цетиризину гидроксизину или другим производным пиперазина а также любому другому компоненту препарата;"}},{"type":"paragraph","data":{"text":"- терминальная стадия почечной недостаточности (КК < 10 мл/мин);"}},{"type":"paragraph","data":{"text":"- детский возраст до 6 месяцев (ввиду ограниченности данных по эффективности и безопасности применения препарата Цетиризин)."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Беременность"}},{"type":"paragraph","data":{"text":"Данные по применению цетиризина во время беременности ограничены (300-1000 исходов беременности). Однако не выявлено случаев формирования пороков развития эмбриональной и неонатальной токсичности с четкой причинно-следственной связью."}},{"type":"paragraph","data":{"text":"Экспериментальные исследования на животных не выявили каких-либо прямых или косвенных неблагоприятных эффектов цетиризина на развивающийся плод (в том числе в постнатальном периоде) течение беременности и постнатальное развитие. При беременности назначение цетиризина возможно после консультации с врачом в случае если предполагаемая польза для матери превышает потенциальный риск для плода."}},{"type":"paragraph","data":{"text":"Период грудного вскармливания"}},{"type":"paragraph","data":{"text":"Не следует применять цетиризин во время грудного вскармливания так как цетиризин экскретируется с грудным молоком."}},{"type":"paragraph","data":{"text":"В период грудного вскармливания применяют после консультации с врачом если предполагаемая польза для матери превышает потенциальный риск для ребенка."}},{"type":"paragraph","data":{"text":"Фертильность"}},{"type":"paragraph","data":{"text":"Доступные данные о влиянии на фертильность человека ограничены однако отрицательного влияния на фертильность в исследованиях на животных не выявлено."}},{"type":"paragraph","data":{"text":"Перед применением препарата если Вы беременны или предполагаете что Вы могли бы быть беременной или планируете беременность необходимо проконсультироваться с врачом."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Внутрь."}},{"type":"paragraph","data":{"text":"Принимать препарат следует вечером так как симптомы становятся более выраженными вечером."}},{"type":"paragraph","data":{"text":"При необходимости препарат Цетиризин можно запивать стаканом воды."}},{"type":"paragraph","data":{"text":"Препарат Цетиризин можно принимать независимо от приема пищи."}},{"type":"paragraph","data":{"text":"Взрослым: 10 мг(20 капель) 1 раз вдень."}},{"type":"paragraph","data":{"text":"Альтернативно доза может быть разделена на два приема (по 10 капель утром и вечером)."}},{"type":"paragraph","data":{"text":"Дети"}},{"type":"paragraph","data":{"text":"Применение у детей от 6 до 12 месяцев возможно только по назначению врача и под строгим медицинским контролем!"}},{"type":"paragraph","data":{"text":"Дети от 6 до 12 месяцев: 25 мг (5 капель) один раз в день."}},{"type":"paragraph","data":{"text":"Дети от 1 года до 6 лет: 2.5 мг (5 капель) два раза в день утром и вечером. Продолжительность лечения не должна превышать 4 недель."}},{"type":"paragraph","data":{"text":"Дети от 6 до 12 лет: 10 мг (20 капель) один раз в день."}},{"type":"paragraph","data":{"text":"Продолжительность лечения не должна превышать 4 недель."}},{"type":"paragraph","data":{"text":"Альтернативно доза может быть разделена на два приема (по 10 капель утром и вечером)."}},{"type":"paragraph","data":{"text":"Дети старше 12 лет: 10 мг (20 капель) один раз в день."}},{"type":"paragraph","data":{"text":"Иногда начальной дозы 5 мг (10 капель) может быть достаточно если это позволяет достичь удовлетворительного контроля симптомов."}},{"type":"paragraph","data":{"text":"Детям с почечной недостаточностью дозу корректируют с учетом КК и массы тела."}},{"type":"paragraph","data":{"text":"Отдельные группы пациентов"}},{"type":"paragraph","data":{"text":"Пациенты пожилого возраста"}},{"type":"paragraph","data":{"text":"Из-за возможного снижения функции почек режим дозирования препарата следует корректировать (смотри подраздел \"Пациенты с почечной недостаточностью\" раздела \"Способ применения и дозы\")."}},{"type":"paragraph","data":{"text":"Пациенты с почечной недостаточностью"}},{"type":"paragraph","data":{"text":"Поскольку препарат Цетиризин выводится из организма в основном почками (смотри подраздел \"Фармакокинетика\") при невозможности альтернативного лечения пациентов с почечной недостаточностью режим дозирования препарата следует корректировать в зависимости от функции почек (величины клиренса креатинина - КК). КК для мужчин можно рассчитать исходя из концентрации сывороточного креатинина по следующей формуле:"}},{"type":"paragraph","data":{"text":"КК для женщин можно рассчитать умножив полученное значение на коэффициент 085."}},{"type":"paragraph","data":{"text":"Дозирование у взрослых пациентов с почечной недостаточностью:"}},{"type":"paragraph","data":{"text":"Почечная недостаточность"}},{"type":"paragraph","data":{"text":"КК (мл/мин)"}},{"type":"paragraph","data":{"text":"Режим дозирования"}},{"type":"paragraph","data":{"text":"Норма"}},{"type":"paragraph","data":{"text":"≥ 80"}},{"type":"paragraph","data":{"text":"10 мг (20 капель) 1 раз в день"}},{"type":"paragraph","data":{"text":"Легкая"}},{"type":"paragraph","data":{"text":"50-79"}},{"type":"paragraph","data":{"text":"10 мг (20 капель) 1 раз в день"}},{"type":"paragraph","data":{"text":"Средняя"}},{"type":"paragraph","data":{"text":"30-49"}},{"type":"paragraph","data":{"text":"5 мг (10 капель) 1 раз в день"}},{"type":"paragraph","data":{"text":"Тяжелая"}},{"type":"paragraph","data":{"text":"10-30"}},{"type":"paragraph","data":{"text":"5 мг (10 капель) через день"}},{"type":"paragraph","data":{"text":"Терминальная стадия - пациенты находящиеся на диализе"}},{"type":"paragraph","data":{"text":"< 10"}},{"type":"paragraph","data":{"text":"прием препарата противопоказан"}},{"type":"paragraph","data":{"text":"Пациенты с нарушением функции печени"}},{"type":"paragraph","data":{"text":"У пациентов с нарушением только функции печени коррекции режима дозирования не требуется."}},{"type":"paragraph","data":{"text":"У пациентов с нарушением и функции печени и функции почек рекомендуется коррекция режима дозирования (смотри таблицу выше)."}},{"type":"paragraph","data":{"text":"Если после лечения улучшения не наступает или появляются новые симптомы необходимо проконсультироваться с врачом."}},{"type":"paragraph","data":{"text":"Применяйте препарат только согласно тому способу применения и в тех дозах которые указаны в инструкции."}},{"type":"paragraph","data":{"text":"Инструкция для открытия флакона"}},{"type":"paragraph","data":{"text":"Флакон закрыт крышкой с контролем первого вскрытия и защитой препятствующей его открытию детьми. Флакон открывается при сильном нажатии крышки вниз с последующим ее отвинчиванием против хода часовой стрелки. После использования крышку флакона необходимо вновь крепко завинтить."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Данные полученные в клинических исследованиях"}},{"type":"paragraph","data":{"text":"Обзор"}},{"type":"paragraph","data":{"text":"Результаты клинических исследований продемонстрировали что применение цетиризина в рекомендованных дозах приводит к развитию незначительных нежелательных эффектов на ЦНС включая сонливость утомляемость головокружение и головную боль. В некоторых случаях была зарегистрирована парадоксальная стимуляция ЦНС."}},{"type":"paragraph","data":{"text":"Несмотря на то что цетиризин является селективным блокатором периферических Н1-рецепторов и практически не оказывает антихолинергического действия сообщалось о единичных случаях затруднения мочеиспускания нарушениях аккомодации и сухости во рту."}},{"type":"paragraph","data":{"text":"Сообщалось о нарушениях функции печени сопровождающихся повышением активности печеночных ферментов и уровня билирубина. В большинстве случаев нежелательные явления разрешались после прекращения приема цетиризина."}},{"type":"paragraph","data":{"text":"Перечень нежелательных побочных эффектов"}},{"type":"paragraph","data":{"text":"Имеются данные полученные в ходе двойных слепых контролируемых клинических исследований направленных на сравнение цетиризина и плацебо или других антигистаминных препаратов применяемых в рекомендованных дозах (10 мг один раз в сутки для цетиризина) более чем у 3200 пациентов на основании которых можно провести достоверный анализ данных по безопасности."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Симптомы"}},{"type":"paragraph","data":{"text":"Симптомы наблюдаемые после явной передозировки препаратом влияли на центральную нервную систему или были связаны с возможным антихолинергическим эффектом. Симптомы которые наблюдались после приема по меньшей мере пятикратного количества рекомендуемой суточной дозы включали следующее: спутанность сознания диарея утомляемость головная боль недомогание мидриаз зуд беспокойство седативный эффект сонливость ступор тахикардия тремор задержка мочи."}},{"type":"paragraph","data":{"text":"Лечение"}},{"type":"paragraph","data":{"text":"Специфического антидота нет."}},{"type":"paragraph","data":{"text":"В случае передозировки рекомендуется симптоматическое или поддерживающее лечение. Промывание желудка и/или прием активированного угля может быть эффективным если передозировка произошла недавно. Цетиризин частично выводится при диализе."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Одновременное применение с азитромицином циметидином эритромицином кетоконазолом или псевдоэфедрином не влияет на фармакокинетические параметры цетиризина. Фармакокинетических взаимодействий не наблюдалось. Согласно испытаниям invitro цетиризин не влияет на эффект связывания белка варфарина. Одновременный прием азитромицина эритромицина кетоконазола теофиллина и псевдоэфедрина не выявил существенных изменений в клинических лабораторных показателях жизненно важных функциях и ЭКГ. В исследовании с одновременным приемом теофиллина (400 мг в день) и цетиризина (20 мг в день) было обнаружено незначительное но статистически достоверное повышение 24-часовой AUC (площади под кривой) на 19 % для цетиризина и на 11 % для теофиллина. Кроме того максимальные уровни в плазме крови увеличились до 77 % и 64 % соответственно для цетиризина и теофиллина. Одновременно клиренс цетиризина уменьшился на -16 % а также на -10 % в случае теофиллина когда цетиризин принимали пациенты которые ранее получали лечение теофиллином. Тем не менее предварительное лечение цетиризином не оказало существенного влияния на фармакокинетические параметры теофиллина."}},{"type":"paragraph","data":{"text":"После однократного приема цетиризина в дозе 10 мг эффект алкоголя (08 %о) значительно не усиливался; статистически значимое взаимодействие с 5 мг диазепама было доказано в одном из 16 психометрических тестов."}},{"type":"paragraph","data":{"text":"Одновременный прием 10 мг цетиризина в день с глипизидом привел к незначительному снижению показателей глюкозы. Этот эффект не имеет клинического значения. Тем не менее рекомендуется раздельный прием - глипизид утром и цетиризин вечером. Степень всасывания цетиризина не снижается при одновременном приеме пищи хотя всасывание замедляется на 1 час."}},{"type":"paragraph","data":{"text":"В исследовании с многократным приемом ритонавира (600 мг два раза в день) и цетиризина (10 мг в день) степень экспозиции цетиризина была увеличена примерно на 40 % в то время как экспозиция ритонавира незначительно изменилась (-11 %) вследствие сопутствующего приема цетиризина."}},{"type":"paragraph","data":{"text":"Если Вы применяете вышеперечисленные или другие лекарственные препараты (в том числе безрецептурные) перед применением препарата Цетиризин проконсультируйтесь с врачом."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Ввиду потенциального угнетающего влияния на центральную нервную систему следует соблюдать осторожность при назначении препарата Цетиризин детям в возрасте от 6 месяцев до 1 года при наличии следующих факторов риска возникновения синдрома внезапной детской смерти таких как (но не ограничиваясь этим списком):"}},{"type":"paragraph","data":{"text":"- синдром апноэ во сне или синдром внезапной детской смерти детей грудного возраста у брата или сестры;"}},{"type":"paragraph","data":{"text":"- злоупотребление матери наркотиками или курением во время беременности;"}},{"type":"paragraph","data":{"text":"- молодой возраст матери (19 лет и моложе);"}},{"type":"paragraph","data":{"text":"- злоупотребление курением няни ухаживающей за ребенком (одна пачка сигарет в день или более);"}},{"type":"paragraph","data":{"text":"- дети регулярно засыпающие лицом вниз и которых не укладывают на спину;"}},{"type":"paragraph","data":{"text":"- недоношенные (гестационный возраст менее 37 недель) или рожденные с недостаточной массой тела (ниже 10-ого перцентиля от гестационного возраста) дети;"}},{"type":"paragraph","data":{"text":"- при совместном приеме препаратов оказывающих угнетающее влияние на центральную нервную систему."}},{"type":"paragraph","data":{"text":"В состав препрата входят вспомогательные вещества метилпарабензол и пропилпарабензол которые могут вызвать аллергические реакции в том числе замедленного типа."}},{"type":"paragraph","data":{"text":"У пациентов с повреждением спинного мозга гиперплазией предстательной железы а также при наличии других предрасполагающих факторов к задержке мочи требуется соблюдение осторожности так как цетиризин может увеличивать риск задержки мочи."}},{"type":"paragraph","data":{"text":"У пациентов с почечной недостаточностью режим дозирования препарата следует корректировать (смотри раздел \"Способ применения и дозы\")."}},{"type":"paragraph","data":{"text":"Из-за возможного снижения функции почек у пациентов пожилого возраста режим дозирования препарата следует корректировать (смотри раздел \"Способ применения и дозы\")."}},{"type":"paragraph","data":{"text":"Рекомендовано соблюдать осторожность при применении цетиризина одновременно с алкоголем так как цетиризин может привести к повышенной сонливости."}},{"type":"paragraph","data":{"text":"Осторожность следует соблюдать у пациентов с эпилепсией и повышенной судорожной готовностью."}},{"type":"paragraph","data":{"text":"Перед назначением аллергологических проб рекомендован трехдневный \"отмывочный\" период ввиду того что H1-гистаминовых рецепторов блокаторы ингибируют развитие кожных аллергических реакций."}},{"type":"paragraph","data":{"text":"Внимательно прочтите инструкцию перед тем как начать применение препарата. Сохраните инструкцию она может понадобиться вновь. Если у Вас возникли вопросы обратитесь к врачу. Лекарственное средство которым Вы лечитесь предназначено лично Вам и его не следует передавать другим лицам поскольку оно может причинить им вред даже при наличии тех же симптомов что и у Вас."}},{"type":"header","data":{"text":"Влияние на способность управлять трансп. ср. и мех.:","level":3}},{"type":"paragraph","data":{"text":"Цетиризин может привести к повышенной сонливости следовательно препарат Цетиризин может оказывать влияние на способность управлять транспортными средствами механизмами."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"В пачке при температуре не выше 25 °С."}},{"type":"paragraph","data":{"text":"Хранить в недоступном для детей месте."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года."}},{"type":"paragraph","data":{"text":"Не использовать по истечении срока годности."}}]}],"source":null},"description_toggle":false,"short_description":"Механизм действия Цетиризин является метаболитом гидроксизина обладает антигистаминным эффектом с противоаллергическим действием. Цетиризин относится к группе конкурентных антагонистов гистамина и блокирует H1-гистаминовые рецепторы с небольшим воздействием на другие рецепторы и практически не оказывает антихолинергического и антисеротонинового действия. Цетиризин оказывает влияние на гистаминзависимую стадию аллергических реакций немедленного действия а также уменьшает миграцию эозинофилов и ограничивает высвобождение медиаторов при аллергических реакциях замедленного типа. Практически не проходит через гематоэнцефалический барьер и следовательно почти не способен достичь центральных рецепторов H1. Фармакодинамика В исследованиях влияния гистамина на кожу действие цетиризина в дозе 10 мг начиналось через I час достигало максимума со 2-ого по 12-ый час и все еще наблюдалось на статистически значимых уровнях через 24 часа. В дополнении к антигистаминному эффекту цетиризин также обладает противовоспалительным эффектом и тем самым оказывает влияние на позднюю фазу аллергической реакции: - при дозе 10 мг один или два раза в день ингибирует позднюю фазу агрегации эозинофилов в коже; - при дозе 30 мг в день ингибирует выведение эозинофилов в бронхиальную альвеолярную жидкость после вызванного аллергеном бронхиального сужения; - ингибирует вызванную калликреином позднюю воспалительную реакцию; - подавляет экспрессию маркеров воспаления таких как 1САМ-1 или VCAM-1; - ингибирует действие гистаминолибераторов таких как PAF или субстанция Р. Фармакокинетика: Всасывание После приема внутрь препарат быстро абсорбируется из желудочно-кишечного тракта. Фармакокинетические параметры цетиризина при его применении в дозах от 5 до 60 мг изменяются линейно. Равновесная концентрация достигается через 3 дня. Фармакокинетический профиль цетиризина аналогичен у взрослых и детей. У детей после приема цетиризина в дозе 5 мг концентрация активной субстанции в организме такая же как и у взрослых после приема 10 мг. У взрослых после приема цетиризина в дозе 10 мг максимальная концентрация (Сmах) в плазме крови достигается через 1-2 часа и составляет 350 нг/мл. У детей после приема цетиризина в дозе 5 мг Сmах в плазме крови достигается через 1 час и составляет 275 нг/мл. При приеме цетиризина в форме капель максимальные концентрации в плазме крови достигаются с более высокой скоростью. Распределение Распределение после приема 10 мг составляет 35 литров у взрослых а связывание с белками плазмы крови - 93 %. У детей объем распределения после приема 5 мг составляет примерно 17 литров. Незначительное количество цетиризина выделяется в грудное молоко. Метаболизм У взрослых 60 % дозы выводится из организма в неизменном виде почками. Выведение После приема 10 мг у взрослых общий клиренс цетиризина составляет 060 мл/мин/кг; период полувыведения (Т1/2) составляет примерно 10 часов. Прием нескольких доз не изменяет фармакокинетические параметры. При приеме препарата в суточной дозе 10 мг в течение 10 дней кумуляции цетиризина не наблюдалось. После окончания лечения уровень цетиризина в плазме крови быстро падает ниже определяемых пределов. Повторные аллергологические тесты можно возобновить через 3 дня. Отдельные группы пациентов Пожилые пациенты: У 16 пожилых лиц при однократном приеме препарата в дозе 10 мг Т1/2 был выше на 50 % а скорость выведения была ниже на 40 % по сравнению с контрольной группой. Снижение клиренса цетиризина у пожилых пациентов вероятно связано с уменьшением функции почек у этой категории пациентов. Дети: У детей от 6 до 12 лет 70 % дозы выводится из организма в неизменном виде почками. После приема 5 мг у детей общий клиренс цетиризина составляет 093 мл/мин/кг. Т1/2 у детей от 6 до 12 лет составляет 6 часов от 2 до 6 лет - 5 часов от 6 месяцев до 2 лет - снижено до 31 часа. Пациенты с почечной недостаточностью: У пациентов с почечной недостаточностью легкой степени тяжести (клиренс креатинина (КК) \u003e 50 мл/мин) фармакокинетические параметры аналогичны таковым \\ здоровых добровольцев с нормальной функцией почек. У пациентов с почечной недостаточностью средней степени тяжести (КК 30-49 мл/мин) Т1/2 удлиняется в 3 раза а общий клиренс снижается на 70 % относительно здоровых добровольцев с нормальной функцией почек. У пациентов находящихся на гемодиализе (КК\u003c7 мл/мин) при приеме препарата внутрь в дозе 10 мг общий клиренс снижается приблизительно на 70 % относительно здоровых добровольцев с нормальной функцией почек а Т1/2 удлиняется в 3 раза. Менее 10 % цетиризина удаляется в ходе стандартной процедуры гемодиализа. Пациенты с печеночной недостаточностью: У пациентов с хроническими заболеваниями печени (гепатоцеллюлярным холестатическим и билиарным циррозом) при однократном приеме препарата в дозе 10 или 20 мг Т1/2 увеличивается примерно на 50 % а клиренс снижается на 40 % по сравнению со здоровыми субъектами. Коррекция дозы необходима только в случае если у пациента с печеночной недостаточностью имеется также сопутствующая почечная недостаточность.","substance":[{"id":197,"title":"Цетиризин","title_latin":"Cetirizinum","slug":"tsetirizin_197"}],"branding":null,"valid_for_quick_buy":true,"is_available_to_delivery":true,"comments":null,"image_alt":"Цетиризин - фото упаковки","image_share":{"isTouch":{"default":"https://vseapteki.ru/cropping/thumbnails/101/82805/share_default/"},"isFromTablet":{"default":"https://vseapteki.ru/cropping/thumbnails/101/82805/share_default/"}},"diseases":[],"other_packages":[{"id":183140,"title":"Цетиризин","subtitle":{"full":"Капли, флакон, 20 мл, 10 мг / мл, для приема внутрь","short":"Капли, 20 мл, 10 мг / мл","package":"20 мл, 10 мг / мл"},"prescription":false,"catalog_section_id":100276,"manufacturer":{"id":2502,"title":"Обновление 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