Category Prednisone And Alcohol

Prednisone Taper Secrets

The Basic Facts of Prednisone Taper

In the initial five days, you’re supposed to take 60 mg of prednisone daily. Make certain you take prednisone for the suggested quantity of times and in recommended amounts. Prednisone comes under the class of drugs called corticosteroids. It may be prescribed along with other medications like analgesics and muscle relaxants depending on the severity of the disorder. It mimics the effects of cortisol by reducing the amount of inflammation in the TMJ joints. Employing prednisone during an active case of diverticulitis may raise the harshness of the illness.

Consult your healthcare provider any questions that you might have about how to utilize Prednisone. So you may be on prednisone for a couple of days or a couple weeks. If prednisone is used for a longer duration of time, the steroid includes a very long list of side effects which may wind up giving you more problems than merely a nagging cough. It is a type of medication that is termed a steroid. It comes in a variety of different mediums. There’s oral prednisone in the shape of pills, which are simple to administer but don’t get the job done as quickly as injectable prednisone.

Typically, prednisone will be supplied in one of two ways. It can also present problems for people with asymptomatic diverticulosis. While it is an effective treatment option, there are other ways to relieve inflammation. Finally, there’s inhalable prednisone that’s probably the ideal mix of convenience and quickness.

Lies You’ve Been Told About Prednisone Taper

Your health care provider may decrease the dosage or try a different medication if it’s bothersome. Your health care provider might also think about prescribing a prednisone taper. The very first step is to seek advice from your health care provider before discontuing aripiprazole. It is crucial to talk about the measures you are just about to take with your physician before going ahead with your plan to wean yourself from aripiprazole. Not every doctor will be the proper fit for your requirements, and that’s okay. Doctors who prescribe prednisone for unrelated health conditions may not anticipate that you’ve got an undiagnosed case of diverticulosis.

In all scenarios, you’re advised to steer clear of steroid medications like prednisone. Its dosage needs to be lowered slowly on the ideas and consent of a health care provider. The dosage of the drug must be increased, or a different corticosteroid drug should be prescribed to control the indicators of the status. In case of toxicity, doses could possibly be delayed, but all treatment has to be administered within 16 weeks of the very first dose. Make sure that you do not miss any dose. If In the event you do miss a dose, take it whenever possible. If it is nearly time for your next dose, skip the missed dose and return to your normal dosing schedule.

Both medications are shown to reduce the severity and length of exacerbations in MS. Recent studies have proven that corticosteroids may also enhance the blood brain barrier leakage and so inhibit the whole inflammatory demyelinating approach. Medications for underactive thyroid supply the identical all-natural thyroid hormone generated by your physique. Underactive thyroid medication might need to be taken for a lifetime to keep wholesome hormone levels. It is crucial to know which medications may be used together, to prevent serious adverse reactions or even death. There are several sorts of blood pressure medication.

The Lost Secret of Prednisone Taper

The very first way is known as a steroid burst as it involves taking plenty of prednisone at once for a couple of days. Also, prednisone and alcohol reactions can differ in the instance of unique drugs. It is imperative to be aware that a little quantity of alcohol could possibly be introduced, if and as soon as the doctor is absolutely certain about the simple fact your system is in the place to tolerate the consumption. In any case, consuming alcohol along with prednisone also is dependent on your general well-being and tolerance levels. It’s possible to still drop weight whilst taking heart medications.

Prednisone Taper Help!

There is a danger of creating osteoporosis and rheumatoid arthritis over the plan of treatment. There’s marked rise in the frequency of urination. Thus, some people today turn 12 day prednisone taper side effects to them to be able to acquire medication they otherwise wouldn’t have been in a position to purchase, which may possibly be a dangerous proposition. Thankfully there are steps that you can take to combat the side results and still drop weight whilst on beta blockers. They may be severe, hence it is better to avoid the consumption altogether. Potential side effects differ from person to person. There are potential side effects with Prednisone usage.

What the In-Crowd Won’t Tell You About Prednisone Withdrawal

You shouldn’t administer prednisone to your pet when it isn’t suggested. Prednisone is made by dehydrogenation of cortisone. It is not an addictive medication. Although it is an effective drug, it needs to be administered carefully. Prednisone for dogs is used for lots of medical autoimmune conditions it’s really a corticosteroid that’s manufactured synthetically.

Prednisone resembles cortisol. It is one such drug that is used to treat a host of ailments in young children. If you’re heavily treated with prednisone, you should await three or more months after stopping before obtaining a live vaccine. An individual must remember that while prednisone definitely does give rise to a lot of side effects, it’s additionally a life-saving drug. In the end, when you have been taking prednisone for some time, you ought not discontinue treatment suddenly.

Make certain you take prednisone for the suggested variety of times and in recommended amounts. In other instances, prednisone might interfere with the activity of the secondary drug. Prednisone might also be prescribed to individuals who have to undergo imaging methods, like CT scan, that involve the usage of intravenous dyes. When it is prescribed it needs to be very closely monitored due to the potential side effects that it can cause. The prednisone ought to be gradually tapered off. It is used to suppress the immune system and is often prescribed to reduce inflammation.

Prednisone Withdrawal: the Ultimate Convenience!

If In the event you do miss a dose, take it whenever possible. The doses would need to be increased for a brief period followed by gradual decrease in dosage. At any time it’s important to obtain the lowest dose you want to control your disease.

Make certain you do not miss any dose. If it’s almost time for your next dose, skip the missed dose and return to your normal dosing schedule. Lowering the dose of prednisone gradually enables the adrenal glands to recuperate slowly.

The drug is utilized in numerous health issues in canines and when it’s discontinued, the procedure needs to be slow and gradual, and might take a couple weeks. It has to be taken under medical supervision. So make sure that it is administered in the right dose. To prevent adverse effects, one ought to select the drug in the prescribed dosage.

The quantity of steroids you take should decrease a bit at a moment. From time to time, they work for a person, and sometimes they don’t. They are to be respected, they are not a drug to be taken lightly. They are a type of medicine with strong anti-inflammatory effects. In the event the steroid is provided for an extremely brief time period, then tapering might not be required before stopping. If you’ve tapered off of steroids or decreased to a maintenance dose, you can also understand what your threshold are or how you want to correct your tapering schedule to lower the side results.

While someone is taking steroids, their entire body attempts to correct the degree of testosterone to usual. Steroids do not supply the euphoria which other drugs do, but they may be equally as addictive as other substances. When you quit taking steroids, your body could be slow in making the additional steroids that you demand.

The effects may change from person to person. Effects of steroid withdrawal can be quite uncomfortable. Short-term side effects are very similar to that of other corticosteroid drugs and might consist of fluid retention, stomach upset, and a rise in blood glucose.

The End of Prednisone Withdrawal

Get in touch with your physician if you have any symptoms, and they could adjust your prednisone taper. Don’t forget, even caffeine can result in withdrawal symptoms. Together with following your physician’s instruction you are able to stick to some tips which will protect against prednisone withdrawal symptoms. One of the most frequent indicators of prednisone withdrawal is a sense of weakness or severe fatigue. Do not quit using prednisone suddenly, or you might have unpleasant withdrawal symptoms. The withdrawal symptoms from steroids are a consequence of low levels of pure testosterone within the body.

Abruptly ceasing using prednisone may result in prednisone withdrawal symptoms. Long-term use of prednisone may also make dogs susceptible to metabolic alterations, together with a higher probability of turning diabetic. Prolonged use of prednisone can impact the human body’s capacity to make natural corticosteroids, thereby increasing the odds of drug dependence.

What to Expect From Prednisone Side Effect?

A Secret Weapon for Prednisone Side Effect

The impacts of steroids don’t just stop at damaging the body, but they are able to make a guy to turn into impotent either temporarily or permanently. Berberine side effects are often overlooked on account of the very low Bereberine toxicity score. They include increased risk of infection, high blood pressure, low blood counts. Prednisone side effect affects these areas as time passes or lengthy use of the drug. Actually, the outcome is quite the opposite. The gain in blood pressure causes the proper side of the heart to work harder and as a consequence get rid of function. Although the numerous health benefits of prednisone make it an invaluable drug, an individual cannot ignore its side results.

Anabolic steroids are the most frequent steroids used.

Acetaminophen is offered in a selection of tablet sizes and liquid concentrations. It is not an NSAID. Although Claritin isn’t free from side effects, they aren’t as bad as one might anticipate. It’s also imperative that you do not combine Claritin with any other antihistamine in order to protect against any form of adverse allergic reaction.

Prolonged use of prednisone can impact the human body’s ability to create natural corticosteroids, thereby increasing the chances of drug dependence. In addition, for mild allergic reactions in dogs, usage of Claritin is usually not vital. You ought to avoid long-term usage of Meloxicam on dogs, as it can lead to serious side effects.

The Ugly Side of Prednisone Side Effect

If you own a doctor who’s not open to testing for progesterone, it might be time to discover a new doctor. The physician will diagnose and will prescribe the kinds of medication required for your treatment.

Every moment, it’s not essential to provide medication for pain relief. It is crucial to keep the medication going even when you see your pet has recovered. The medication may also interfere with normal bowel feature, which can lead to diarrhea or produce the dog feel constipated. In the same way, broad-spectrum praziquantel medication is effective in eliminating other internal parasites also. Although the dosage is contingent on the seriousness of the dog’s condition, doses in the assortment of are routinely administered. Thus, a careful dosage needs to be supplied to the dog.

Prednisone was know to result in long-term effects which itas advisable to totally understand to give you the absolute most informed decision when looking at the usage of the drug. It can also reduce the discomfort, albeit with several side effects. It can also be used to treat sarcoid rash, but it may cause the thinning of the skin. The medication Prednisone exists as a kind of glucocorticoid. Although it is an effective drug, it needs to be administered carefully. It is a prodrug that is converted by the liver into prednisolone, which is the active drug and also a steroid. You fear taking Prednisone or any other type of medicine for Psoriasis.

Children that are ITP patients usually do not require any long-term treatments. Hence, the fundamental treatment aims at lessening the pain of the sufferer. As stated before, the ideal treatment for a cracked rib is to wait around in order for it to heal naturally. Thus far, there’s no known cause or cure.

Acute and unbearable pain is easily the most dangerous portion of the gout. You might also experience pain towards the face of the cracked rib. Nobody knows how it works to lessen pain and fever. So, you must assess whether the symptoms occurring are because of an allergic reaction. In severe situations, the signs can be life-threatening. Once you observe any of the symptoms, you should seek advice from your doctor for additional assistance. In many instances, it doesn’t show noticeable symptoms and the infection subsides by itself.

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Cetirizine

Cetirizine, prominently marketed under the brand name Zyrtec among others, is a potent second-generation antihistamine used in the treatment of hay fever, allergies, angioedema, and urticaria.[5] It acts as a selective antagonist of the histamine H1 receptor.

Second-generation antihistamines like cetirizine are less able to cross the blood–brain barrier and therefore have diminished effects on the central nervous system compared to first-generation drugs. As such, they are less likely to cause drowsiness or memory impairment.

Contents

  • 1 Medical uses
    • 1.1 Allergies
    • 1.2 Rhinovirus infection
    • 1.3 Kimura’s disease
    • 1.4 Available forms
  • 2 Adverse effects
    • 2.1 Withdrawal
  • 3 Pharmacology
    • 3.1 Pharmacodynamics
    • 3.2 Pharmacokinetics
      • 3.2.1 Absorption
      • 3.2.2 Distribution
      • 3.2.3 Metabolism
      • 3.2.4 Elimination
  • 4 Chemistry
    • 4.1 Synthesis
  • 5 Society and culture
    • 5.1 Brand names
    • 5.2 Availability
  • 6 References
    • 6.1 Books and journals
  • 7 External links

Medical uses[edit]

Allergies[edit]

Cetirizine’s primary indication is for hay fever and other allergies. Because the symptoms of itching and redness in these conditions are caused by histamine acting on the H1 receptor, blocking those receptors temporarily relieves those symptoms.

Cetirizine is also commonly prescribed to treat acute and (in particular cases) chronic urticaria, more efficiently than any other second-generation antihistamine[citation needed].

Rhinovirus infection[edit]

Interleukin 6 and interleukin 8 have been shown to be elevated in acute respiratory distress syndrome.[6] One recent study of airway epithelial cells showed that levocetirizine, the active enantiomer of cetirizine, may have beneficial effects on the pathophysiologic changes related to human rhinovirus (HRV) infection.[7]

Kimura’s disease[edit]

Cetirizine is an effective agent in treating the symptoms of Kimura’s disease which predominantly affects the lymph nodes and soft tissue of the head and neck in the form of tumor-like lesions. Cetirizine’s properties of being effective both in the treatment of pruritus (itching) and as an anti-inflammatory agent make it suitable for the treatment of the pruritus associated with these lesions.[8] In a 2005 study, the American College of Rheumatology conducted treatments initially using prednisone, followed by steroid dosages and azathioprine, omeprazole, and calcium and vitamin D supplements over the course of two years.[8] The skin condition of the patient began to improve and the skin lesions lessened. However, there were symptoms of cushingoid and hirsutism observed before the patient was removed from the courses of steroids and placed on 10 mg/day of cetirizine to prevent skin lesions;[8] an agent suitable for the treatment of pruritus associated with such lesions.[8] Asymptomatically, the patient’s skin lesions disappeared after treatment with cetirizine, blood eosinophil counts became normal,[8] corticosteroid effects were resolved,[8] and a remission began within a period of two months.[8] It is also thought that the inhibition of eosinophils may be the key to treatment of Kimura’s disease due to the role of eosinophils, rather than other cells with regards to the lesions of the skin.[8]

Available forms[edit]

Cetirizine is available over-the-counter in the form of 5 and 10 mg tablets. A 20mg strength is available by prescription only.[1]

Adverse effects[edit]

Commonly reported side effects of cetirizine include headache (16%), dry mouth (5.7%), drowsiness (5–20%), and fatigue (5.6%), while more serious but rare side effects include cardiac failure, tachycardia, and edema.[9]

Withdrawal[edit]

A 2016 study published in Drug Safety suggests “a causal relation between withdrawal of (levo)cetirizine and the occurrence of unbearable pruritus”, concluding that “healthcare professionals should be aware that in some patients this reaction can occur.” Patients studied were found to have been using cetirizine continuously for months or years.[10]

Long-term daily usage of cetirizine may result in what resembles antihistamine dependency. No official study has been conducted to determine how long a patient may take cetirizine daily before expecting to encounter withdrawal symptoms when treatment stops. Many patients seeking help with withdrawal symptoms report having taken cetirizine for more than three years, while others report having taken it for no longer than one week.[11][12]

Insatiable, generalized itching is the most commonly-reported withdrawal side effect, though others have reported severe rebound of original, pre-treatment systems as well, including sneezing and runny nose.[13][14]

Pharmacology[edit]

L-Stereoisomer, levocetirizine (top) and D-stereoisomer of cetirizine.

Pharmacodynamics[edit]

Cetirizine acts as a highly selective antagonist of the histamine H1 receptor.[1] The Ki values for the H1 receptor are approximately 6 nM for cetirizine, 3 nM for levocetirizine, and 100 nM for dextrocetirizine, indicating that the levorotatory enantiomer is the main active form.[1] Cetirizine has 600-fold or greater selectivity for the H1 receptor over a wide variety of other sites, including muscarinic acetylcholine, serotonin, dopamine, and α-adrenergic receptors, among many others.[1] The drug shows 20,000-fold or greater selectivity for the H1 receptor over the five muscarinic acetylcholine receptors, and hence does not exhibit anticholinergic effects.[15][16] It shows negligible inhibition of the hERG channel (IC50 > 30 µM)[17] and no cardiotoxicity has been observed with cetirizine at doses of up to 60 mg/day, six times the normal recommended dose[1] and the highest dose of cetirizine that has been studied in healthy subjects.[18]

Cetirizine crosses the blood–brain barrier only slightly, and for this reason, it produces minimal sedation compared to many other antihistamines.[19] A positron emission tomography (PET) study found that brain occupancy of the H1 receptor was 12.6% for 10 mg cetirizine, 25.2% for 20 mg cetirizine, and 67.6% for 30 mg hydroxyzine.[20] (A 10 mg dose of cetirizine equals about a 30 mg dose of hydroxyzine in terms of peripheral antihistamine effect.)[21] PET studies with antihistamines have found that brain H1 receptor occupancy of more than 50% is associated with a high prevalence of somnolence and cognitive decline, whereas brain H1 receptor occupancy of less than 20% is considered to be non-sedative.[22] In accordance, H1 receptor occupancy correlated well with subjective sleepiness for 30 mg hydroxyzine but there was no correlation for 10 or 20 mg cetirizine.[20] As such, brain penetration and brain H1 receptor occupancy by cetirizine are dose-dependent, and in accordance, while cetirizine at doses of 5 to 10 mg have been reported to be non-sedating or mildly sedating, a higher dose of 20 mg has been found to induce significant drowsiness in other studies.[20]

Cetirizine has been shown to inhibit eosinophil chemotaxis and LTB4 release.[23] At a dosage of 20 mg, Boone et al. found that it inhibited the expression of VCAM-1 in patients with atopic dermatitis.[23]

Pharmacokinetics[edit]

Absorption[edit]

Cetirizine is rapidly and extensively absorbed upon oral administration in tablet or syrup form.[1] The oral bioavailability of cetirizine is at least 70% and of levocetirizine is at least 85%.[3] The Tmax of cetirizine is approximately 1.0 hour regardless of formulation and its onset of action has been reported to be as early as 20 minutes.[2] The pharmacokinetics of cetirizine have been found to increase linearly with dose across a range of 5 to 60 mg.[1] Its Cmax following a single dose has been found to be 257 ng/mL for 10 mg and 580 ng/mL for 20 mg.[2] Food has no effect on the bioavailability of cetirizine but has been found to delay the Tmax by 1.7 hours (i.e., to approximately 2.7 hours) and to decrease the Cmax by 23%.[1][2][24] Similar findings were reported for levocetirizine, which had its Tmax delayed by 1.25 hours and its Cmax decreased by about 36% when administered with a high-fat meal.[24] Steady-state levels of cetirizine occur within 3 days and there is no accumulation of the drug with chronic administration.[2] Following once-daily administration of 10 mg cetirizine for 10 days, the mean Cmax was 311 ng/mL.[25]

Distribution[edit]

The mean plasma protein binding of cetirizine has been found to be 93 to 96% across a range of 25 to 1,000 ng/mL independent of concentration.[2] Plasma protein binding of 88 to 96% has also been reported across multiple studies.[3] The drug is bound to albumin with high affinity, while α1-acid glycoprotein and lipoproteins contribute much less to total plasma protein binding.[3] The unbound or free fraction of levocetirizine has been reported to be 8%.[3] The true volume of distribution of cetirizine is unknown but is estimated to be 0.3 to 0.45 L/kg.[1][3] Cetirizine poorly and slowly crosses the blood–brain barrier, which is due mainly to its chemical properties but also to a minor extent to its activity as a P-glycoprotein substrate.[3]

Metabolism[edit]

Cetirizine does not undergo extensive metabolism.[1] It is notably not metabolized by the cytochrome P450 system.[26] Because of this, it does not interact significantly with drugs that inhibit or induce cytochrome P450 enzymes such as theophylline, erythromycin, clarithromycin, cimetidine, or alcohol.[1] While cetirizine does not undergo extensive metabolism or metabolism by the cytochrome P450 enzyme, it does undergo some metabolism by other means, the metabolic pathways of which include oxidation and conjugation.[1][2] Plasma radioactivity attributed to unchanged cetirizine is more than 90% at 2 hours, 80% at 10 hours, and 70% at 24 hours, indicating limited and slow metabolism.[2] The enzymes responsible for transformation of cetirizine have not been identified.[1]

Elimination[edit]

Cetirizine is eliminated approximately 70 to 85% in the urine and 10 to 13% in the feces.[1] About 50 or 60% of cetirizine eliminated in the urine is unchanged.[1][2] It is eliminated in the urine via an active transport mechanism.[2] The elimination half-life of cetirizine ranges from 6.5 to 10 hours in healthy adults, with a mean across studies of approximately 8.3 hours.[1][2] Its duration of action is at least 24 hours.[2] The elimination half-life of cetirizine is increased in the elderly (to 12 hours), in hepatic impairment (to 14 hours), and in renal impairment (to 20 hours).[2]

Chemistry[edit]

Cetirizine contains L- and D-stereoisomers. Chemically, levocetirizine is the active L-enantiomer of cetirizine. The drug is a member of the diphenylmethylpiperazine group of antihistamines. Analogues include cyclizine and hydroxyzine.

Synthesis[edit]

Cetirizine synthesis:[27]

The 1-[(4-chlorophenylmethyl]-piperazine is alkylated with methyl (2-chloroethoxy)-acetate in the presence of sodium carbonate and xylene solvent to produce the Sn2 substitution product in 28% yield. Saponification of the acetate ester is done by refluxing with potash in absolute ethanol to afford a 56% yield of the potassium salt intermediate. This is then hydrolyzed with aqueous HCl and extracted to give an 81% yield of the carboxylic acid product.

Society and culture[edit]

A package of 10 mg cetirizine tablets.

Zyrtec-D, a combination of cetirizine and pseudoephedrine.

Brand names[edit]

Cetirizine is marketed under the brand names Alatrol, Alerid, Alzene, Cetirin, Cetzine, Cezin, Histazine, Humex, Letizen, Reactine, Razene, Rigix, Triz, Zetop, Zirtec, Zirtek, Zodac, Zyllergy, Zynor, Zyrlek, and Zyrtec among others.

Availability[edit]

Formerly prescription-only in many countries, cetirizine is now available without prescription in most countries. In some countries it is available over-the-counter only in packages containing seven or ten 10 mg doses.

Like many other antihistamine medications, cetirizine is commonly prescribed in combination with pseudoephedrine, a decongestant. These combinations are often marketed using the same brand name as the cetirizine with a “-D” suffix (Zyrtec-D, Virlix-D, etc.)

References[edit]

  • ^ a b c d e f g h i j k l m n o p q r s t Portnoy JM, Dinakar C (2004). “Review of cetirizine hydrochloride for the treatment of allergic disorders”. Expert Opin Pharmacother. 5 (1): 125–35. doi:10.1517/14656566.5.1.125. PMID 14680442. 
  • ^ a b c d e f g h i j k l m n o Simons FE, Simons KJ (1999). “Clinical pharmacology of new histamine H1 receptor antagonists”. Clin Pharmacokinet. 36 (5): 329–52. doi:10.2165/00003088-199936050-00003. PMID 10384858. 
  • ^ a b c d e f g h Chen C (2008). “Physicochemical, pharmacological and pharmacokinetic properties of the zwitterionic antihistamines cetirizine and levocetirizine”. Curr. Med. Chem. 15 (21): 2173–91. doi:10.2174/092986708785747625. PMID 18781943. 
  • ^ a b Simons FE (2002). “Comparative pharmacology of H1 antihistamines: clinical relevance”. Am. J. Med. 113 Suppl 9A: 38S–46S. doi:10.1016/s0002-9343(02)01436-5. PMID 12517581. 
  • ^ “Medscape Log In”. 
  • ^ Chollet-Martin S, Montravers P, Gibert C, Elbim C, Desmonts JM, Fagon JY, Gougerot-Pocidalo MA (November 1993). “High levels of interleukin-8 in the blood and alveolar spaces of patients with pneumonia and adult respiratory distress syndrome”. Infection and Immunity. 61 (11): 4553–9. PMC 281204 . PMID 8406851. 
  • ^ Jang YJ, Wang JH, Kim JS, Kwon HJ, Yeo NK, Lee BJ (March 2009). “Levocetirizine inhibits rhinovirus-induced ICAM-1 and cytokine expression and viral replication in airway epithelial cells”. Antiviral Research. 81 (3): 226–33. doi:10.1016/j.antiviral.2008.12.001. PMID 19110001. 
  • ^ a b c d e f g h Ben-Chetrit E, Amir G, Shalit M (February 2005). “Cetirizine: An effective agent in Kimura’s disease”. Arthritis Rheum. 53 (1): 117–8. doi:10.1002/art.20908. PMID 15696573. 
  • ^ “Zyrtec Side Effects”. drugs.com. Drugs.com. Retrieved 21 August 2015. 
  • ^ Ekhart C, van der Horst P, van Hunsel F (December 2016). “Unbearable Pruritus After Withdrawal of (Levo)cetirizine”. Drug Safety – Case Reports. 3 (1): 16. doi:10.1007/s40800-016-0041-9. PMC 5124431 . PMID 27889900. 
  • ^ “Zyrtec Withdrawal Is a Nightmare”. People’s Pharmacy. Retrieved 9 September 2017. 
  • ^ “Itching Withdrawal From Cetirizine Or Zyrtec”. MedsChat.com. Retrieved 9 September 2017. 
  • ^ “Cetirizine (Zyrtec) Withdrawal & Unbearable Itching”. People’s Pharmacy. Retrieved 9 September 2017. 
  • ^ “addicted to zyrtec?”. MedHelp. Retrieved 9 September 2017. 
  • ^ Zhang L, Cheng L, Hong J (2013). “The clinical use of cetirizine in the treatment of allergic rhinitis”. Pharmacology. 92 (1–2): 14–25. doi:10.1159/000351843. PMID 23867423. 
  • ^ Orzechowski RF, Currie DS, Valancius CA (2005). “Comparative anticholinergic activities of 10 histamine H1 receptor antagonists in two functional models”. Eur. J. Pharmacol. 506 (3): 257–64. doi:10.1016/j.ejphar.2004.11.006. PMID 15627436. 
  • ^ Taglialatela M, Pannaccione A, Castaldo P, Giorgio G, Zhou Z, January CT, Genovese A, Marone G, Annunziato L (1998). “Molecular basis for the lack of HERG K+ channel block-related cardiotoxicity by the H1 receptor blocker cetirizine compared with other second-generation antihistamines”. Mol. Pharmacol. 54 (1): 113–21. doi:10.1124/mol.54.1.113. PMID 9658196. 
  • ^ Hulhoven R, Rosillon D, Letiexhe M, Meeus MA, Daoust A, Stockis A (2007). “Levocetirizine does not prolong the QT/QTc interval in healthy subjects: results from a thorough QT study”. Eur. J. Clin. Pharmacol. 63 (11): 1011–7. doi:10.1007/s00228-007-0366-5. PMID 17891537. The equivalent dose of 60 mg cetirizine is also the highest dose ever administered in healthy subjects [13]. 
  • ^ Gupta, A; Chatelain P; Massingham R; Jonsson EN; Hammarlund-Udenaes M (February 2006). “Brain distribution of cetirizine enantiomers: comparison of three different tissue-to-plasma partition coefficients: K(p), K(p,u), and K(p,uu)”. Drug Metab. Dispos. 34 (2): 318–23. doi:10.1124/dmd.105.007211. PMID 16303872. 
  • ^ a b c Tashiro M, Kato M, Miyake M, Watanuki S, Funaki Y, Ishikawa Y, Iwata R, Yanai K (2009). “Dose dependency of brain histamine H(1) receptor occupancy following oral administration of cetirizine hydrochloride measured using PET with [11C]doxepin”. Hum Psychopharmacol. 24 (7): 540–8. doi:10.1002/hup.1051. PMID 19697300. 
  • ^ van den Elzen MT, van Os-Medendorp H, van den Brink I, van den Hurk K, Kouznetsova OI, Lokin AS, Laheij-de Boer AM, Röckmann H, Bruijnzeel-Koomen CA, Knulst AC (2017). “Effectiveness and safety of antihistamines up to fourfold or higher in treatment of chronic spontaneous urticaria”. Clin Transl Allergy. 7: 4. doi:10.1186/s13601-017-0141-3. PMC 5309999 . PMID 28289538. […] 30 mg of hydroxyzine equals about 10 mg cetirizine [11] […] 
  • ^ Yanai K, Tashiro M (2007). “The physiological and pathophysiological roles of neuronal histamine: an insight from human positron emission tomography studies”. Pharmacol. Ther. 113 (1): 1–15. doi:10.1016/j.pharmthera.2006.06.008. PMID 16890992. 
  • ^ a b Boone M, Lespagnard L, Renard N, Song M, Rihoux JP (July 2000). “Adhesion molecule profiles in atopic dermatitis vs. allergic contact dermatitis: pharmacological modulation by cetirizine”. J Eur Acad Dermatol Venereol. 14 (4): 263–6. doi:10.1046/j.1468-3083.2000.00017.x. PMID 11204513. Retrieved 19 November 2009. 
  • ^ a b Paśko P, Rodacki T, Domagała-Rodacka R, Palimonka K, Marcinkowska M, Owczarek D (2017). “Second generation H1 – antihistamines interaction with food and alcohol-A systematic review”. Biomed. Pharmacother. 93: 27–39. doi:10.1016/j.biopha.2017.06.008. PMID 28622592. 
  • ^ “Zyrtec prescribing information” (PDF). May 2006. Archived from the original (PDF) on 4 January 2010. Retrieved 19 November 2009. 
  • ^ Massoud Mahmoudi (2 June 2016). Allergy and Asthma: Practical Diagnosis and Management. Springer. pp. 574–. ISBN 978-3-319-30835-7. 
  • ^ US patent 4525358, Baltes E, De Lannoy J, Rodriguez L, “2-[4-(Diphenylmethyl)-1-piperazinyl]-acetic acids and their amides”, issued 25 June 1985, assigned to UCB Pharmaceuticals, Inc. 
  • Books and journals[edit]

  • Anderson, P. O., Knoben, J. E., et al. (2002) Handbook of clinical drug data 10th ed. McGraw-Hill International
  • Pfizer Inc., et al. (2006) ZYRTEC (cetirizine hydrochloride) Tablets, Chewable Tablets and Syrup For Oral Use Pfizer Incorporated publications
  • Chetrit, E. B., Amir, G., Shalit, M. (2005). Cetirizine: an effective agent in Kimura’s Disease Arthritis & Rheumatism (Arthritis care & research) Vol 53, p117-118
  • External links[edit]

    • U.S. National Library of Medicine: Drug Information Portal – Cetirizine

    Others

    See also
    Receptor/signaling modulators


    Source: https://en.wikipedia.org/wiki/Cetirizine

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