EMEDZ.NET

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Dear Readers! I started this blog when my daughter was in the NICU. She had ventriculitis. Her CSF report grew E.coli. But, she was injected Teicoplanin directly into her brain. The doctors made two errors here:

Teicoplanin is for gram-positive bacteria only. It does not treat E.coli.
Teicoplanin is not for intraventricular use. The manufacturer strongly discourage injecting Teicoplanin into the brain.

My daughter bled into the brain. She lived for another two years and ultimately died.

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Cetirizine (Zyrtec, Sunizine) for Flu and Allergies

Cetirizine (Zyrtec, sunizine) inhibits histamine receptors present in the skin, gastrointestinal tract and blood vessels. It is used to treat patients with the following conditions:

Itching due to urticaria and allergic symptoms of the respiratory tract.

Off-Label Uses of Cetirizine in Adults include

Anaphylaxis
Acute allergic and recurrent angioedema
Reactions due to intravenous medications

Cetirizine (Zyrtec) dose in Adults

Cetirizine (Zyrtec) dose in Allergic rhinitis (runny nose) and conjunctivitis:

10 mg once daily. It may be given 2 - 5 hours before exposure to the allergen, however, daily administration is more effective.

For symptoms of hay fever or other upper respiratory allergies as OTC drug:

5 to 10 mg once daily to a maximum dose of 10 mg/day.

Off label use of Cetirizine in the treatment of Anaphylaxis as an adjunct to epinephrine for the relief of cutaneous symptoms:

Note: Cetirizine should not be used as monotherapy. It is also not effective in patients with shock and in relieving lower respiratory tract symptoms.

10 mg as a single dose

Off-label use of Cetirizine in the treatment of acute allergic and recurrent idiopathic Angioedema:

Note: It is not indicated for angioedema with anaphylaxis as it is not effective in the treatment of hypotension and symptoms of lower airway obstruction.

10 mg once or two times a day to a maximum dose of 20 mg twice daily

Off label use for premedication as an alternative agent in the treatment of Infusion reaction:
- 10 mg administered 30 - 60 minutes before the infusion of certain chemotherapy agents and biologics.

Use of Cetirizine in the treatment of acute and chronic spontaneous Urticaria:
- 10 mg once daily initially, the dose may be increased in increments of 10 mg every 1- 4 weeks to a maximum dose of 20 mg twice daily if the symptoms are not controlled.

Cetirizine (Zyrtec) dose in Children

Use of Cetirizine in the treatment of Chronic urticaria in children:

Infants 6 - 12 months of age:
- 2.5 mg once daily
Children 12 - 23 months of age:
- 2.5 mg once daily initially to a maximum dose of 2.5 mg twice daily
Children 2 - 5 years of age:
- 2.5 mg once daily to a maximum dose of 2.5 mg twice daily or 5 mg once daily

Use of Cetirizine in the treatment of Allergic rhinitis:

Infants 6 - 12 months of age:
- 2.5 mg once daily
Children 12 - 23 months of age:
- 2.5 mg once daily initially to a maximum dose of 2.5 mg twice daily

Use of Cetirizine in the treatment of hay fever and other Allergic symptoms:

Children 2 - 5 years of age:
- 2.5 mg once daily to a maximum dose of 2.5 mg twice daily or 5 mg once daily
Children older than 6 years and Adolescents:
- 5 to 10 mg once a day.

Pregnancy Risk Factor B

Cetirizine can be used to relieve allergic symptoms in pregnant women. However, it is best to use the lowest dose.

Cetirizine use during Breastfeeding:

Breastmilk is enriched with cetirizine.
Because of its less sedative effects, a second-generation antihistamine might be preferable to the first.
However, infants should be monitored for irritability and drowsiness.
Cetirizine can also reduce prolactin secretion, which may cause an increase in milk production in lactating mothers.

Cetirizine (Zyrtec) dose in Renal Disease:

The manufacturer has not recommended any dose adjustment in patients with renal disease, however, the following guidelines may be followed:

GFR of more than 50 mL/minute:
- No adjustment in the dose is required
GFR of less than 50 mL/minute:
- 5 mg once a day.
Intermittent hemodialysis:
- 5 mg once a day or three times a week
Peritoneal dialysis:
- 5 mg once a day.

Cetirizine (Zyrtec) dose in Liver Disease:

The manufacturer has not recommended any dose adjustment in patients with liver disease.
Because of its sedating properties, it should be used with caution in advanced liver disease.

Common Side Effects of Cetirizine:

Central nervous system:
- Drowsiness
- Headache

Less Common Side Effects of Cetirizine include:

Central nervous system:
- Insomnia
- Fatigue
- Malaise
- Dizziness
Gastrointestinal:
- Abdominal pain
- Xerostomia
- Diarrhea
- Nausea
- Vomiting
Respiratory:
- Pharyngitis
- Epistaxis
- Bronchospasm

Contraindications to Cetirizine:

Allergy or sensitivity to cetirizine, hydrazine, or any other component of the formulation

Warnings and Precautions

CNS depression:
- Patients who are using heavy machinery or those who need mental alertness such as driving should use it with caution.
Hepatic impairment
- In the case of advanced liver disease, use caution.
Renal impairment
- Patients with a GFR of less than 50 ml/min should be cautious and adjusted accordingly.

Cetirizine (systemic): Drug Interaction

Risk Factor C (Monitor therapy)
Acetylcholinesterase Inhibitors	May diminish the therapeutic effect of Anticholinergic Agents. Anticholinergic Agents may diminish the therapeutic effect of Acetylcholinesterase Inhibitors.
Alcohol (Ethyl)	Alcohol's CNS depressing impact may be amplified by CNS depressants (Ethyl).
Alizapride	May enhance the CNS depressant effect of CNS Depressants.
Amantadine	CNS depressants may have an enhanced CNS depressant impact.
Amezinium	Antihistamines may intensify Amezinium's stimulant effects.
Amphetamines	may lessen antihistamines' sedative effects.
Anticholinergic Agents	Other anticholinergic agents' negative or hazardous effects could be amplified.
Betahistine	Betahistine's therapeutic impact may be reduced by antihistamines.
Botulinum Toxin-Containing Products	may strengthen an anticholinergic agent's anticholinergic action.
Brexanolone	Brexanolone's CNS depressing effects may be amplified by other CNS depressants.
Brimonidine (Topical)	May enhance the CNS depressant effect of CNS Depressants.
Bromopride	May enhance the CNS depressant effect of CNS Depressants.
Cannabidiol	May enhance the CNS depressant effect of CNS Depressants.
Cannabis	May enhance the CNS depressant effect of CNS Depressants.
Chloral Betaine	May enhance the adverse/toxic effect of Anticholinergic Agents.
Chlorphenesin Carbamate	May enhance the adverse/toxic effect of CNS Depressants.
CNS Depressants	May enhance the adverse/toxic effect of other CNS Depressants.
Dimethindene (Topical)	May enhance the CNS depressant effect of CNS Depressants.
Doxylamine	May enhance the CNS depressant effect of CNS Depressants. Management: The manufacturer of Diclegis (doxylamine/pyridoxine), intended for use in pregnancy, speciﬁcally states that use with other CNS depressants is not recommended.
Dronabinol	May enhance the CNS depressant effect of CNS Depressants.
Erdaﬁtinib	May increase the serum concentration of P-glycoprotein/ABCB1 Substrates.
Esketamine	May enhance the CNS depressant effect of CNS Depressants.
Gastrointestinal Agents (Prokinetic)	Anticholinergic Agents may diminish the therapeutic effect of Gastrointestinal Agents (Prokinetic).
Glucagon	Anticholinergic Agents may enhance the adverse/toxic effect of Glucagon. Speciﬁcally, the risk of gastrointestinal adverse effects may be increased.
HydrOXYzine	May enhance the CNS depressant effect of CNS Depressants.
Itopride	Anticholinergic Agents may diminish the therapeutic effect of Itopride.
Kava Kava	May enhance the adverse/toxic effect of CNS Depressants.
Lofexidine	May enhance the CNS depressant effect of CNS Depressants. Management: Drugs listed as exceptions to this monograph are discussed in further detail in separate drug interaction monographs.
Lumacaftor	May decrease the serum concentration of P-glycoprotein/ABCB1 Substrates. Lumacaftor may increase the serum concentration of P-glycoprotein/ABCB1 Substrates.
Magnesium Sulfate	May enhance the CNS depressant effect of CNS Depressants.
MetyroSINE	CNS Depressants may enhance the sedative effect of MetyroSINE.
Mianserin	May enhance the anticholinergic effect of Anticholinergic Agents.
Minocycline	May enhance the CNS depressant effect of CNS Depressants.
Mirabegron	Anticholinergic Agents may enhance the adverse/toxic effect of Mirabegron.
Mirtazapine	CNS Depressants may enhance the CNS depressant effect of Mirtazapine.
Nabilone	May enhance the CNS depressant effect of CNS Depressants.
Nitroglycerin	Anticholinergic Agents may decrease the absorption of Nitroglycerin. Speciﬁcally, anticholinergic agents may decrease the dissolution of sublingual nitroglycerin tablets, possibly impairing or slowing nitroglycerin absorption.
P-glycoprotein/ABCB1 Inducers	May decrease the serum concentration of Pglycoprotein/ABCB1 Substrates. P-glycoprotein inducers may also further limit the distribution ofp-glycoprotein substrates to speciﬁc cells/tissues/organs where p-glycoprotein is present in large amounts (e.g., brain, T-lymphocytes, testes, etc.).
P-glycoprotein/ABCB1 Inhibitors	May increase the serum concentration of Pglycoprotein/ABCB1 Substrates. P-glycoprotein inhibitors may also enhance the distribution of pglycoprotein substrates to speciﬁc cells/tissues/organs where p-glycoprotein is present in large amounts (e.g., brain, T-lymphocytes, testes, etc.).
Pilsicainide	May increase the serum concentration of Cetirizine (Systemic). Cetirizine (Systemic) may increase the serum concentration of Pilsicainide.
Piribedil	CNS Depressants may enhance the CNS depressant effect of Piribedil.
Pitolisant	Antihistamines may diminish the therapeutic effect of Pitolisant.
Pramipexole	CNS Depressants may enhance the sedative effect of Pramipexole.
Ramosetron	Anticholinergic Agents may enhance the constipating effect of Ramosetron.
Ranolazine	May increase the serum concentration of P-glycoprotein/ABCB1 Substrates.
ROPINIRole	CNS Depressants may enhance the sedative effect of ROPINIRole.
Rotigotine	CNS Depressants may enhance the sedative effect of Rotigotine.
Ruﬁnamide	May enhance the adverse/toxic effect of CNS Depressants. Speciﬁcally, sleepiness and dizziness may be enhanced.
Selective Serotonin Reuptake Inhibitors	CNS Depressants may enhance the adverse/toxic effect of Selective Serotonin Reuptake Inhibitors. Speciﬁcally, the risk of psychomotor impairment may be enhanced.
Tetrahydrocannabinol	May enhance the CNS depressant effect of CNS Depressants.
Tetrahydrocannabinol and Cannabidiol	May enhance the CNS depressant effect of CNS Depressants.
Thiazide and Thiazide-Like Diuretics	Anticholinergic Agents may increase the serum concentration of Thiazide and Thiazide-Like Diuretics.
Topiramate	Anticholinergic Agents may enhance the adverse/toxic effect of Topiramate.
Trimeprazine	May enhance the CNS depressant effect of CNS Depressants.
Risk Factor D (Consider therapy modification)
Benzylpenicilloyl Polylysine	Antihistamines may diminish the diagnostic effect of Benzylpenicilloyl Polylysine. Management: Suspend systemic H1 antagonists for benzylpenicilloyl-polylysine skin testing and delay testing until systemic antihistaminic effects have dissipated. A histamine skin test may be used to assess persistent antihistaminic effects.
Blonanserin	CNS Depressants may enhance the CNS depressant effect of Blonanserin.
Buprenorphine	CNS Depressants may enhance the CNS depressant effect of Buprenorphine. Management: Consider reduced doses of other CNS depressants, and avoiding such drugs in patients at high risk of buprenorphine overuse/self-injection. Initiate buprenorphine patches (Butrans brand) at 5 mcg/hr in adults when used with other CNS depressants.
Chlormethiazole	May enhance the CNS depressant effect of CNS Depressants. Management: Monitor closely for evidence of excessive CNS depression. The chlormethiazole labeling states that an appropriately reduced dose should be used if such a combination must be used.
Droperidol	May enhance the CNS depressant effect of CNS Depressants. Management: Consider dose reductions of droperidol or of other CNS agents (eg, opioids, barbiturates) with concomitant use. Exceptions to this monograph are discussed in further detail in separate drug interaction monographs.
Flunitrazepam	CNS Depressants may enhance the CNS depressant effect of Flunitrazepam.
Hyaluronidase	Antihistamines may diminish the therapeutic effect of Hyaluronidase. Management: Patients receiving antihistamines (particularly at larger doses) may not experience the desired clinical response to standard doses of hyaluronidase. Larger doses of hyaluronidase may be required.
HYDROcodone	CNS Depressants may enhance the CNS depressant effect of HYDROcodone. Management: Avoid concomitant use of hydrocodone and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug.
Methotrimeprazine	CNS Depressants may enhance the CNS depressant effect of Methotrimeprazine. Methotrimeprazine may enhance the CNS depressant effect of CNS Depressants. Management: Reduce adult dose of CNS depressant agents by 50% with initiation of concomitant methotrimeprazine therapy. Further CNS depressant dosage adjustments should be initiated only after clinically effective methotrimeprazine dose is established.
Opioid Agonists	CNS Depressants may enhance the CNS depressant effect of Opioid Agonists. Management: Avoid concomitant use of opioid agonists and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug.
OxyCODONE	CNS Depressants may enhance the CNS depressant effect of OxyCODONE. Management: Avoid concomitant use of oxycodone and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug.
Perampanel	May enhance the CNS depressant effect of CNS Depressants. Management: Patients taking perampanel with any other drug that has CNS depressant activities should avoid complex and high-risk activities, particularly those such as driving that require alertness and coordination, until they have experience using the combination.
Pramlintide	May enhance the anticholinergic effect of Anticholinergic Agents. These effects are speciﬁc to the GI tract.
Secretin	Anticholinergic Agents may diminish the therapeutic effect of Secretin. Management: Avoid concomitant use of anticholinergic agents and secretin. Discontinue anticholinergic agents at least 5 half-lives prior to administration of secretin.
Sodium Oxybate	May enhance the CNS depressant effect of CNS Depressants. Management: Consider alternatives to combined use. When combined use is needed, consider minimizing doses of one or more drugs. Use of sodium oxybate with alcohol or sedative hypnotics is contraindicated.
Suvorexant	CNS Depressants may enhance the CNS depressant effect of Suvorexant. Management: Dose reduction of suvorexant and/or any other CNS depressant may be necessary. Use of suvorexant with alcohol is not recommended, and the use of suvorexant with any other drug to treat insomnia is not recommended.
Tapentadol	May enhance the CNS depressant effect of CNS Depressants. Management: Avoid concomitant use of tapentadol and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug.
Zolpidem	CNS Depressants may enhance the CNS depressant effect of Zolpidem. Management: Reduce the Intermezzo brand sublingual zolpidem adult dose to 1.75 mg for men who are also receiving other CNS depressants. No such dose change is recommended for women. Avoid use with other CNS depressants at bedtime; avoid use with alcohol.
Risk Factor X (Avoid combination)
Aclidinium	May enhance the anticholinergic effect of Anticholinergic Agents.
Azelastine (Nasal	CNS Depressants may enhance the CNS depressant effect of Azelastine (Nasal).
Bromperidol	May enhance the CNS depressant effect of CNS Depressants.
Cimetropium	Anticholinergic Agents may enhance the anticholinergic effect of Cimetropium.
Eluxadoline	Anticholinergic Agents may enhance the constipating effect of Eluxadoline.
Glycopyrrolate (Oral Inhalation	Anticholinergic Agents may enhance the anticholinergic effect of Glycopyrrolate (Oral Inhalation).
Glycopyrronium (Topical)	May enhance the anticholinergic effect of Anticholinergic Agents.
Ipratropium (Oral Inhalation)	May enhance the anticholinergic effect of Anticholinergic Agents.
Levosulpiride	Anticholinergic Agents may diminish the therapeutic effect of Levosulpiride.
Orphenadrine	CNS Depressants may enhance the CNS depressant effect of Orphenadrine.
Oxatomide	May enhance the anticholinergic effect of Anticholinergic Agents.
Oxomemazine	May enhance the CNS depressant effect of CNS Depressants.
Paraldehyde	CNS Depressants may enhance the CNS depressant effect of Paraldehyde.
Potassium Chloride	Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Chloride. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium chloride.
Potassium Citrate	Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Citrate.
Revefenacin	Anticholinergic Agents may enhance the anticholinergic effect of Revefenacin.
Thalidomide	CNS Depressants may enhance the CNS depressant effect of Thalidomide.
Tiotropium	Anticholinergic Agents may enhance the anticholinergic effect of Tiotropium.
Umeclidinium	May enhance the anticholinergic effect of Anticholinergic Agents.

Monitoring parameters:

Monitor the patient's response to therapy, mental status, and anticholinergic effects

How to take Cetirizine?

It is administered without regard to meals. The Chewable tablet should be chewed before swallowing

Mechanism of action of Cetirizine:

Cetirizine is a competitor to histamine receptors found in the gastrointestinal tract and blood vessels as well as the respiratory tract.

The treatment of allergies by inhibiting histamine can result in relief (by using vasoconstrictive properties, and inhibition of the chemotaxis between basophils and eosinophils).

The Onset of Action is about 0.7 hours, and cutaneous allergic symptoms can be suppressed for about 24 hours.

It is rapidly absorbed and is 93% bound with proteins.

The half-life elimination of Cetirizine in children is 6.2 hours, and in adults is 8 hours.

It takes one hour to reach peak serum concentration.

It is excreted mostly via urine, as an unchanged drug.

Cetirizine brand names:

All Day Allergy Children's
All Day Allergy
Allergy Relief
Allergy
Relief/Indoor/Outdoor
Cetirizine HCl Allergy Child
Cetirizine HCl Children's Allergy
Cetirizine HCl Hives Relief
GoodSense All Day Allergy
Zyrtec Allergy
Zyrtec Children's Allergy
Aceterin
Aceto
Acidrine
Acitrin
Acura
Adezio
Agelmin
Alatro
Alercet
Alercina
Alergine
Alerid
Alerid-10
Allercet
Allergy-Care
Allerkid
Allersan
Allertek
Alyr
Alzyr
Alzytec
Amertil
Anti-Hist Allergy
Aricetin
Arix
Artiz
Ascet
Askey
Askey DT
Atopix
Atrizin
Bluetec
Cabal
Ceritec
Cetallerg
Cetigen
Cetihexal
Cetihis
Cetimed
Cetiram
Cetirax
CetirHexal
Cetirin
Cetiristad
Cetix
Cetixin
Cetizin
Cetrak
Cetrimed
Cetrine
Cetrix
Cetro
Cetymin
Cezera
Cezin
Epirizine
Estin
Falergi
Finallerg
Gencet
Glotrizine
Green Nose
H-One
Histacet
Histacetin
Histalong
Histazine
Histec
Lergium
Letizen
N-Alergya
Nohist
Noler
Nosemin
Omcet
Ozen
Parlazin
Prixlae
Razene
Reactin
Reactine
Rolinoz
Ronex
Ryvel
Ryzen
Ryzicor
Selitex
Simtec
Sunizine
Sutac
Talzic
Terizin
Texzine
Tirizine
Triz
Trizin 5
Virlix
Xero-Sed
Zensil
Zericin
Zertin
Zertine
Zetaler
Zetalerg
Zetop
Zilarex
Zirec
Zirpine
Zirtec
Zirtek
Zirtin
Zodac
Zyllergy
Zyncet
Zyrac
Zyrak
Zyrcon
Zyrfar
Zyrlex
Zyrrtec
Zyrtec
Zyrtec Allergy
Zyrtec-R

Cetirizine Brands in Pakistan:

Cetirizine [Syrup 1 Mg/Ml]
Neset	Surge Laboratories (Pvt) Ltd

Cetirizine [Syrup 1 Mg/5ml]
Baydal	Bayer Health Care

Cetirizine [Syrup 2 Mg/5ml]
CLOMIN	GLITZ PHARMA

Cetirizine [Syrup 5 Mg/5ml]
AKSOZINE	AKSON PHARMACEUTICALS (PVT) LTD.
ALCE	DERMA TECHNO PAKISTAN
ALERID	PHARMATEC PAKISTAN (PVT) LTD.
ALGEZEN	OLIVE LABORATORIES
ALLAMINE	SHAFAZ PHARMA INTERNATIONAL (PVT) LTD.
ALLOS	ADAMJEE PHARMACEUTICALS (PVT) LTD.
ALZINE	BIOGENICS PAKISTAN (PVT) LTD.
ARIX	TABROS PHARMA
ASKOGIX	IDEAL PHARMACEUTICAL INDUSTRIES
AVEC	PLATINUM PHARMACEUTICALS (PVT.) LTD.
CENEX	DR. RAZA PHARMA (PRIVATE) LIMITED
CERIGEX	FEDRO PHARMACEUTICAL
CERIZINE	PHARMEVO (PVT) LTD.
CETRIN	PARAMOUNT PHARMACEUTICALS
CETRIZA	SAYYED PHARMACEUTICALS
CETSUN	HISUN PHARMACEUTICALS
CETZI	JAWA PHARMACEUTICALS(PVT) LTD.
CEZINE	P.D.H. PHARMACEUTICALS (PVT) LTD.
CEZIX	PEARL PHARMACEUTICALS
CISTAZINE	PHARMEDIC (PVT) LTD.
CITPHARM	EPHARM LABORATORIES
CITRICARE	CARE PHARMACEUTICALS
CTZINE	MEDICRAFT PHARMACEUTICALS (PVT) LTD.
DAVIZIN	DAVIS PHARMACEUTICAL LABORATORIES
DAYLONG	TRIGON PHARMACEUTICALS PAKISTAN (PVT) LTD.
DEEBAR	MEDICEENA PHARMA (PVT) LTD.
DICET	SHROOQ PHARMACEUTICALS
DOPNIL	STANDPHARM PAKISTAN (PVT) LTD.
EIDEM	DELUX CHEMICAL INDUSTRIES
FASTIC	SEMOS PHARMACEUTICALS (PVT) LTD.
GIXER	BARRETT HODGSON PAKISTAN (PVT) LTD.
HISTEX	XENON PHARMACEUTICALS (PVT) LTD.
INCIDAL-NEO	BAYER HEALTH CARE
INZEE	INDUS PHARMA (PVT) LTD.
ITIZ	ZANCTOK PHARMACEUTICALS
LOTOZIN	LOTUS PHARMACEUTICALS (PVT) LTD
MACRIZINE	MAC & RANS PHARMACEUTICALS (PVT) LTD
MAXZINE	MAX PHARMACEUTICALS
MIRAZIN	MIRACLE PHARMACEUTICALS(PVT) LTD
NEOZINE	NEO MEDIX
NEUTRIZINE	NEUTRO PHARMA (PVT) LTD.
NIMZINE	NIMRALL LABORATORIES
NO ALL	HARMANN PHARMACEUTICAL LABORATORIES (PVT) LTD.
RAKZINE	RAKAPOSHI PHARMACEUTICAL (PVT) LTD.
REGOGEX	REGENT LABORATORIES LTD.
REX	ALBRO PHARMA
RHIZIN	CIBEX (PRIVATE) LIMITED
RONEX	HILTON PHARMA (PVT) LIMITED
ROZEN	RASCO PHARMA
SAPIZINE	SAPIENT PHARMA
SEDIL	SAMI PHARMACEUTICALS (PVT) LTD.
STAMIN	Shaigan Pharmaceuticals (PVT) LTD
STAND CITRI	STANDARD DRUG CO.
TICZINE	LOWITT PHARMACEUTICALS (PVT) LTD
TIRIX	ALLIANCE PHARMACEUTICALS (PVT) LTD.
ZANLAN	NOVARTIS PHARMA (PAK) LTD
ZANLAN	NOVARTIS PHARMA (PAK) LTD
ZECIT	POLYFINE CHEMPHARMA (PVT) LTD.
ZETRINE	EFROZE CHEMICAL INDUSTRIES (PVT) LTD.
ZILCIT	ZINTA PHARMACEUTICALS INDUSTRIES
ZINE	LIBRA PHARMACEUTICALS (PVT) LTD
ZYRET	REX PHARMACEUTICALS PAKISTAN
ZYRTEC	AGP (PRIVATE) LTD.

Cetirizine [Susp 1 Mg/5ml]
CETRANEN	NENZA PHARMACEUTICALS (PVT) LIMITED

Cetirizine [Susp 5 Mg/5ml]
CETRAZIT	ATLANTIC PHARMACEUTICALS (PVT) LTD.

Cetirizine [Soln 5 Mg/5ml]
LINAZINE	ALINA COMBINE PHARMACEUTICALS (PVT) LTD.

Cetirizine [Oral Soln 5 Mg/5ml]
RIGIX	AGP (PRIVATE) LTD.

Cetirizine [Tabs 10 Mg]
ACTILIX-CTZ	GLAXOSMITHKLINE
AKSOZINE	AKSON PHARMACEUTICALS (PVT) LTD.
ALARZA	MAX PHARMACEUTICALS
ALARZA	MAX PHARMACEUTICALS
ALCE	DERMA TECHNO PAKISTAN
ALCIT	HIZAT PHARMACEUTICAL INDUSTRIES (PVT) LTD.
ALEGRA	TAGMA PHARMA (PVT) LTD.
ALER	LLOYDS PHARMACEUTICALS
ALERGO	PHARMIX LABORATORIES (PRIVATE) LIMITED.
ALERID	PHARMATEC PAKISTAN (PVT) LTD.
ALERWISE	PHARMAWISE LABS. (PVT) LTD.
ALERYAN	RORYAN PHARMACEUTICAL INDUSTRIES (PVT) LTD
ALERZINE	MEDERA PHARMACEUTICALS (PVT) LTD.
ALEX	INNVOTEK PHARMACEUTICALS
ALGEZEN	OLIVE LABORATORIES
ALLAMINE	SHAFAZ PHARMA INTERNATIONAL (PVT) LTD.
ALLERGID	HYGEIA PHARMACEUTICALS
ALLOS	ADAMJEE PHARMACEUTICALS (PVT) LTD.
ALZEX	ALSON PHARMACEUTICALS
ALZINE	BIOGENICS PAKISTAN (PVT) LTD.
AREX	DANAS PHARMACEUTICALS (PVT) LTD
ARIX	TABROS PHARMA
ASAZINE	ZEPHYR PHARMATEC (PVT) LTD.
ASKOGIX	IDEAL PHARMACEUTICAL INDUSTRIES
ASTEMINE	SIZA INTERNATIONAL (PVT) LTD.
AVAZIN	ASKARI PHARMACEUTICALS.
AVEC	PLATINUM PHARMACEUTICALS (PVT.) LTD.
BAYDAL	BAYER HEALTH CARE
BAYDAL	BAYER HEALTH CARE
BIOCIT	BIOGEN PHARMA
BYTEC	BATALA PHARMACEUTICALS.
CAYZINE	CAYLEX PHARMACEUTICALS (PVT) LTD.
CENE	VEGA PHARMACEUTICALS LTD.
CENEX	DR. RAZA PHARMA (PRIVATE) LIMITED
CERIDAL	AXIS PHARMACEUTICALS
CERIGEX	FEDRO PHARMACEUTICAL
CERIZINE	PHARMEVO (PVT) LTD.
CET	WILSHIRE LABORATORIES (PVT) LTD.
CETAHIST	PHARMACARE LABORATORIES (PVT) LTD.
CETIRIZINE	PULSE PHARMACEUTICALS
CETRANEN	NENZA PHARMACEUTICALS (PVT) LIMITED
CETRIAIM	AIMS TRADERS
CETRIHIT	UNIPHARMA (PVT) LTD.
CETRIMAK	MAKSON PHARMACEUTICALS
CETRIN	PARAMOUNT PHARMACEUTICALS
CETRIX	DON VALLEY PHARMACEUTICALS (PVT) LTD.
CETSUN	HISUN PHARMACEUTICALS
CETZI	JAWA PHARMACEUTICALS(PVT) LTD.
CEZEN	ENGLISH PHARMACEUTICALS INDUSTRIES
CEZINE	P.D.H. PHARMACEUTICALS (PVT) LTD.
CEZIX	PEARL PHARMACEUTICALS
CIPZIN	LEAMA CHEMI PHARMA (PVT.) LTD.
CISTAZINE	PHARMEDIC (PVT) LTD.
CITGEN	GENOME PHARMACEUTICALS (PVT) LTD
CITPHARM	EPHARM LABORATORIES
CITRESAL	UNIVERSAL PHARMACEUTICALS (PVT) LTD
CITRISAF	SAAAF PHARMACEUTICALS
CITRIWEL	WELMARK PHARMACEUTICALS
CITRIZA	SAYYED PHARMACEUTICALS
CITZAR	RORYAN PHARMACEUTICAL INDUSTRIES (PVT) LTD
CONCIDOL	CONVELL LABORATORIES
COXYZIN	GLOBAL PHARMACEUTICALS
CTZINE	MEDICRAFT PHARMACEUTICALS (PVT) LTD.
CYTEN	BLOOM PHARMACEUTICALS (PVT) LTD.
D-HISTINE	FLOW PHARMACEUTICALS (PVT) LTD.
DAISY	MEGA PHARMACEUTICALS (PVT) LTD
DAVIZIN	DAVIS PHARMACEUTICAL LABORATORIES
DEEBAR	MEDICEENA PHARMA (PVT) LTD.
DEMAST	PAKHEIM INTERNANATIONAL PHARMA
DICET	SHROOQ PHARMACEUTICALS
DOPNIL	STANDPHARM PAKISTAN (PVT) LTD.
EIDEM	DELUX CHEMICAL INDUSTRIES
FASTIC	SEMOS PHARMACEUTICALS (PVT) LTD.
FIRAX	USAWA PHARMACEUTICALS
FOZIN	FOZAN PHARMACEUTICALS INDUSTRIERS (PVT) LTD
GIXER	BARRETT HODGSON PAKISTAN (PVT) LTD.
GRAYZINE	GRAY`S PHARMACEUTICALS
HEALAZIN	HEAL PHARMACEUTICALS PVT LTD
HETRIZINE	SHAWAN PHARMACEUTICALS
HIRAZINE	21ST CENTURY PHARMACEUTICALS CO.
HISMATEC	Z-JANS PHARMACEUTICAL (PVT) LTD.
HISMIN	TRISON RESEARCH LABORATORIES (PVT) LTD
HISTANT	F.M. PHARMACEUTICALS INTERNATIONAL
HISTEX	XENON PHARMACEUTICALS (PVT) LTD.
INCIDAL-NEO	BAYER HEALTH CARE
INCIDAL-NEO	BAYER HEALTH CARE
INSTAZIN	FRIENDS PHARMA (PVT) LTD
INZEE	INDUS PHARMA (PVT) LTD.
ITRAT	SAYDON PHARMACEUTICAL INDUSTRIES (PVT) LTD.
LINAZINE	ALINA COMBINE PHARMACEUTICALS (PVT) LTD.
LOTOZIN	LOTUS PHARMACEUTICALS (PVT) LTD
LZINE	LINEAR PHARMA
MEDI-H1	MEDICON PHARMACEUTICALS INDUSTRIES (PVT) LTD
MISIDOL	HEALERS LABORATORIES
MUSTEX	MASS PHARMA (PRIVATE) LIMITED
NAWAZIN	NAWAN LABORATORIES (PVT) LTD.
NIMIZINE	NIMRALL LABORATORIES
NIMZINE	NIMRALL LABORATORIES
NIZEN	ZEPHYR PHARMATEC (PVT) LTD.
NO ALL	HARMANN PHARMACEUTICAL LABORATORIES (PVT) LTD.
NOSTAMIN	SANTE (PVT) LIMITED
NT HIST	ZESION PHARMACEUTICAL (PVT) LTD
OPTIZIN	CANDID PHARMACEUTICALS
ORTIZIN	OBSONS PHARMACEUTICALS
PANAZIN	PANACEA PHARMACEUTICALS
RAKZINE	RAKAPOSHI PHARMACEUTICAL (PVT) LTD.
REGOGEX	REGENT LABORATORIES LTD.
REX	ALBRO PHARMA
RHIZIN	CIBEX (PRIVATE) LIMITED
RIGIX	AGP (PRIVATE) LTD.
RONEX	HILTON PHARMA (PVT) LIMITED
ROTRAZIN	ROGEN PHARMACEUTICALS
ROZEN	RASCO PHARMA
SAPIZINE	SAPIENT PHARMA
SEDIL	SAMI PHARMACEUTICALS (PVT) LTD.
SELZINE	SELMORE AGENCIES
SERZINE	QINTAR PHARMACUTICALS
STAMIN	Shaigan Pharmaceuticals (PVT) LTD
STAND CITRI	STANDARD DRUG CO.
TICKNIL	SILVER OAK CORPORATION.
TICZINE	LOWITT PHARMACEUTICALS (PVT) LTD
TIRIX	ALLIANCE PHARMACEUTICALS (PVT) LTD.
TRINE	SHAHEEN AGENCIES
TRIZIM	REX PHARMACEUTICALS PAKISTAN
TRYZIN	PULSE PHARMACEUTICALS
TYZITEC	STAR LABORATORIES (PVT) LTD.
URTICAR	MEDERA PHARMACEUTICALS (PVT) LTD.
VIRLOS	FERROZA INTERNATIONAL PHARMACEUTICALS (PVT) LTD.
WEBZINE	WEBROS PHARMACEUTICALS
WINZIM	WNS FIELD PHARMACEUTICALS
XERO-SED	HAMAZ PHARMACEUTICAL (PVT) LTD.
XYDEN	DYSON RESEARCH LABORATORIES
Z-TEK	PAKHEIM INTERNANATIONAL PHARMA
ZANLAN	NOVARTIS PHARMA (PAK) LTD
ZANLAN	NOVARTIS PHARMA (PAK) LTD
ZEATIN	GLAXOSMITHKLINE
ZEC	MEDISURE LABORATORIES PAKISTAN (PVT.) LTD.
ZECIT	POLYFINE CHEMPHARMA (PVT) LTD.
ZETRINE	EFROZE CHEMICAL INDUSTRIES (PVT) LTD.
ZILCIT	ZINTA PHARMACEUTICALS INDUSTRIES
ZINE	LIBRA PHARMACEUTICALS (PVT) LTD
ZINGO	GOODMAN INTERNATIONAL,
ZINOLUR	REMINGTON PHARMACEUTICAL INDUSTRIES (PVT) LTD.
ZIRTEK	HANSEL PHARMACEUTICALS PVT (LTD)
ZYRTEC	AGP (PRIVATE) LTD.
ZYSIC	JINNAH PHARMACEUTICALS
ZYTIZINE	SHAZALS PHARMACEUTICALS

Cetirizine [Caps 10 Mg]
CETORID	HOOVER PHARMACEUTICALS (PVT) LTD
TARCIT	SEARLE PAKISTAN (PVT.) LTD.