• Clinical and Experimental Pediatrics
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• v.62 no.2
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• pp.75-78
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• 2019

Although rare, antihistamines can cause adverse effects, including drug-induced eruptions or anaphylaxis. A 4-year-old child visited the pediatric department of a hospital for skin eruptions after administration of antihistamines, (e.g., ucerax [hydroxyzine] or leptizine [levocetirizine]), for cholinergic rashes; he did not have pruritus. Skin prick, intradermal, and drug provocation tests were performed to determine the relationship between the antihistamines and eruptions. Levocetirizine induced wheals in the skin prick test and a rash in the oral drug provocation test. In contrast, ketotifen induced no reaction in the skin prick test but showed a positive reaction in the oral provocation test. Our case report highlights that children can experience the same types of adverse reactions as seen in adults, and cross-reactivity between various antihistamines can occur.

• Korean Journal of Clinical Pharmacy
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• v.24 no.3
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• pp.213-218
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• 2014

Objectives: The aim of this study was to identify the causal relationship between use of levocetrizine or cetrizine, and liver injury, by comparing frequency and pattern of hepatotoxicity in levocetrizine or cetrizine prescribed patients. Methods: This is a retrospective observational study, using data retrieved from electronic medical record system. Among 1164 patients prescribed levocetrizine or cetrizine during study period (Jul, 2009 - Jun, 2010) at Seoul National University Hospital, 543 patients with more than 4- time liver function test (LFT) results were included in final analysis. Liver injury was defined as greater than 3 times elevated level of alanine aminotransferase or 2 times elevated level of alkaline phosphatase or total bilirubin, compared to upper limit of normal, in patient with normal liver function at baseline. The frequency and pattern of liver injury were assessed. Results: Incidence of liver injury in patients prescribed with levotcetrizine or cetrizine were 1.48% and 2.94%, respectively. With few exceptions, most injuries were shown to be hepatocellular type. Rapid recovery was observed after drug cessation and long term use tends to be associated with incidence of liver injury. In patient with digestive system disorder, rate of liver injury was significantly higher (p=0.011). Conclusion: The result of this study implies potential need of liver toxicity monitoring, especially in patients taking long term levecetrizine or cetrizine or in patient with digestive system disorder. However, prospective large scale observational study is needed to confirm liver injury associated with the use of levocetirizine or cetirizine.

• Korean Journal of Clinical Pharmacy
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• v.22 no.2
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• pp.176-180
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• 2012

The stability of triamcinolone in three kinds of oral liquid syrups at 4 and $25^{\circ}C$ was studied for 21 days. Twenty tablets of 4 mg triamcinolone were mixed with 100 mL of each oral liquid syrup, which is Levotuss$^{(R)}$Syrup (levodropropizine 6 mg/mL), Ucerax$^{(R)}$Syrup (hydroxyzine 2 mg/mL), and Xyzal$^{(R)}$Liquid (levocetirizine 0.5 mg/mL). The chromatographic analysis after deliberate degradation showed no evidence of any breakdown product likely to interfere with the chromatographic peak of the parent substance. The relationship between triamcinolone concentrations and peak areas was linear from 50 to 1000 ${\mu}g/mL$ ($r^2$ = 0.9998). The analysis method was precise, with coefficients of variation no greater than 5.4%. Triamcinolone was stable for up to 14 and 21 days in Levotuss$^{(R)}$Syrup at 25 and $4^{\circ}C$, respectively; in Ucerax$^{(R)}$Syrup and Xyzal$^{(R)}$Syrup, it was stable for at least 21 days at both temperatures. The percentages of initial triamcinolone concentration remaining after 21 days were $72.3{\pm}3.2$ and $94.9{\pm}6.0%$ and $93.2{\pm}4.9$ and $92.4{\pm}5.7%$, and $92.6{\pm}1.2$ and $92.7{\pm}2.2%$ in Levotuss$^{(R)}$Syrup, Ucerax$^{(R)}$Syrup, and Xyzal$^{(R)}$Syrup at 25 and $4^{\circ}C$, respectively. The pH variations of all test solutions were within 0.8. Based on the results, it was concluded that triamcinolone in three oral liquid syrups which are Levotuss$^{(R)}$syrup, Ucerax$^{(R)}$syrup and Xyzal$^{(R)}$syrup was chemically and physically stable in both states of refrigeration and room temperature for at least 14 days.