A Transient Pruritic Eruption Exacerbated by Heat
Rachael Morris-Jones, Ann-Marie Powell, Emma Benton in 100 CASES in Dermatology, 2011
This chapter presents the case study of a 26-year-old woman attends the dermatology clinic complaining of a 4-month history of an itchy eruption. She describes the eruption as ‘cloud-like’. She previously suffered from eczema as a child but this rash is different. She tells you that although the eruption waxes and wanes, with individual lesions lasting 8 to 12 hours, she is rarely clear of lesions for more than half a day. Sometimes she goes to bed with the eruption and wakes clear, but the opposite can also occur. She has never experienced angioedema. The eruption is partially attenuated by cetirizine 10 mg daily, which she is taking for her hayfever. Her only other medication is occasional ibuprofen for dysmenorrhoea. The patient is suffering from urticaria, which is characterized by wheals or ‘hives’ that represent areas of cutaneous mast cell degranulation, releasing histamine and other mediators, followed by transient oedema and erythema.
Levocetirizine in the treatment of allergic diseases
Published in Expert Opinion on Pharmacotherapy, 2009
Francesca Scordamaglia, Enrico Compalati, Ilaria Baiardini, Antonio Scordamaglia, Giorgio Walter Canonica
Background: Levocetirizine, the R-enantiomer of cetirizine dihydrochloride, is a new molecule with a potent and selective antihistamine activity. Objective: To investigate the evidence that levocetirizine is an effective therapy for allergic disease. Methods: Evaluation of published articles in English, or having an English abstract. Results: Clinical trials indicate that levocetirizine is safe and effective for the treatment of allergic rhinitis and chronic idiopathic urticaria. The compound shows a rapid onset of action, high bioavailability and affinity for the H1 receptor. Moreover, this molecule demonstrates many anti-inflammatory effects that enhance the clinical therapeutic benefit not only in short-term but also in long-term treatments, as reported in recent trials utilizing levocetirizine for several months. Conclusion: Levocetirizine confirms its safe effective activity for treatment of allergic disease in both adults and children.
Statistical optimization of controlled release microspheres containing cetirizine hydrochloride as a model for water soluble drugs
Published in Pharmaceutical Development and Technology, 2015
Khalid M. El-Say, Abdel-Rahim M. El-Helw, Osama A. A. Ahmed, Khaled M. Hosny, Tarek A. Ahmed, Rasha M. Kharshoum, Usama A. Fahmy, Majed Alsawahli
The purpose was to improve the encapsulation efficiency of cetirizine hydrochloride (CTZ) microspheres as a model for water soluble drugs and control its release by applying response surface methodology. A 33 Box–Behnken design was used to determine the effect of drug/polymer ratio (X1), surfactant concentration (X2) and stirring speed (X3), on the mean particle size (Y1), percentage encapsulation efficiency (Y2) and cumulative percent drug released for 12 h (Y3). Emulsion solvent evaporation (ESE) technique was applied utilizing Eudragit RS100 as coating polymer and span 80 as surfactant. All formulations were evaluated for micromeritic properties and morphologically characterized by scanning electron microscopy (SEM). The relative bioavailability of the optimized microspheres was compared with CTZ marketed product after oral administration on healthy human volunteers using a double blind, randomized, cross-over design. The results revealed that the mean particle sizes of the microspheres ranged from 62 to 348 µm and the efficiency of entrapment ranged from 36.3% to 70.1%. The optimized CTZ microspheres exhibited a slow and controlled release over 12 h. The pharmacokinetic data of optimized CTZ microspheres showed prolonged tmax, decreased Cmax and AUC0–∞ value of 3309 ± 211 ng h/ml indicating improved relative bioavailability by 169.4% compared with marketed tablets.
The fetal safety of cetirizine: An observational cohort study and meta-analysis
Published in Journal of Obstetrics and Gynaecology, 2014
F. Etwel, N. Djokanovic, M. E. Moretti, R. Boskovic, J. Martinovic, G. Koren
Cetirizine, a second-generation antihistamine, is an active metabolite of hydroxyzine used in the treatment of allergies, but the data on fetal safety are inconclusive. Pregnant women who were counselled by the ‘Motherisk Program’ regarding cetirizine exposure were enrolled in a cohort study and compared with pregnant women counselled for non-teratogenic exposures. The objective was to measure the rate of adverse pregnancy outcomes. Subsequently, we also conducted a meta-analysis of cohort studies that examined the pregnancy outcomes of women exposed to hydroxyzine or cetirizine during pregnancy. In the cohort study, there were no significant differences in the rates of major malformations between the cetirizine exposed and comparison group. In the meta-analysis, cetirizine was not associated with increased teratogenic risk. In contrast, a meta-analysis of cetirizine and hydroxyzine studies showed a marginal association with major malformations. Cetirizine is not associated with a clinically important increase in risk of adverse fetal outcomes.