Cirrus – application, composition, mode of action, side effects

Proven content

Cirrus is a preparation that has antiallergic and nasal decongestion properties. It is used to treat the symptoms of seasonal and perennial allergic rhinitis. How does Cirrus work and what is the composition? What indications and contraindications exist for its use? What precautions should be taken when taking the drug and what side effects can it cause? How to use Cirrus and with what drugs should not be combined?

An allergy is a pathological reaction of the immune system in response to contact with an allergen. The symptoms of allergies can cause us many inconveniences in everyday life. In such situations, it is worth reaching for an effective drug that will help alleviate or overcome the symptoms of allergies. One of such prescription preparations is Cirrus, used in allergology and family medicine.

Cirrus – general characteristics of the drug

Cirrus is a medicine whose active substances are cetirizine dihydrochloride and pseudephedrine hydrochloride. Its international name is Cetirizini dichydrochloridum + Pseudoephedryni hydrochloridum.

It is a preparation used to combat the symptoms of seasonal and year-round allergies, such as: stuffy nose, sneezing, runny nose and itchy nose and conjunctiva. Cirrus is used for antiallergic activity and to reduce nasal congestion.

The drug is in the form of prolonged-release tablets and is sold in a pack containing 14 tablets. The drug is available only with a prescription issued by a doctor.

Cirrus prepared dinner it is not refundable and we have to pay approximately PLN 26 for a package of Cirrus. The drug should be stored in a dry place that is difficult to reach for children.

The distributor of Cirrus in Poland is UCB Pharma Sp. z o. o. has been present on the market since 1928. The seat of the company is invariably in Brussels, and for over 30 years the company has been operating in Poland, with an office located in Warsaw and medical representatives in all regions of Poland. The company is an international and biopharmaceutical company that is present on the markets of around 40 countries around the world, focusing its activities on serious systemic diseases.

What are allergens and what do they cause? Check: Allergens – types of allergens, allergy symptoms

Composition and mode of action of Cirrus

Cirrus is a combined preparation containing two active substances: cetirizine and pseudoephedrine. One tablet contains 5 mg of cetirizine dihydrochloride and 120 mg of pseudoephedrine hydrochloride.

The first of them shows antihistamine effect, selective for histamine type 1 (H1) receptors. Cetirizine is a second-generation antihistamine substance that practically does not penetrate the blood-brain barrier. Its task is to block peripheral H1 receptors and inhibit the peripheral action of histamine. In people with hypersensitivity, this substance works by inhibiting the inflow of cells in the late phase of the inflammatory reaction to the skin and conjunctiva. Thanks to cetirizine, the symptoms of an allergic reaction such as sneezing, runny nose, swelling and itching of the mucous membranes are alleviated, as well as the prevention of bronchospasm and the formation of skin reactions.

The second main ingredient in Cirrus is pseudoephedrine o sympathomimetic effect. It works by activating the adrenergic receptors (alpha type) of the smooth muscles in the walls of blood vessels, causing the vessels to contract and reducing congestion and swelling of the nasal mucosa.

The active substances in Cirrus are rapidly absorbed from the gastrointestinal tract after oral administration. The maximum plasma concentration of cetirizine occurs within 60 minutes of taking the drug, while pseudoephedrine occurs within 2-6 hours, and both components are mainly excreted unchanged in the urine.

In addition to the active substance, Cirrus contains excipients. The immediate-release layer contains: lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, colloidal anhydrous silica and magnesium stearate.

On the other hand, in the extended-release layer there are such auxiliary substances as: hypromellose, microcrystalline cellulose, colloidal anhydrous silica and magnesium stearate.

The tablet coating consists of: Opadry Y-1-7000 white, hypromellose, titanium dioxide (E171) and macrogol 400.

How to distinguish a runny nose from allergies? Read: Common runny nose or allergy? How to tell them apart?

Indications for the use of Cirrus

Cirrus is prescribed by a doctor to treat the symptoms of perennial or seasonal allergic rhinitis. The preparation is indicated when, in addition to the antiallergic effect, reduction of nasal congestion is required. Cirrus is indicated mainly to relieve associated allergies:

1. nasal congestion;
2. sneezing;
3. runny nose (runny nose)
4. itchy nose;
5. itching of the conjunctiva and nose;
6. stuffy nose feeling.

How to distinguish allergy from flu and coronavirus? Read on: Allergy, Flu or Coronavirus? Symptoms can be confusing

Contraindications to the use of Cirrus

Cirrus cannot always be used to treat allergy symptoms in every patient. The main contraindication to the administration of this drug is known hypersensitivity to any component of the drug, as well as to ephedrine, piperazine or its derivatives.

Certain diseases and other circumstances may also constitute a contraindication to the use of or an indication for dose adjustment of Cirrus. In some situations it may also be necessary to undergo certain check-ups before taking this medicine, which should be done by your doctor after a medical history.

The diseases that require consultation before introducing Cirrus into treatment include:

1. severe arterial hypertension;
2. severe form of ischemic heart disease;
3. severe renal failure;
4. decompensated hyperthyroidism;
5. severe heart rhythm disturbances;
6. the presence of a pheochromocytoma of the adrenal medulla;
7. glaucoma and increased intraocular pressure;
8. urinary retention;
9. stroke, as well as an increased risk of hemorrhagic stroke;
10. taking dihydroergotamine (a medicine for migraine);
11. are taking monoamine oxidase inhibitors (MAOIs) or have been taking them in the last two weeks.

A contraindication to the use of Cirrus is also the age of the patient. The preparation should not be used by children under the age of 12 due to the content of pseudoephedrine and the lack of available studies on the safety and effectiveness of the drug in this age group.

Has the pandemic affected the quality of life of allergy sufferers? Read on: Allergy and pandemic. What is the life of allergy sufferers like today?

How to take and dose Cirrus

Cirrus is an orally administered drug with a prolonged release time. The drug is intended for use by adults and children from 12 years of age.

The recommended dose of Cirrus in adults and children over 12 years of age, it is one tablet taken twice a day (morning and evening) with or between meals.

Patients with renal impairment or hepatic impairment should reduce the dosage of Cirrus to 1 tablet a day.

The use of Cirrus in children under 12 years of age is contraindicated.

The preparation should be used when symptoms appear. If the symptoms worsen and do not disappear after 5 days, contact your doctor immediately.

Period of taking Cirrus should not exceed the period of symptoms and should not exceed 2 to 3 weeks. After alleviating allergic symptoms, such as rhinitis, treatment may be continued with a cetirizine-only preparation.

Cirrus tablets should be swallowed whole (not chewed, crushed or crushed) and washed down with plenty of water. Although high-fat meals do not change the bioavailability of any of the active substances, after eating them, the maximum plasma concentration of cetirizine is lower and occurs much later.

If you have any doubts about how to use the preparation, consult your doctor or pharmacist. Incorrect use or dosage of the drug may harm your health or life.

How to take medication correctly? Check: How to take medications effectively?

Overdosing or missing a dose of Cirrus

The use of Cirrus should be under the constant supervision of a doctor in the doses prescribed by him. In case a patient forgets to take a tablet, do not supplement the tablet by taking a double dose. However, in the event of taking a larger dose of the drug than recommended, immediately consult a doctor.

Cetirizine, the active substance of Cirrus, taken at a higher dose may adversely affect the central nervous system.

The main symptoms that may occur from an overdose of Cirrus are: diarrhea, dizziness, tiredness, headache, malaise, urinary retention, pupil dilation, increased heart rate, heart rhythm disturbances, increase in blood pressure, apnea, sedation, loss of consciousness, bluish skin, cardiovascular collapse, hallucinations, insomnia, tremors and seizures.

Some of the above symptoms, such as arrhythmias, circulatory collapse, coma and respiratory failure, can be fatal.

Symptoms related mainly to effects on the central nervous system or symptoms suggestive of an anticholinergic effect, e.g. toxic psychosis with delusions and hallucinations, may occur in the event of a significant overdose of Cirrus.

In the event of an overdose and any symptoms occurring, immediately contact your doctor or the nearest emergency department.

Treatment of an overdose of Cirrus should be conducted in a hospital setting. It mainly consists of inducing vomiting and gastric lavage. Although hemodialysis removes cetirizine and pseudoephedrine from the body to a small extent, there is no complete antidote for overdose.

An overdose of Cirrus causes contraindications to the administration of sympathomimetic amines.

In the event of high blood pressure and tachycardia, drugs that block alpha-adrenergic receptors or drugs that block beta-adrenergic receptors should be used. If seizures occur, administer intravenous diazepam (rectally for children).

Incorrect use of Cirrus, especially exceeding the dose may pose a threat to our health and life, so you should follow all the recommendations of your doctor or pharmacist.

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Side effects of taking Cirrus

The use of Cirrus may cause the patient to experience side effects. However, side effects do not have to occur in every person who uses this drug.

It is important to report any suspected adverse reactions after authorization of the medicinal product so that the benefit / risk balance of the medicinal product can be monitored.

The general classification of the frequency of adverse body reactions (ADRs) is based on the following principles: very common (≥1 / 10), common (≥1 / 100 to <1/10), uncommon (≥1 / 1 to <000/1), rare ( ≥100 / 1 to <10 / 000), very rare (<1 / 1), not known (cannot be estimated from the available data).

The occurrence of side effects depends on the dose used. The side effects often disappear with continued treatment.

The following side effects may occur during drug therapy with Cirrus:

1. common: nervousness, insomnia, dizziness and headache, sleepiness, increased heart rate, dry mouth, nausea, feeling weak;
2. occurring uncommonly: anxiety, agitation;
3. occurring rarely: hypersensitivity reactions, hallucinations, convulsions, tremors, arrhythmias, pallor, high blood pressure, vomiting, liver dysfunction, dry skin, rash, increased sweating, hives, painful, difficult urination;
4. occurring very rarely: psychotic disorders, dysgeusia, stroke, ischemic colitis, drug rash, circulatory collapse, angioedema;
5. frequency unknown: disturbed eye accommodation, blurred vision, unusual dilation of the pupils, eye pain, decreased vision, abnormal light tolerance, shortness of breath, erectile dysfunction, severe skin reactions, palpitations, decreased blood flow to the optic nerve.

Although the use of Cirrus, as well as the use of other drugs, may cause side effects, the expected benefits of using the drug are usually greater than the harm that may result from taking the preparation. If disturbing symptoms occur, immediately consult a doctor or report to the nearest emergency department.

What are antihistamines and how do they work? Read on: Antihistamines – what are they?

Use of Cirrus during pregnancy and lactation

During pregnancy and lactation, it is very important to consult a doctor before taking any medication in order to clarify beyond any doubt the potential risks and benefits associated with the use of the drug.

Women who are pregnant or planning to become pregnant should inform their doctor who will prescribe them Cirrus. Although there are insufficient data on the use of this drug in pregnant women, its use is not recommended.

Pseudoephedrine, the active substance of Cirrus, used in the first trimester of pregnancy is associated with an increase in the incidence of congenital gastroschisis (a developmental defect of the abdominal wall with displacement of the intestines out of the abdominal cavity) and small intestine arthritis (congenital obstruction of the small intestine). Pseudoephedrine also has a vasoconstrictor effect, therefore it should not be administered in the third trimester of pregnancy as it may reduce uteroplacental circulation.

However, for the second active substance of Cirrus, cetirizine, there is no evidence of adverse effects during pregnancy or of any effects on the health of the fetus and neonate.

As cetirizine and pseudoephedrine pass into breast milk, Cirrus should not be used during breast-feeding so that it does not pass into the baby’s body.

The use of Cirrus in pregnant or breastfeeding women is acceptable when the benefits of the therapy for the mother outweigh the potential risk to the fetus, only after consultation and on the recommendation of a doctor.

What is worth knowing about proper supplementation during pregnancy? Check: Conscious choices. Diet and supplementation in pregnancy

Interactions of Cirrus with alcohol and other drugs

The initiation of therapy with Cirrus requires a detailed interview with the patient regarding all recently taken medications, including over-the-counter medications. The use of certain medications at the same time as taking Cirrus can cause serious side effects.

Studies on the drug did not show any significant interactions that could adversely affect the action of cetirizine contained in it with cimetidine, erythromycin, ketoconazole, azithromycin, antipyrine, pseudoephedrine, diazepam, glipizide or theophylline.

However, it is worth noting that there are preparations that may interact with Cirrus. The pseudoephedrine hydrochloride in Cirrus is a sympathomimetic amine that interacts with monoamine oxidase inhibitors. The combination of these substances can lead to a hypertensive crisis.

Moreover, the combination of pseudoephedrine with cardiac glycosides, e.g. digitoxin or digoxin, may induce an ecotopic increase in the activity of the cardiac conduction system. Medicines that should not be used at the same time as Cirrus include:

1. dihydroergotamina;
2. linezolid;
3. tricyclic antidepressants, e.g. imipramine, amitriptyline, doxepin;
4. vasoconstrictor drugs, e.g. bromocriptine, pergolide, lisuride, cabergoline, ergotamine;
5. nasal decongestants, e.g. phenylephrine, phenylpropanolamine, ephedrine;
6. appetite suppressants, e.g. mazindol, penteramine;
7. psychostimulants, e.g. amphetamine and its derivatives;
8. drugs to lower blood pressure, e.g. methyldopa, guanethidine, reserpine, bisoprolol, atenolol;
9. cardiac glycosides;
10. Central nervous system depressants, e.g. sedatives;
11. antacids, e.g. aluminum or magnesium hydroxide, omeprazole;
12. halogenated general anesthetics;
13. kaolin;
14. theophylline;
15. rytonawir.

It should be noted that apart from the interaction of Cirrus with other drugs, it may also react with the consumed alcohol. Similarly to drugs that inhibit the functions of the central nervous system, alcohol consumption may also cause such inhibition and worsen psychophysical efficiency.

When you combine Cirrus with drugs that depress the central nervous system and drink alcohol, your reaction skills, mental performance and concentration may be further impaired.

Which drugs should never be combined with each other? Check: Dangerous interactions

Precautions while taking Cirrus

Taking Cirrus may require special care in certain circumstances. The use of this preparation must be discussed with a physician in advance, who will individually assess the risk that the implementation of Cirrus may entail in the treatment of the patient’s condition. Particular precautions should be taken in the case of comorbidities, such as:

1. diagnosed with rare hereditary problems of galactose intolerance, lactase deficiency or glucose-galactose malabsorption;
2. diabetes;
3. hyperthyroidism;
4. hypertension;
5. tachycardia and arrhythmias;
6. ischemic heart disease;
7. moderate renal failure;
8. moderate liver failure;
9. enlarged prostate or difficult emptying of the bladder;
10. people at increased risk of blood clotting conditions (e.g. due to inflammatory bowel disease).

Special precautions for the use of Cirrus should be observed in the elderly.

In addition, patients who plan to drive vehicles, perform potentially hazardous activities or operate machines should not exceed the recommended dose of the drug and pay attention to the individual response of the body to the drug.

It should be noted that there may be various individual reactions to Cirrus and that this preparation may cause drowsiness, fatigue and psychophysical fitness. That is why it is so important to exercise caution when taking Cirrus in the treatment process.

What might be the consequences of an untreated allergy? Check: Effects of untreated allergies

Cirrus substitutes available on the market

Products with the same international name and in the same form do not always have to be a substitute for a given drug, because the content of active substances, i.e. the dose of the drug, determines the use of a drug.

It is important to remember that even when the dose of the active ingredient is similar, the patient may not always benefit from a substitute, as he may be allergic to any of the excipients of the drug.

Therefore, before using a substitute for Cirrus, read the package leaflet and it is best to discuss a change of Cirrus with your doctor or pharmacist.

Potential substitutes for Cirrus can be such preparations as:

1. Cirrus Two cetirizine dihydrochloride and pseudoephedrine hydrochloride with two active substances;
2. Acatarick Allergythe active substance of which is cetirizine dihydrochloride is an antiallergic drug indicated in adults and children aged 6 years and older;
3. Letizen with the active substance cetirizine dihydrochloride, it is an antiallergic drug, indicated in adults and children aged 6 years and older;
4. Cetirizine Genoptimthe active ingredient of which is cetirizine dihydrochloride, which belongs to a group of medicines called antihistamines, used to treat people with hay fever;
5. Cetirizine Genoptim SPHthe active substance of which is cetirizine dihydrochloride is an antiallergic (antihistamine) medicine indicated in adults and children from 6 years of age;
6. Aerinaze in tablet form, which is a combination drug, the active substances of which are: desloratadine, which is an antihistamine, and pseudoephedrine sulfate, which is a decongestant;
7. artizinethe active substance of which is cetirizine dihydrochloride;
8. CetAlergin Ten it is an antiallergic drug, when used in therapeutic doses it inhibits the early and late phase of the allergic reaction, alleviating the symptoms of allergy, its active substance is cetirizine dihydrochloride;
9. Cetrix, the active ingredient of which is cetirizine dihydrochloride, belongs to a group of medicines called systemic antihistamines, which are antiallergic;
10. Zyrtec UCB with the active substance cetirizine dihydrochloride, is an antiallergic drug.

When is it worth asking the pharmacy about drug substitutes? Check: Swap when you can