Levokast 4/2.5mg Suspension 60ml Allschoolabs -

Specification

INTRODUCTION
LEVOKAST 4/2.5MG SUSPENSION is a combination of Levocetirizine and Montelukast which belongs to theroup of medicines called H1 receptor antagonists and Leukotriene receptor antagonists respectively. LEVOKAST 4/2.5MG SUSPENSION is indicated for the treatment and prevention of allergic rhinitis, chronic idiopathic urticaria (allergic skin reaction with red raised itchy bumps on skin) and bronchial asthma in children aged between 2-5 years.
Allergic rhinitis (also known as hay fever) is a heterogeneous?disorder characterized by inflammation of the inner lining of the nose accompanied by?nasal decongestion, repeated sneezing, wheezing or red, watery and itchy eyes.
It is usually caused by allergens such as pollens, dust, mould or flakes of skin from certain animals and can occur seasonally or year-round. Bronchial asthma is a long-term medical condition in which the path of the airways becomes inflamed, narrow and swollen. Symptoms include coughing, wheezing and chest tightness.
LEVOKAST 4/2.5MG SUSPENSION is contraindicated for use in children with severe kidney impairment. Consult your pediatrician before using LEVOKAST 4/2.5MG SUSPENSION.
LEVOKAST 4/2.5MG SUSPENSION may cause certain unpleasant neuropsychiatric events (such as behaviour and mood-related changes: agitation including aggressive behaviour or hostility, depression) in some children and so parents or caregivers should immediately consult your child?s doctor if you notice any unusual behaviour in your child.
The most common side effects of taking LEVOKAST 4/2.5MG SUSPENSION are upper respiratory tract infection, fever, cough, inflammation of the pharynx, dryness of mouth, headache and sleepiness. Consult your child?s doctor if any of the side effects worsen.
USES OF LEVOKAST 4/2.5MG SUSPENSION

Treats and prevents allergic rhinitis, chronic idiopathic urticaria and bronchial asthma in children aged between 2-5 years

HOW LEVOKAST 4/2.5MG SUSPENSION WORKS
LEVOKAST 4/2.5MG SUSPENSION provides relief from the symptoms of allergic rhinitis, asthma and urticaria where levocetirizine acts by blocking the actions of histamines (a substance that causes an allergic reaction), at the H1 receptors present on the surface of cells and montelukast acts by blocking the action of leukotrienes D4 (an inflammatory molecule causing narrowing and swelling of the airways) in the lungs, thus causing relaxation of smooth muscle, reduction in swelling and/or inflammation of the airways and a marked decrease in the onset of allergic reactions.
DIRECTIONS FOR USE
Give LEVOKAST 4/2.5MG SUSPENSION to your child as advised by the physician. Shake well before use. Use a measuring cup to properly measure the dose. Your child?s doctor will decide the correct dose and duration of LEVOKAST 4/2.5MG SUSPENSION for your child depending upon the child?s age, body weight and disease condition.
SIDE EFFECTS OF LEVOKAST 4/2.5MG SUSPENSION

COMMON

Sinusitis (inflammation of the nasal passage)

Rhinorrhea (thin mucus discharge from nose)

Upper respiratory infection

Cough, cold, fever or flu-like symptoms

Pharyngitis (inflammation of the pharynx)

Headache and tiredness

Dizziness, sleepiness

Nausea, vomiting, dry mouth, thirst, stomach pain, diarrhoea, indigestion

Otitis media (inflammation or infection of the ears)

Skin rash, eczema, urticaria (itching)

Myopia or conjunctivitis (eye problems)

Varicella infection

Bleeding from the nose

Muscle pain, joint pain

UNCOMMON

Behaviour and mood related changes: dream abnormalities, including nightmares, trouble sleeping, sleepwalking, irritability, feeling anxious, restlessness

Drowsiness, tingling, prickling and numbness sensation usually in hands or legs

Bruising, itching, hives

Muscle cramps

Bedwetting in children

Weakness, feeling unwell, swelling

RARE

Behaviour and mood related changes: disturbance in attention, memory impairment

Uncontrolled muscle movements
Stopiving LEVOKAST 4/2.5MG SUSPENSION to your child and contact doctor immediately if your child experiences any of the following side effects:
Allergic reactions including swelling of the face, lips, tongue, and/or throat which may cause difficulty in breathing or swallowing

Behaviour and mood related changes: agitation including aggressive behaviour or hostility, depression

Seizure

Increased bleeding tendency

Tremor

Palpitations

HOW TO MANAGE SIDE EFFECTS
Nausea and vomiting:
Follow a simple meal plan for your child while administering LEVOKAST 4/2.5MG SUSPENSION. Avoidiving foods that are oily, fried or spicy foods. Do not let your child to lie down or sleep immediately after eating. Consult the child?s doctor if the symptom does not improve.
Diarrhoea:
Advise your child to drink plenty of water and stay hydrated. Avoidiving your child a high-fat diet or spicy foods. Try to avoidiving any medicine on your own to your child to treat diarrhoea. Consult the child?s doctor if the symptomets worse.
Stomach pain:
Advise your child to rest and relax. Tell your child to eat and drink slowly or try to have lesser and more frequent meals. Keep a heating pad on the child?s stomach to relieve pain. Consult the child?s doctor if the symptomets worse.
Headache:
Apply hot or cold-water bag on your child?s head. Advise your child to take rest in a quiet room. Massage the child?s scalp or head with mild pressure for relieving effect. Consult the child?s doctor if the symptom does not improve.
Skin rash:
Avoid hot showers because hot water can irritate your child?s skin further. Tell your child not to scratch the affected area. Use protective clothing for your child whenoing outdoors. Regularly moisturize your child?s skin. Consult your child?s doctor if the symptom did not improve.
WARNING & PRECAUTIONS

PREGNANCY
LEVOKAST 4/2.5MG SUSPENSION is not recommended for use in pregnant women as it is used only in children. Consult your doctor for advice.
BREASTFEEDING
LEVOKAST 4/2.5MG SUSPENSION is not recommended for use in breastfeeding women as it is used only in children. Consult your doctor for advice.
DRIVING AND USING MACHINES
Do not let your child drive their play cycle in outdoors or make them travel along with you for long hours, because this medicine may cause somnolence, sleepiness, tiredness or dizziness in them.
KIDNEY
LEVOKAST 4/2.5MG SUSPENSION is not recommended for use in children with severe impairment of kidney function and should be used with caution in children with impaired kidney function. Consult your child?s doctor for advice before administration of LEVOKAST 4/2.5MG SUSPENSION to your child.
LIVER
LEVOKAST 4/2.5MG SUSPENSION should be taken with caution in children with liver disease. Consult your child?s doctor for advice before administration of LEVOKAST 4/2.5MG SUSPENSION to your child.
ALLERGY
Talk to your child?s doctor if your child is allergic to Montelukast, Levocetirizine or Cetirizine or other ingredients of LEVOKAST 4/2.5MG SUSPENSION.
LUNGS
LEVOKAST 4/2.5MG SUSPENSION is not recommended for use in children with acute asthma attacks including status asthmaticus. Consult your child?s doctor for advice before administration of LEVOKAST 4/2.5MG SUSPENSION to your child.
OTHERS
LEVOKAST 4/2.5MG SUSPENSION is not recommended for use if your child:
Hasalactose intolerance (an inherited condition in which the body cannot convertalactose tolucose)

Has Lapp lactase deficiency (deficiency of the enzyme lactase in the body)

Haslucose-galactose malabsorption

Has phenylketonuria (release of phenylalanine in urine)
Beforeiving LEVOKAST 4/2.5MG SUSPENSION to your child, inform the child?s doctor if your child:
Has epilepsy

Has sensitivity to aspirin or other NSAIDs

Has schedule for allergy skin tests

Has any predisposing factors of urinary retention (Ex. spinal cord lesion, prostatic hyperplasia)
Use in pediatrics:
LEVOKAST 4/2.5MG SUSPENSION is strictly not recommended for use in children aged below 2 years of age. Consult your child?s doctor for advice.
Use ineriatrics:
LEVOKAST 4/2.5MG SUSPENSION is not recommended for use in elderly patients as it is used only in children. Consult your doctor for advice.
INTERACTIONS
A. Drug-Drug interactions:
Beforeiving LEVOKAST 4/2.5MG SUSPENSION to your child, inform to child?s doctor if your child is taking or receiving any of the following medicines:
Gemfibrozil?(used to control high blood cholesterol levels)

Phenytoin, phenobarbital (used to treat epilepsy)

Rifampicin (used to treat tuberculosis)

Ritonavir (a medicine used to treat viral infections)

Theophylline (a medicine used to treat asthma)

Alcohol containing medicines (Ex. antitussives)
Overdosage:
If your child or anyone else accidentally takes too much of LEVOKAST 4/2.5MG SUSPENSION, consult your child?s doctor immediately or visit the nearby hospital. Overdosage symptoms of LEVOKAST 4/2.5MG SUSPENSION might include stomach pain, thirst, sleepiness, headache, vomiting, psychomotor hyperactivity, agitation and restlessness.
SYNOPSIS

Drug :?? Levocetirizine, Montelukast

Pharmacological Category :?? H1 receptor antagonist, Leukotriene receptor antagonist

Therapeutic Indication :?? Allergic rhinitis, Bronchial asthma, Chronic idiopathic urticaria

Dosage Forms :?? Tablet, Capsule, Dispersible Tablet, Oral Solution, Syrup, Suspension

MORE INFORMATION

Keep LEVOKAST 4/2.5MG SUSPENSION out of reach of children

Store LEVOKAST 4/2.5MG SUSPENSION at room temperature

FAQs ABOUT LEVOKAST 4/2.5MG SUSPENSION
My child is having a cough as well as allergic symptoms. Can Iive both LEVOKAST 4/2.5MG SUSPENSION and cough medicine together?
No, avoid concomitant use of cough medicine with LEVOKAST 4/2.5MG SUSPENSION because it can add on the side effects like excessive sleepiness, fatigue and dizziness in your child. Always consult your pediatrician before using any medicine on your child. Ask your pediatrician to suggest any non-alcoholic cough medicine during treatment with LEVOKAST 4/2.5MG SUSPENSION.
Can LEVOKAST 4/2.5MG SUSPENSION make my child sleep?
Yes, LEVOKAST 4/2.5MG SUSPENSION can cause sleepiness or drowsiness in some children, although not everybodyets them. This is quite normal and does not need to worry about it. Avoid unnecessary distractions in children and try to make them stay relaxed. Avoid taking them outdoors unnecessarily. Avoidiving them concomitant medicines that can make them drowsier like cough syrups or sedatives. If the symptom does not improve or worsens contact your child?s doctor.
Can LEVOKAST 4/2.5MG SUSPENSION affects my child?s mood?
Yes, LEVOKAST 4/2.5MG SUSPENSION can cause hyperactivity in some children, although not everybodyets them. Contact your pediatrician immediately if you notice any unusual psychological behaviour in your child during treatment with LEVOKAST 4/2.5MG SUSPENSION.
Can I stopiving LEVOKAST 4/2.5MG SUSPENSION to my child once the symptoms subside?
No, do not stop LEVOKAST 4/2.5MG SUSPENSION abruptly without consulting your child?s doctor. Withdrawing the therapy with LEVOKAST 4/2.5MG SUSPENSION abruptly can make the symptoms reappear in your child. Always follow the instructioniven by your pediatrician to achieve better results.
Can LEVOKAST 4/2.5MG SUSPENSION be used to treat acute asthmatic attacks in children?
No, LEVOKAST 4/2.5MG SUSPENSION is used only to prevent asthma attacks. LEVOKAST 4/2.5MG SUSPENSION should not be used on an asthma attack that has been started already. Contact child?s doctor oro to the nearby hospital to avoid exacerbation of the attack.
Is LEVOKAST 4/2.5MG SUSPENSION safe to use in children with kidney problems?
LEVOKAST 4/2.5MG SUSPENSION is not recommended for use in children with severe impairment of kidney function and should be used with caution in children with impaired kidney function. Consult your child?s doctor for advice before administration of LEVOKAST 4/2.5MG SUSPENSION to your child.
REFERENCES
1. KD. Tripathi. Histamines and Antihistamines & Drugs for cough and bronchial asthma. Essentials of medical pharmacology. Seventh edition. 2013. Page ? 166-168 & 228-229.
2. Peter J. Barnes. Pulmonary pharmacology. Randal A. Skidgel, Allen P. Kaplan and Ervin. Erdos. Histamine, Bradykinin, and their antagonists.oodman &ilman?s: The Pharmacological basics of Therapeutics. 12th Edition. New York McGraw Hill Medical 2011. Page ? 918-923 & 1052-1054.
3. Maktuba Khabibullaevna Mirrakhimova,ulnoza Aloevna Toshmatova, Dilbar Rahimovna Kurbanova, Eleonora Rinatovna Shamsiyeva, Mavjuda Bar. Clinical Efficacy of Montelukast (L-Montus Kid) in the Control of Mild Persistent Bronchial Asthma in Children. Journal of Critical Reviews. [Revised in February 2020] [Accessed on 13th October 2021] http://www.jcreview.com/fulltext/197-1587300312.pdf
4. Frank Hampel, Paul Ratner, Jean-Marc C Haeusler. Safety and tolerability of levocetirizine dihydrochloride in infants and children with allergic rhinitis or chronic urticaria. ResearchGate. July 2010. [Accessed on 13th October 2021] https://www.researchgate.net/publication/46157790_Safety_and_tolerability_of_levocetirizine_dihydrochloride_in_infants_and_children_with_allergic_rhinitis_or_chronic_urticaria
5. B Knorr,?H H Nguyen,?G L Kearns,?C Villaran,?M L Boza,?T F Reiss,?J D Rogers,?J Zhang,?P Larson,?S Spielberg. Montelukast dose selection in children ages 2 to 5 years: comparison of population pharmacokinetics between children and adults. NIH National Library of Medicine, National center for biotechnology information. Pubmed.gov. June 2001. [Accessed on 13th October 2021] https://pubmed.ncbi.nlm.nih.gov/11402629/
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7. Cipla Ltd. Montair LC & Montair LC kid DT / Syrup?(Montelukast sodium Levocetirizine dihydrochloride). Ciplamed.com. [Revised in December 2020]. [Accessed on 13th October 2021] https://www.ciplamed.com/content/montair-lc-montair-lc-kid-dt-syrup
8. Cipla Ltd. Rid-AR Tablets & Rid-AR Kid DT/Syrup?(Montelukast sodium Levocetirizine dihydrochloride). Ciplamed.com. [Revised in November 2013]. [Accessed on 13th October 2021] https://www.ciplamed.com/content/rid-ar-tablets-rid-ar-kid-dtsyrup
9. Torrent Pharmaceuticals Ltd. Lezyncet-M. Torrentian.com. [Revised in April 2020]. [Accessed on 13th October 2021] https://www.torrentian.com/pisheet/Upload/PI_Sheet/2915.pdf
10. Centaur Pharma. MTnL Kid syrup. Centaurpharma.com. [Accessed on 13th October 2021] https://www.centaurpharma.com/downloads/peadiatrics/oth-respiratory/MTnL Kids Syrup.pdf
USEFUL DIAGNOSTIC TESTS