Available data with levocetirizine use during human pregnancy are insufficient to determine any drug-associated risks of miscarriage, birth defects, or adverse maternal or fetal outcomes. In animal reproduction studies, there was no evidence of fetal harm with the administration of levocetirizine during organogenesis at doses greatly exceeding the maximum recommended human dose MRHD in adults doses up to and times, respectively, in pregnant rats and rabbits ; animal studies are not always indicative of human response.
Pregnant patients should see their health care professional for a proper diagnosis and treatment recommendations. The American College of Obstetricians and Gynecologists and the American College of Allergy, Asthma, and Immunology consider cetirizine and loratadine as acceptable alternatives in pregnancy, preferably after the first trimester, when first-generation antihistamines are not tolerated. There are no data available on the presence of levocetirizine in human milk, the effects on the breastfed infant, or the effects on milk production.
Levocetirizine is the R-enantiomer of cetirizine. Cetirizine is excreted in human breast milk, but quantitative amounts are not known. Urinary retention has been reported during post-marketing trials with levocetirizine. Therefore, use levocetirizine with caution in patients with predisposing factors of urinary retention e. Discontinue levocetirizine if urinary retention occurs. In the geriatric patient with renal impairment, it is recommended that initial doses of levocetirizine be adjusted.
According to the OBRA guidelines, cough, cold, and allergy medications should be used only for a limited duration less than 14 days unless there is documented evidence of enduring symptoms that cannot otherwise be alleviated and for which a cause cannot be identified and corrected.
Acetaminophen; Caffeine; Dihydrocodeine: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence. Limit the use of opioid pain medication with cetirizine to only patients for whom alternative treatment options are inadequate. If concurrent use is necessary, use the lowest effective doses and minimum treatment durations needed to achieve the desired clinical effect. Acetaminophen; Codeine: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence.
Acetaminophen; Hydrocodone: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence. Acetaminophen; Oxycodone: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence. Coadministration may increase the risk of CNS depressant-related side effects. If concurrent use is necessary, monitor for excessive sedation and somnolence. Acetaminophen; Propoxyphene: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence.
Alfentanil: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence. Coadministration may increase the risk of anticholinergic and CNS depressant-related side effects. If concurrent use is necessary, monitor for excessive anticholinergic effects, sedation, and somnolence. Dopaminergic agents have also been associated with sudden sleep onset during activities of daily living such as driving, which has resulted in accidents in some cases.
Prescribers should re-assess patients for drowsiness or sleepiness regularly throughout treatment, especially since events may occur well after the start of treatment. Aspirin, ASA; Caffeine; Dihydrocodeine: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence.
Aspirin, ASA; Carisoprodol; Codeine: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence. Aspirin, ASA; Oxycodone: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence.
Use caution during coadministration. Belladonna; Opium: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence. Benzhydrocodone; Acetaminophen: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence. Brompheniramine; Guaifenesin; Hydrocodone: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence.
Brompheniramine; Hydrocodone; Pseudoephedrine: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence.
Butalbital; Acetaminophen; Caffeine; Codeine: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence. Carbidopa; Levodopa; Entacapone: Moderate Caution is recommended during concurrent use of cetirizine or levocetirizine with COMT inhibitors because of the possibility for additive sedative effects. COMT inhibitors have also been associated with sudden sleep onset during activities of daily living such as driving, which has resulted in accidents in some cases.
Patients should be advised to avoid driving or other tasks requiring mental alertness until they know how the combination affects them. Carbinoxamine; Hydrocodone; Phenylephrine: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence.
Carbinoxamine; Hydrocodone; Pseudoephedrine: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence. Cenobamate: Moderate Monitor for excessive sedation and somnolence during coadministration of cenobamate and cetirizine.
Concurrent use may result in additive CNS depression. Chlorpheniramine; Codeine: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence. Chlorpheniramine; Dihydrocodeine; Phenylephrine: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence. Chlorpheniramine; Dihydrocodeine; Pseudoephedrine: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence.
Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence. Chlorpheniramine; Hydrocodone: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence. Chlorpheniramine; Hydrocodone; Phenylephrine: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence. Chlorpheniramine; Hydrocodone; Pseudoephedrine: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence.
Codeine: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence. Codeine; Guaifenesin: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence. Codeine; Guaifenesin; Pseudoephedrine: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence. Codeine; Phenylephrine; Promethazine: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence.
Codeine; Promethazine: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence. COMT inhibitors: Moderate Caution is recommended during concurrent use of cetirizine or levocetirizine with COMT inhibitors because of the possibility for additive sedative effects.
Cetirizine did not alter ritonavir disposition. Desloratadine: Minor Although desloratadine is considered a 'non-sedating' antihistamine, dose-related sedation has been noted. For this reason, it would be prudent to monitor for drowsiness during concurrent use of desloratadine with CNS depressants such as other H1-blockers. Desloratadine; Pseudoephedrine: Minor Although desloratadine is considered a 'non-sedating' antihistamine, dose-related sedation has been noted.
CNS depression is a desired effect of dexmedetomidine; however, concurrent use with a CNS depressant may prolong recovery. If concurrent use is necessary, monitor patients closely. Dihydrocodeine; Guaifenesin; Pseudoephedrine: Moderate Concomitant use of opioid agonists with cetirizine may cause excessive sedation and somnolence.
Vantage Covid September 15, Cornerstone Therapeutics. Related Topics Company Strategy. Download PDF. Share This Article. We use cookies on this website. By using this site, you agree that we may store and access cookies on your device. Find out more. Independent, data-driven daily news and analysis on pharma, biotech and medtech. There is currently no safe chronic opioid option. When considering patients for long-acting hydrocodone, the authors would advise to follow clear negative prognostic factors that have been established for chronic opioid treatment and include patients in an unstable or abusive living situation or with inadequate support, patients with poorly defined pain complaints with limited response to moderate opioid dosages, or those with somatoform disorders.
Multidisciplinary pain medicine treatment appears to enhance adherence and decrease adverse events. National Center for Biotechnology Information , U. Journal List J Pain Res v. J Pain Res. Published online Jan Author information Copyright and License information Disclaimer.
This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited. This article has been cited by other articles in PMC. Abstract Hydrocodone is a semisynthetic opioid, which has been used for decades as a short-acting analgesic combined with acetaminophen or less commonly ibuprofen. Keywords: hydrocodone, long-acting opioids, opioid abuse, acetaminophen toxicity, tamper-resistant opioids.
Current role of hydrocodone Hydrocodone, especially prescribed in combination with acetaminophen, is the most commonly prescribed opioid in the US. Long-acting opioids There have been only a few studies that have compared the different long-acting opioids.
Positive aspects of long-acting hydrocodone Hydrocodone is a well established semisynthetic opioid, which has been used for acute and chronic pain for decades. Estimations of abuse potential of long-acting hydrocodone Trials of intravenous opioid administration in opioid abusers have estimated roughly equivalent abuse potential between morphine, oxycodone, and hydrocodone. Hydrocodone pharmacokinetics, dosing, and potential long-term adverse effects Time-based administration of chronic opioid therapy has been shown, in at least one study, to result in increased overall opioid dosages and also in higher rates of patient concern about control over their opioid consumption.
Conclusion The pending availability of long-acting oral hydrocodone medications will add another type of long-acting opioid medication to the chronic pain armamentarium. Footnotes Disclosure The authors report no conflicts of interest in this work. References 1. Rockville, MD: Farrell S. Acetaminophen Toxicity Medscape Reference. Results of a prospective study of acute liver failure at 17 tertiary care centers in the United States.
Ann Intern Med. US Food and Drug Administration. Acetaminophen information. Monitoring the Future Study. Emergency department visits involving nonmedical use of selected prescription drugs in the United States, — Pain PalliatCare Pharmacother. Abuse risks and routes of administration of different prescription opioid compounds and formulations.
Harm reduction journal. Hydrocodone rescheduling amendment and pipeline products on the horizon. P and T: a peer-reviewed journal for formulary management. Portland OR : Evaluation of abuse of prescription and illicit drugs in chronic pain patients receiving shortacting hydrocodone or long-acting methadone opioids. Pain Physician. Hawley C. Abuse Experts Worried.
Melville NA. Egalet Ltd. Egalet Ltd-Tamper Resistance. Mastropietro D, Omidian H. Current approaches in tamper-resistant and abuse-deterrent formulations.
Drug development and industrial pharmacy.
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