Licod-M
Generic Name
Levocetirizine + Montelukast
Manufacturer
Popular Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| licod m syrup | ৳ 82.00 | N/A |
Description
Overview of the medicine
Licod-M Syrup is a combination medication containing an antihistamine (Levocetirizine) and a leukotriene receptor antagonist (Montelukast). It is used to relieve symptoms of allergic rhinitis (seasonal and perennial) and to prevent asthma attacks.
Uses & Indications
Dosage
Adults
Usually 10 mL (Levocetirizine 5 mg + Montelukast 8 mg) orally once daily in the evening, or as directed by the physician. Note: Adult dose of Montelukast is typically 10 mg. This syrup formulation (4mg/5mL Montelukast) would require 12.5mL for 10mg Montelukast. So, it's often a pediatric formulation or combined with tablets for adults.
Elderly
No specific dose adjustment is required unless there is renal impairment. Use with caution.
Renal_impairment
Dose adjustment for Levocetirizine may be necessary. For mild to moderate impairment, 5 mL once daily. For severe impairment, not recommended or use with extreme caution.
How to Take
Take orally, usually once daily in the evening, with or without food. Use a measuring spoon or cup for accurate dosing.
Mechanism of Action
Levocetirizine selectively inhibits peripheral H1-receptors, thereby reducing histamine-mediated allergic symptoms. Montelukast selectively inhibits the cysteinyl leukotriene (CysLT1) receptor, which reduces bronchoconstriction and inflammatory effects associated with leukotrienes in asthma and allergic rhinitis.
Pharmacokinetics
Onset
Levocetirizine: ~1 hour. Montelukast: Bronchodilation within 1 day.
Excretion
Levocetirizine: Primarily excreted unchanged in urine (85.4%). Montelukast: Primarily excreted in feces via bile (approximately 86%).
Half life
Levocetirizine: ~7-10 hours. Montelukast: ~2.7-5.5 hours.
Absorption
Levocetirizine is rapidly and extensively absorbed, reaching peak plasma concentration in about 0.9 hours. Montelukast is rapidly absorbed after oral administration, with peak plasma concentration in about 2-4 hours.
Metabolism
Levocetirizine: Minimally metabolized. Montelukast: Extensively metabolized by CYP3A4, 2C8, and 2C9 enzymes in the liver.
Side Effects
Contraindications
- Hypersensitivity to Levocetirizine, Montelukast, or any components of the formulation.
- Severe renal impairment (creatinine clearance <10 mL/min) for Levocetirizine.
- Acute asthma attacks (Montelukast is not indicated for the reversal of bronchospasm in acute asthma attacks).
- Patients with galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption (if excipients contain lactose/galactose, though less common in syrups).
Drug Interactions
Rifampin
Induces CYP enzymes, potentially decreasing Montelukast plasma concentrations.
Ritonavir
May increase plasma concentrations of Levocetirizine.
Phenobarbital
Decreases Montelukast AUC, but no dosage adjustment is recommended.
CNS Depressants (e.g., alcohol, sedatives)
Concurrent use with Levocetirizine may increase CNS depression.
Storage
Store below 30°C in a cool, dry place. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include drowsiness, agitation, headache, abdominal pain. Treatment is symptomatic and supportive. Gastric lavage and activated charcoal may be considered. Hemodialysis is not effective.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have not shown harm, but adequate studies in pregnant women are lacking. Use during pregnancy only if clearly needed. Both Levocetirizine and Montelukast are excreted in breast milk; caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from the date of manufacture, depending on manufacturer specifications.
Availability
Available in pharmacies and hospitals
Approval Status
Approved by national drug authority
Patent Status
Off-patent
Clinical Trials
Extensive clinical trials have established the efficacy and safety of both Levocetirizine and Montelukast individually and in combination for the treatment of allergic rhinitis and asthma. Studies have shown significant improvement in symptom scores and quality of life.
Lab Monitoring
- Generally not required for routine use. Liver function tests may be considered in patients with pre-existing hepatic impairment or prolonged use of Montelukast. Renal function monitoring for Levocetirizine in patients with renal impairment.
Doctor Notes
- Emphasize evening administration due to sedative potential of Levocetirizine and optimal Montelukast efficacy.
- Counsel patients/caregivers on monitoring for neuropsychiatric side effects, especially mood changes, agitation, or suicidal ideation.
- Adjust dose in patients with renal impairment, particularly for Levocetirizine.
- Not for acute asthma attacks; patients should carry their rescue inhaler.
Patient Guidelines
- Take this medicine regularly as prescribed, preferably in the evening.
- Do not exceed the recommended dose.
- Be aware of potential drowsiness and use caution when driving or operating machinery.
- Monitor for any behavioral changes or mood disturbances, especially in children, and report to your doctor immediately.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose.
Driving Precautions
This medicine may cause drowsiness, dizziness, or impaired judgment. Patients should be advised to exercise caution when driving a car or operating potentially hazardous machinery until they know how they react to the medication.
Lifestyle Advice
- Avoid exposure to known allergens that trigger your symptoms.
- Maintain a clean and dust-free environment.
- Quit smoking and avoid secondhand smoke.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.