SG-plus
Generic Name
Levocetirizine Dihydrochloride + Montelukast Sodium
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| sg plus 5 mg syrup | ৳ 20.64 | N/A |
Description
Overview of the medicine
SG-plus syrup is a combination medication containing Levocetirizine Dihydrochloride and Montelukast Sodium. It is primarily used for the symptomatic treatment of allergic rhinitis (seasonal and perennial), chronic idiopathic urticaria, and as prophylaxis and chronic treatment of asthma.
Uses & Indications
Dosage
Adults
Children (6-14 years): 5 ml (Levocetirizine 2.5 mg + Montelukast 4 mg) once daily in the evening. For adults and adolescents (15 years and older): Generally, a higher strength tablet form is preferred, but if syrup is used, 10 ml once daily in the evening.
Elderly
No specific dose adjustment is generally required for elderly patients with normal renal function. Caution with renal impairment.
Renal_impairment
Dose adjustment may be required. Consult a physician. For severe renal impairment, use is generally not recommended or dosage significantly reduced.
How to Take
Take orally, once daily in the evening, with or without food. For best results, take at the same time each day.
Mechanism of Action
Levocetirizine, an H1-receptor antagonist, blocks histamine action, reducing allergic symptoms. Montelukast, a leukotriene receptor antagonist, inhibits leukotrienes, reducing bronchoconstriction and inflammation associated with asthma and allergic rhinitis.
Pharmacokinetics
Onset
Levocetirizine: ~1 hour. Montelukast: Within 1 day for asthma effects.
Excretion
Levocetirizine: Primarily excreted unchanged in urine. Montelukast: Primarily excreted in faeces via bile.
Half life
Levocetirizine: ~7-10 hours. Montelukast: ~2.7-5.5 hours.
Absorption
Levocetirizine: Rapidly and extensively absorbed after oral administration, peak plasma concentration reached in 0.9 hours. Montelukast: Rapidly absorbed after oral administration, peak plasma concentration reached in 2-4 hours.
Metabolism
Levocetirizine: Minimally metabolized in the liver (less than 14% of the dose). Montelukast: Extensively metabolized by CYP3A4, 2C8, and 2C9 enzymes in the liver.
Side Effects
Contraindications
- Hypersensitivity to levocetirizine, montelukast, or any component of the formulation.
- Severe renal impairment (creatinine clearance less than 10 ml/min).
- End-stage renal disease requiring dialysis.
- Children under 6 years of age for this combination syrup.
Drug Interactions
Phenytoin
May decrease plasma concentrations of montelukast.
Ritonavir
May increase plasma concentrations of levocetirizine.
Theophylline
No significant pharmacokinetic interaction with levocetirizine. Montelukast clearance may be affected by drugs inducing/inhibiting CYP enzymes.
Phenobarbital
May decrease plasma concentrations of montelukast.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include drowsiness, somnolence, agitation, abdominal pain, headache, and hyperactivity. Management is primarily supportive and symptomatic. Gastric lavage may be considered soon after ingestion. Hemodialysis is not effective.
Pregnancy & Lactation
Use during pregnancy only if clearly needed and the potential benefits outweigh the potential risks to the fetus. It is unknown if levocetirizine or montelukast are excreted in human milk; caution should be exercised when administered to a nursing woman.
Side Effects
Contraindications
- Hypersensitivity to levocetirizine, montelukast, or any component of the formulation.
- Severe renal impairment (creatinine clearance less than 10 ml/min).
- End-stage renal disease requiring dialysis.
- Children under 6 years of age for this combination syrup.
Drug Interactions
Phenytoin
May decrease plasma concentrations of montelukast.
Ritonavir
May increase plasma concentrations of levocetirizine.
Theophylline
No significant pharmacokinetic interaction with levocetirizine. Montelukast clearance may be affected by drugs inducing/inhibiting CYP enzymes.
Phenobarbital
May decrease plasma concentrations of montelukast.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include drowsiness, somnolence, agitation, abdominal pain, headache, and hyperactivity. Management is primarily supportive and symptomatic. Gastric lavage may be considered soon after ingestion. Hemodialysis is not effective.
Pregnancy & Lactation
Use during pregnancy only if clearly needed and the potential benefits outweigh the potential risks to the fetus. It is unknown if levocetirizine or montelukast are excreted in human milk; caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from manufacturing date (unopened).
Availability
Available in pharmacies nationwide
Approval Status
Approved by DGDA
Patent Status
Generics available
Clinical Trials
Clinical trials have demonstrated the efficacy and safety of Levocetirizine and Montelukast combination in treating allergic rhinitis and asthma symptoms, including studies specifically in pediatric populations.
Lab Monitoring
- Liver function tests (LFTs) may be monitored periodically, especially if liver impairment is suspected or during long-term therapy. Renal function should be monitored in patients with renal impairment.
Doctor Notes
- Advise parents/caregivers to monitor for neuropsychiatric symptoms, especially with Montelukast.
- Emphasize consistent daily dosing for optimal asthma control.
- Review renal function in patients with kidney impairment before prescribing.
Patient Guidelines
- Take this medicine exactly as prescribed by your doctor.
- Do not stop taking this medicine suddenly without consulting your doctor, especially if treating asthma.
- Be aware of potential side effects like drowsiness; avoid driving or operating heavy machinery if affected.
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 to catch up.
Driving Precautions
This medicine may cause drowsiness or dizziness. Avoid driving or operating machinery until you know how it affects you.
Lifestyle Advice
- Avoid known allergens that trigger your symptoms.
- Maintain a healthy lifestyle, including regular exercise and a balanced diet.
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