Цетиризин является карбоксилированным метаболитом гидроксизина, принадлежит к классу антигистаминных препаратов производных пиперазина. Действие цетиризина и его противоаллергические эффекты основаны на избирательной блокаде периферических гистаминовых H1-рецепторов. При помощи этого механизма цетиризин подавляет ранние аллергические реакции, опосредованные гистамином, снижает миграцию клеток воспаления и высвобождение медиаторов, связанных с поздними аллергическими реакциями. Цетиризин имеет лишь незначительные антихолинергические и антисеротонинергические эффекты.
Показания к применению
Сезонный и круглогодичный аллергический ринит и конъюнктивит
Поллиноз (сенная лихорадка)
Зудящие аллергические дерматозы
Крапивница (в т.ч. хроническая идиопатическая)
Отек Квинке
Противопоказания
Почечная недостаточность (КК менее 10 мл/мин)
Беременность
Период лактации (грудное вскармливание)
Детский возраст до 1 года
Повышенная чувствительность к цетиризину или другим компонентам препарата.C осторожностью следует применять препарат при хронической почечной недостаточности средней и тяжелой степени (требуется коррекция режима дозирования), а также у пациентов пожилого возраста (требуется коррекция режима дозирования)
Применение при беременности и в период грудного вскармливания
Отсутствуют данные клинических исследований применения препарата при беременности, в связи с чем Парлазин; противопоказан при беременности. Цетиризин выделяется с грудным молоком, поэтому препарат противопоказан во время грудного вскармливания. При необходимости применения препарата в период лактации необходимо решить вопрос о прекращении грудного вскармливания.
Способ применения и дозы
Препарат принимают внутрь. Капли перед приемом растворяют в небольшом количестве воды. Взрослым и детям в возрасте от 12 лет: по 10 мг (20 капель) 1 раз/сут, предпочтительно на ночь. Детям в возрасте 1-2 лет: по 2.5 мг (5 капель) 2 раза/сут. Детям в возрасте 2-6 лет: по 5 мг (10 капель) однократно. Так же можно разделить эту дозу на два приема по 2.5 мг (по 5 капель утром и вечером). Детям в возрасте 6-12 лет: по 5 мг (10 капель) 2 раза/сут утром и вечером; или 10 мг (20 капель) вечером. Может возникнуть необходимость снижения дозы у пожилых пациентов. При нарушении функции почек дозу следует устанавливать индивидуально в соответствии с функцией почек. Приведенная ниже таблица окажет помощь в подборе дозы. Для использования этой таблицы следует оценить КК у пациента в мл/мин. После определения концентрации креатинина сыворотки крови (мг%) значение КК (мл/мин) можно оценить по следующей формуле: КК = [140 - возраст (лет)] × масса тела (кг)/72 - креатинин сыворотки крови (мг%)У женщин полученное значение следует умножить на 0.85Подбор дозы в зависимости от КККК (мл/мин) Дозирование≥80 10 мг 1 раз/сут50-79 10 мг 1 раз/сут30-49 5 мг 1 раз/сут11-29 5 мг 1 раз в два дня≤10 (гемодиализ) Противопоказано
Побочное действие
Обычно препарат переносится хорошо. В очень редких случаях возможно возникновение нижеследующих побочных эффектов. Со стороны органов кроветворения: тромбоцитопения. Со стороны нервной системы: сонливость, головокружение, головная боль, агрессия, возбуждение, спутанность сознания, депрессия, галлюцинации, бессонница, тик, судороги, дискинезния, дистония, парастезии, обморок, тремор. Со стороны органа зрения: нарушение аккомодации, нарушение зрительного восприятия, нистагм. Со стороны сердечно-сосудистой системы: тахикардия. Со стороны дыхательной системы: ринит, фарингит. Со стороны пищеварительной системы: сухость слизистой оболочки полости рта, тошнота, боль в животе, диарея, нарушение функции печени (повышение активности печеночных трансаминаз, щелочной фосфатазы, ГГТ, концентрации билирубина). Со стороны мочевыделительной системы: расстройство мочеиспускания, недержание мочи. Со стороны кожи и подкожной клетчатки: зуд, сыпь, крапивница, ангионевротический отек. Аллергические реакции: гиперчувствительность, вплоть до развития анафилактического шока. Прочие: увеличение массы тела, усталость, астения, недомогание, отеки.
При появлении реакций гиперчувствителъности прием препарата следует немедленно прекратить. Из-за снижения скорости выведения цетиризина он может накапливаться в организме пациентов с нарушенной функцией почек; при этом может возрастать частота и тяжесть побочных антихолинергических эффектов или действие на ЦНС, даже в случае приема обычной дозы для взрослых. Поэтому в таких случаях рекомендуется снижать дозу. Пожилые пациенты особенно чувствительны к антихолинергическому действию антигистаминных препаратов (например, сухость во рту, задержка мочи). Если эти побочные эффекты наблюдаются длительно, а также при нарастании их интенсивности, прием препарата следует прекратить. Несмотря на то, что цетиризин редко вызывает антихолинергические побочные эффекты или тяжелое побочное действие на ЦНС, он может накапливаться (возрастное снижение почечной функции более вероятно у пожилых пациентов) и вызывать антихолинергические побочные эффекты или побочное действие на ЦНС даже при введении обычной дозы для взрослых. Капли содержат вспомогательное вещество метилпарагидроксибензоат, который может вызвать поздние аллергические реакции. Прием препарата Парлазин; следует прекратить не менее чем за 3 дня до выполнения аллергической кожной пробы во избежание ложноотрицательных результатов. Влияние на способность к вождению автотранспорта и управлению механизмамиВ период лечения необходимо соблюдать осторожность при вождении автотранспорта и занятии другими потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций.
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Вспомогательные вещества: глицерол - 250 мг, пропиленгликоль - 350 мг, натрия сахаринат - 10 мг, натрия ацетата тригидрат - 10 мг, метилпарагидроксибензоат - 1.35 мг, пропилпарагидроксибензоат - 0.15 мг, ледяная уксусная кислота - 0.5 мг, вода очищенная - до 1 мл."}}]},{"id":2,"name":"Фармакологические свойства","slug":"pharmacologic_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Цетиризин является карбоксилированным метаболитом гидроксизина, принадлежит к классу антигистаминных препаратов производных пиперазина. Действие цетиризина и его противоаллергические эффекты основаны на избирательной блокаде периферических гистаминовых H1-рецепторов. При помощи этого механизма цетиризин подавляет ранние аллергические реакции, опосредованные гистамином, снижает миграцию клеток воспаления и высвобождение медиаторов, связанных с поздними аллергическими реакциями. 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При нарушении функции почек дозу следует устанавливать индивидуально в соответствии с функцией почек. Приведенная ниже таблица окажет помощь в подборе дозы. Для использования этой таблицы следует оценить КК у пациента в мл/мин. После определения концентрации креатинина сыворотки крови (мг%) значение КК (мл/мин) можно оценить по следующей формуле: КК = [140 - возраст (лет)] × масса тела (кг)/72 - креатинин сыворотки крови (мг%)У женщин полученное значение следует умножить на 0.85Подбор дозы в зависимости от КККК (мл/мин) Дозирование≥80 10 мг 1 раз/сут50-79 10 мг 1 раз/сут30-49 5 мг 1 раз/сут11-29 5 мг 1 раз в два дня≤10 (гемодиализ) Противопоказано"}}]},{"id":7,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Обычно препарат переносится хорошо. В очень редких случаях возможно возникновение нижеследующих побочных эффектов. Со стороны органов кроветворения: тромбоцитопения. Со стороны нервной системы: сонливость, головокружение, головная боль, агрессия, возбуждение, спутанность сознания, депрессия, галлюцинации, бессонница, тик, судороги, дискинезния, дистония, парастезии, обморок, тремор. Со стороны органа зрения: нарушение аккомодации, нарушение зрительного восприятия, нистагм. Со стороны сердечно-сосудистой системы: тахикардия. Со стороны дыхательной системы: ринит, фарингит. Со стороны пищеварительной системы: сухость слизистой оболочки полости рта, тошнота, боль в животе, диарея, нарушение функции печени (повышение активности печеночных трансаминаз, щелочной фосфатазы, ГГТ, концентрации билирубина). Со стороны мочевыделительной системы: расстройство мочеиспускания, недержание мочи. Со стороны кожи и подкожной клетчатки: зуд, сыпь, крапивница, ангионевротический отек. Аллергические реакции: гиперчувствительность, вплоть до развития анафилактического шока. 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