Левоцетиризин, (R)-энантиомер цетиризина, является ингибитором периферических Н1-гистаминовых рецепторов, сродство которого в 2 раза выше, чем у цетиризина. После однократного приема левоцетиризина наблюдалось связывание Н1-гистаминовых рецепторов на 90% через 4 ч и на 57% через 24 ч.; Оказывает влияние на гистаминозависимую стадию аллергических реакций; уменьшает миграцию эозинофилов, уменьшает сосудистую проницаемость, ограничивает высвобождение медиаторов воспаления. Предупреждает развитие и облегчает течение аллергических реакций, оказывает антиэкссудативное, противозудное действие; практически не оказывает антихолинергического и антисеротонинового действия. В терапевтических дозах практически не оказывает седативного действия. Действие начинается через 12 мин после приема однократной дозы у 50% пациентов, через 1 ч у 95% пациентов и продолжается в течение 24 ч. Не оказывает влияния на интервал QT на ЭКГ.
Показания к применению
Лечение симптомов круглогодичного (персистирующего) и сезонного (интермиттирующего) аллергических ринитов и аллергического конъюнктивита, таких как зуд, чихание, заложенность носа, ринорея, слезотечение, гиперемия конъюнктивы
Поллиноз (сенная лихорадка)
Крапивница, в т.ч. хроническая идиопатическая крапивница
Отек Квинке (в качестве вспомогательной терапии)
Другие аллергические дерматозы, сопровождающиеся зудом и высыпаниями
Противопоказания
Гиперчувствительность к левоцетиризину и другим производным пиперазина или к любому из вспомогательных компонентов препарата
Повышенная чувствительность к другим производным пиперазина
Терминальная почечная недостаточность с КК менее 10 мл/мин
Беременность
Детский возраст до 6 лет (для данной лекарственной формы)
Врожденная непереносимость галактозы, дефицит лактазы или мальабсорбция глюкозы-галактозы (из-за содержания в препарате лактозы)
С осторожностью:
Хроническая почечная недостаточность с КК более 10 мл/мин, но менее 50 мл/мин (требуется коррекция режима дозирования)
Пожилой возраст (возможно снижение клубочковой фильтрации)
Необходимо соблюдать осторожность при одновременном приеме с алкоголем
Применение при беременности и в период грудного вскармливания
Применение препарата при беременности противопоказано.; Левоцетиризин выделяется с грудным молоком, поэтому при необходимости применения препарата в период лактации грудное вскармливание рекомендуется прекратить.
Способ применения и дозы
Таблетку следует принимать внутрь, не разжевывая и запивая жидкостью, независимо от приема пищи. Рекомендуется принимать суточную дозу в один прием. Взрослые, подростки и дети старше 6 лет Рекомендуемая суточная доза составляет 5 мг (1 таблетка).; Пациенты пожилого возраста; У пожилых пациентов с умеренной и тяжелой почечной недостаточностью рекомендуется коррекция дозы (см. "Пациенты с нарушением функции почек" ниже).; Пациенты с нарушением функции почек; Интервал между приемами препарата определяют индивидуально с учетом функции почек. Информация о коррекции дозы приведена в таблице ниже. Для ее использования следует рассчитать КК (мл/мин) на основании концентрации креатинина в сыворотке (мг/дл); КК для мужчин можно рассчитать, исходя из концентрации сывороточного креатинина, по следующей формуле: КК (мл/мин) =[140 - возраст (лет)]×масса тела (кг)/72×ККсыворот, (мг/дл); КК для женщин можно рассчитать, умножив полученное значение на коэффициент 0.85.; Коррекция дозы у пациентов с нарушением функции почек; Группа КК (мл/мин) Доза и кратность приема; Нормальная функция >80 5 мг 1 раз/сут; Легкая ХПН 50-79 5 мг 1 раз/сут; Умеренная ХПН 30-49 5 мг 1 раз в 2 суток; Тяжелая ХПН <30 5 мг 1 раз в 3 суток; Терминальная ХПН — пациенты на диализе <10 Противопоказано; У детей с нарушением функции почек дозу корректируют индивидуально с учетом КК и массы тела. Отдельных данных по применению у детей с нарушением функции почек нет.; При изолированном нарушении функции печени коррекции дозы не требуется. У пациентов с печеночно-почечной недостаточностью рекомендуется коррекция дозы.; Продолжительность лечения; Лечение аллергического ринита проводят в соответствии с течением заболевания; прием препарата можно прекратить при исчезновении симптомов и возобновить при рецидиве. В случае хронического аллергического ринита может быть прописано продолжительное лечение в период действия аллергенов. В настоящее время клинический опыт применения левоцетиризина в виде таблеток, покрытых пленочной оболочкой, 5 мг ограничен 6 месяцами.
Побочное действие
Определение частоты побочных реакций (в соответствии с MedDRA): очень часто (≥1/10), часто (≥1/100, <1/10), нечасто (≥1/1000, <1/100), редко (≥1/10 000, <1/1000), очень редко (< 1/10 000), частота неизвестна (по имеющимся данным определить частоту встречаемости побочного эффекта не представляется возможным).; Со стороны иммунной системы: очень редко - реакции гиперчувствительности, в т.ч. анафилактические реакции.; Со стороны нервной системы: часто - головная боль; нечасто - сонливость; очень редко - агрессия, возбуждение, галлюцинации, депрессия, судороги.; Со стороны органа зрения: очень редко - зрительные расстройства.; Со стороны сердечно-сосудистой системы: очень редко - ощущение сердцебиения, тахикардия.; Со стороны дыхательной системы: очень редко - одышка.; Со стороны пищеварительной системы: часто - сухость слизистой оболочки полости рта; нечасто - боли в животе; очень редко - тошнота, диарея, гепатит.; Со стороны кожи и подкожных тканей: очень редко - зуд, сыпь.; Аллергические реакции: очень редко - ангионевротический отек, лекарственная сыпь, крапивница.; Со стороны костно-мышечной системы: очень редко - миалгия.; Общие реакции: часто - утомляемость; нечасто - астения.; Со стороны лабораторных показателей: очень редко - нарушение показателей функции печени, увеличение массы тела.
Передозировка
Симптомы: возможны сонливость у взрослых и возбуждение, а также беспокойство, сменяющиеся сонливостью, у детей.; Лечение: специфических антидотов левоцетиризина нет. В случае передозировки рекомендуется симптоматическое или поддерживающее лечение. Если после приема препарата прошло немного времени, следует провести промывание желудка. Левоцетиризин практически не выводится при гемодиализе.
Особые указания
Во время лечения препаратом не рекомендуется принимать этанол.; Влияние на способность к вождению автотранспорта и управлению механизмами; Левоцетиризин, при его приеме в рекомендованных дозах, не оказывает отрицательного влияния на внимание и скорость психомоторных реакций и способность управлять транспортными средствами. Тем не менее, в период приема препарата целесообразно воздерживаться от занятий потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций.
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дигидрохлорид 5 мг.; Вспомогательные вещества: лактозы моногидрат - 67.5 мг, целлюлоза микрокристаллическая - 25 мг, карбоксиметилкрахмал натрия - 1 мг, кремния диоксид коллоидный - 0.5 мг, магния стеарат - 1 мг.; Состав пленочной оболочки: гипромеллоза 2910/5 - 3.3 мг, макрогол 6000 - 0.35 мг, тальк - 0.85 мг, титана диоксид (E171) - 0.5 мг."}}]},{"id":2,"name":"Фармакологические свойства","slug":"pharmacologic_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Левоцетиризин, (R)-энантиомер цетиризина, является ингибитором периферических Н1-гистаминовых рецепторов, сродство которого в 2 раза выше, чем у цетиризина. После однократного приема левоцетиризина наблюдалось связывание Н1-гистаминовых рецепторов на 90% через 4 ч и на 57% через 24 ч.; Оказывает влияние на гистаминозависимую стадию аллергических реакций; уменьшает миграцию эозинофилов, уменьшает сосудистую проницаемость, ограничивает высвобождение медиаторов воспаления. Предупреждает развитие и облегчает течение аллергических реакций, оказывает антиэкссудативное, противозудное действие; практически не оказывает антихолинергического и антисеротонинового действия. В терапевтических дозах практически не оказывает седативного действия. Действие начинается через 12 мин после приема однократной дозы у 50% пациентов, через 1 ч у 95% пациентов и продолжается в течение 24 ч. Не оказывает влияния на интервал QT на ЭКГ."}}]},{"id":3,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"list","data":{"style":"unordered","items":["Лечение симптомов круглогодичного (персистирующего) и сезонного (интермиттирующего) аллергических ринитов и аллергического конъюнктивита, таких как зуд, чихание, заложенность носа, ринорея, слезотечение, гиперемия конъюнктивы","Поллиноз (сенная лихорадка)","Крапивница, в т.ч. хроническая идиопатическая крапивница","Отек Квинке (в качестве вспомогательной терапии)","Другие аллергические дерматозы, сопровождающиеся зудом и высыпаниями"]}}]},{"id":4,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"list","data":{"style":"unordered","items":["Гиперчувствительность к левоцетиризину и другим производным пиперазина или к любому из вспомогательных компонентов препарата","Повышенная чувствительность к другим производным пиперазина","Терминальная почечная недостаточность с КК менее 10 мл/мин","Беременность","Детский возраст до 6 лет (для данной лекарственной формы)","Врожденная непереносимость галактозы, дефицит лактазы или мальабсорбция глюкозы-галактозы (из-за содержания в препарате лактозы)"]}},{"type":"paragraph","data":{"text":"С осторожностью:"}},{"type":"list","data":{"style":"unordered","items":["Хроническая почечная недостаточность с КК более 10 мл/мин, но менее 50 мл/мин (требуется коррекция режима дозирования)","Пожилой возраст (возможно снижение клубочковой фильтрации)","Необходимо соблюдать осторожность при одновременном приеме с алкоголем"]}}]},{"id":5,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Применение препарата при беременности противопоказано.; Левоцетиризин выделяется с грудным молоком, поэтому при необходимости применения препарата в период лактации грудное вскармливание рекомендуется прекратить."}}]},{"id":6,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Таблетку следует принимать внутрь, не разжевывая и запивая жидкостью, независимо от приема пищи. Рекомендуется принимать суточную дозу в один прием. Взрослые, подростки и дети старше 6 лет Рекомендуемая суточная доза составляет 5 мг (1 таблетка).; Пациенты пожилого возраста; У пожилых пациентов с умеренной и тяжелой почечной недостаточностью рекомендуется коррекция дозы (см. \"Пациенты с нарушением функции почек\" ниже).; Пациенты с нарушением функции почек; Интервал между приемами препарата определяют индивидуально с учетом функции почек. Информация о коррекции дозы приведена в таблице ниже. Для ее использования следует рассчитать КК (мл/мин) на основании концентрации креатинина в сыворотке (мг/дл); КК для мужчин можно рассчитать, исходя из концентрации сывороточного креатинина, по следующей формуле: КК (мл/мин) =[140 - возраст (лет)]×масса тела (кг)/72×ККсыворот, (мг/дл); КК для женщин можно рассчитать, умножив полученное значение на коэффициент 0.85.; Коррекция дозы у пациентов с нарушением функции почек; Группа КК (мл/мин) Доза и кратность приема; Нормальная функция \u003e80 5 мг 1 раз/сут; Легкая ХПН 50-79 5 мг 1 раз/сут; Умеренная ХПН 30-49 5 мг 1 раз в 2 суток; Тяжелая ХПН \u003c30 5 мг 1 раз в 3 суток; Терминальная ХПН — пациенты на диализе \u003c10 Противопоказано; У детей с нарушением функции почек дозу корректируют индивидуально с учетом КК и массы тела. Отдельных данных по применению у детей с нарушением функции почек нет.; При изолированном нарушении функции печени коррекции дозы не требуется. У пациентов с печеночно-почечной недостаточностью рекомендуется коррекция дозы.; Продолжительность лечения; Лечение аллергического ринита проводят в соответствии с течением заболевания; прием препарата можно прекратить при исчезновении симптомов и возобновить при рецидиве. В случае хронического аллергического ринита может быть прописано продолжительное лечение в период действия аллергенов. В настоящее время клинический опыт применения левоцетиризина в виде таблеток, покрытых пленочной оболочкой, 5 мг ограничен 6 месяцами."}}]},{"id":7,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Определение частоты побочных реакций (в соответствии с MedDRA): очень часто (≥1/10), часто (≥1/100, \u003c1/10), нечасто (≥1/1000, \u003c1/100), редко (≥1/10 000, \u003c1/1000), очень редко (\u003c 1/10 000), частота неизвестна (по имеющимся данным определить частоту встречаемости побочного эффекта не представляется возможным).; Со стороны иммунной системы: очень редко - реакции гиперчувствительности, в т.ч. анафилактические реакции.; Со стороны нервной системы: часто - головная боль; нечасто - сонливость; очень редко - агрессия, возбуждение, галлюцинации, депрессия, судороги.; Со стороны органа зрения: очень редко - зрительные расстройства.; Со стороны сердечно-сосудистой системы: очень редко - ощущение сердцебиения, тахикардия.; Со стороны дыхательной системы: очень редко - одышка.; Со стороны пищеварительной системы: часто - сухость слизистой оболочки полости рта; нечасто - боли в животе; очень редко - тошнота, диарея, гепатит.; Со стороны кожи и подкожных тканей: очень редко - зуд, сыпь.; Аллергические реакции: очень редко - ангионевротический отек, лекарственная сыпь, крапивница.; Со стороны костно-мышечной системы: очень редко - миалгия.; Общие реакции: часто - утомляемость; нечасто - астения.; Со стороны лабораторных показателей: очень редко - нарушение показателей функции печени, увеличение массы тела."}}]},{"id":8,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Симптомы: возможны сонливость у взрослых и возбуждение, а также беспокойство, сменяющиеся сонливостью, у детей.; Лечение: специфических антидотов левоцетиризина нет. В случае передозировки рекомендуется симптоматическое или поддерживающее лечение. Если после приема препарата прошло немного времени, следует провести промывание желудка. Левоцетиризин практически не выводится при гемодиализе."}}]},{"id":9,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Во время лечения препаратом не рекомендуется принимать этанол.; Влияние на способность к вождению автотранспорта и управлению механизмами; Левоцетиризин, при его приеме в рекомендованных дозах, не оказывает отрицательного влияния на внимание и скорость психомоторных реакций и способность управлять транспортными средствами. Тем не менее, в период приема препарата целесообразно воздерживаться от занятий потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций."}}]}],"source":{"title":"36.6","url":"https://366.ru"}},"description_toggle":false,"short_description":"Левоцетиризин, (R)-энантиомер цетиризина, является ингибитором периферических Н1-гистаминовых рецепторов, сродство которого в 2 раза выше, чем у цетиризина. После однократного приема левоцетиризина наблюдалось связывание Н1-гистаминовых рецепторов на 90% через 4 ч и на 57% через 24 ч.; Оказывает влияние на гистаминозависимую стадию аллергических реакций; уменьшает миграцию эозинофилов, уменьшает сосудистую проницаемость, ограничивает высвобождение медиаторов воспаления. Предупреждает развитие и облегчает течение аллергических реакций, оказывает антиэкссудативное, противозудное действие; практически не оказывает антихолинергического и антисеротонинового действия. В терапевтических дозах практически не оказывает седативного действия. Действие начинается через 12 мин после приема однократной дозы у 50% пациентов, через 1 ч у 95% пациентов и продолжается в течение 24 ч. 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