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INTRODUCTION 1 AL M SYRUP is a combination of Levocetirizine and Montelukast which belongs to the group of medicines called H1 receptor antagonists and Leukotriene receptor antagonists respectively. 1 AL M SYRUP is indicated for the treatment and prevention of allergic rhinitis, chronic idiopa...
1 AL M SYRUP is a combination of Levocetirizine and Montelukast which belongs to the group of medicines called H1 receptor antagonists and Leukotriene receptor antagonists respectively. 1 AL M SYRUP is indicated for the treatment and prevention of allergic rhinitis, chronic idiopathic urticaria (allergic skin reaction with red raised itchy bumps on skin) and bronchial asthma in children aged between 2-5 years.
Allergic rhinitis (also known as hay fever) is a heterogeneous disorder characterized by inflammation of the inner lining of nose accompanied by nasal decongestion, repeated sneezing, wheezing or red, watery and itchy eyes.
It is usually caused by allergens such as pollens, dust, mould or flakes of skin from certain animals and can occur seasonally or year-round. Bronchial asthma is a long-term medical condition in which the path of the airways becomes inflamed, narrow and swollen. Symptoms include coughing, wheezing and chest tightness.
1 AL M SYRUP is contraindicated for use in children with severe kidney impairment. Consult your pediatrician before using 1 AL M SYRUP.
1 AL M SYRUP may cause certain unpleasant neuropsychiatric events (such as behaviour and mood-related changes: agitation including aggressive behaviour or hostility, depression) in some children and so parents or caregivers should immediately consult your child’s doctor if you notice any unusual behaviour in your child.
The most common side effects of taking 1 AL M SYRUP are upper respiratory tract infection, fever, cough, inflammation of the pharynx, dryness of mouth, headache and sleepiness. Consult your child’s doctor if any of the side effects worsen.
1 AL M SYRUP provides relief from the symptoms of allergic rhinitis, asthma and urticaria where levocetirizine acts by blocking the actions of histamines (a substance that causes an allergic reaction), at the H1 receptors present on the surface of cells and montelukast acts by blocking the action of leukotrienes D4 (an inflammatory molecule causing narrowing and swelling of the airways) in the lungs, thus causing relaxation of smooth muscle, reduction in swelling and/or inflammation of the airways and a marked decrease in the onset of allergic reactions.
Give 1 AL M SYRUP to your child as advised by the physician. Shake well before use. Use a measuring cup to properly measure the dose. Your child’s doctor will decide the correct dose and duration of 1 AL M SYRUP for your child depending upon the child’s age, body weight and disease condition.
Stop giving 1 AL M SYRUP to your child and contact the doctor immediately if your child experiences any of the following side effects:
Nausea and vomiting:
Follow a simple meal plan for your child while administering 1 AL M SYRUP. Avoid giving foods that are oily, fried or spicy foods. Do not let your child to lie down or sleep immediately after eating. Consult the child’s doctor if the symptom does not improve.
Diarrhoea:
Advise your child to drink plenty of water and stay hydrated. Avoid giving your child a high-fat diet or spicy foods. Try to avoid giving any medicine on your own to your child to treat diarrhoea. Consult the child’s doctor if the symptom gets worse.
Stomach pain:
Advise your child to rest and relax. Tell your child to eat and drink slowly or try to have lesser and more frequent meals. Keep a heating pad on the child’s stomach to relieve pain. Consult the child’s doctor if the symptom gets worse.
Headache:
Apply a hot or cold-water bag on your child’s head. Advise your child to take a rest in a quiet room. Massage the child’s scalp or head with mild pressure for relieving effect. Consult the child’s doctor if the symptom does not improve.
Skin rash:
Avoid hot showers because hot water can irritate your child’s skin further. Tell your child not to scratch the affected area. Use protective clothing for your child when going outdoors. Regularly moisturize your child’s skin. Consult your child’s doctor if the symptom did not improve.
1 AL M SYRUP is not recommended for use in pregnant women as it is used only in children. Consult your doctor for advice.
1 AL M SYRUP is not recommended for use in breastfeeding women as it is used only in children. Consult your doctor for advice.
Do not let your child drive their play cycle in outdoors or make them travel along with you for long hours, because this medicine may cause somnolence, sleepiness, tiredness or dizziness in them.
1 AL M SYRUP is not recommended for use in children with severe impairment of kidney function and should be used with caution in children with impaired kidney function. Consult your child’s doctor for advice before administration of 1 AL M SYRUP to your child.
1 AL M SYRUP should be taken with caution in children with liver disease. Consult your child’s doctor for advice before administration of 1 AL M SYRUP to your child.
Talk to your child’s doctor if your child is allergic to Montelukast, Levocetirizine or Cetirizine or other ingredients of 1 AL M SYRUP.
1 AL M SYRUP is not recommended for use in children with acute asthma attacks including status asthmaticus. Consult your child’s doctor for advice before administration of 1 AL M SYRUP to your child.
1 AL M SYRUP is not recommended for use if your child:
Before giving 1 AL M SYRUP to your child, inform the child’s doctor if your child:
Use in pediatrics:
1 AL M SYRUP is strictly not recommended for use in children aged below 2 years of age. Consult your child’s doctor for advice.
Use in geriatrics:
1 AL M SYRUP is not recommended for use in elderly patients as it is used only in children. Consult your doctor for advice.
A. Drug-Drug interactions:
Before giving 1 AL M SYRUP to your child, inform to child’s doctor if your child is taking or receiving any of the following medicines:
Overdosage:
If your child or anyone else accidentally takes too much of 1 AL M SYRUP, consult your child’s doctor immediately or visit the nearby hospital. Overdosage symptoms of 1 AL M SYRUP might include stomach pain, thirst, sleepiness, headache, vomiting, psychomotor hyperactivity, agitation and restlessness.
| Drug | : | Levocetirizine, Montelukast |
| Pharmacological Category | : | H1receptor antagonist, Leukotriene receptor antagonist |
| Therapeutic Indication | : | Allergic rhinitis, Bronchial asthma, Chronic idiopathic urticaria |
| Dosage Forms | : | Tablet, Capsule, Softgel capsule, Dispersible tablet, Syrup, Suspension |
My child is having a cough as well as allergic symptoms. Can I give both 1 AL M SYRUP and cough medicine together?
No, avoid concomitant use of cough medicine with 1 AL M SYRUP because it can add on the side effects like excessive sleepiness, fatigue and dizziness in your child. Always consult your paediatrician before using any medicine on your child. Ask your paediatrician to suggest any non-alcoholic cough medicine during treatment with 1 AL M SYRUP.
Can 1 AL M SYRUP make my child sleep?
Yes, 1 AL M SYRUP can cause sleepiness or drowsiness in some children, although not everybody gets them. This is quite normal and does not need to worry about it. Avoid unnecessary distractions in children and try to make them stay relaxed. Avoid taking them outdoors unnecessarily. Avoid giving them concomitant medicines that can make them drowsier like cough syrups or sedatives. If the symptom does not improve or worsens contact your child’s doctor.
Can 1 AL M SYRUP affects my child’s mood?
Yes, 1 AL M SYRUP can cause hyperactivity in some children, although not everybody gets them. Contact your paediatrician immediately if you notice any unusual psychological behaviour in your child during treatment with 1 AL M SYRUP.
Can I stop giving 1 AL M SYRUP to my child once the symptoms subside?
No, do not stop 1 AL M SYRUP abruptly without consulting your child’s doctor. Withdrawing the therapy with 1 AL M SYRUP abruptly can make the symptoms reappear in your child. Always follow the instruction given by your paediatrician to achieve better results.
Can 1 AL M SYRUP be used to treat acute asthmatic attacks in children?
No, 1 AL M SYRUP is used only to prevent asthma attacks. 1 AL M SYRUP should not be used on an asthma attack that has been started already. Contact the child’s doctor or go to the nearby hospital to avoid exacerbation of the attack.
Is 1 AL M SYRUP safe to use in children with kidney problems?
1 AL M SYRUP is not recommended for use in children with severe impairment of kidney function and should be used with caution in children with impaired kidney function. Consult your child’s doctor for advice before administration of 1 AL M SYRUP to your child.
1. KD. Tripathi. Histamines and Antihistamines & Drugs for cough and bronchial asthma. Essentials of medical pharmacology. Seventh edition. 2013. Page – 166-168 & 228-229.
2. Peter J. Barnes. Pulmonary pharmacology. Randal A. Skidgel, Allen P. Kaplan and Ervin G. Erdos. Histamine, Bradykinin, and their antagonists. Goodman & Gilman’s: The Pharmacological basics of Therapeutics. 12th Edition. New York McGraw Hill Medical 2011. Page – 918-923 & 1052-1054.
3. Maktuba Khabibullaevna Mirrakhimova, Gulnoza Aloevna Toshmatova, Dilbar Rahimovna Kurbanova, Eleonora Rinatovna Shamsiyeva, Mavjuda Bar. Clinical Efficacy of Montelukast (L-Montus Kid) in the Control of Mild Persistent Bronchial Asthma in Children. Journal of Critical Reviews. [Revised in February 2020] [Accessed on 13th October 2021] http://www.jcreview.com/fulltext/197-1587300312.pdf
4. Frank Hampel, Paul Ratner, Jean-Marc C Haeusler. Safety and tolerability of levocetirizine dihydrochloride in infants and children with allergic rhinitis or chronic urticaria. ResearchGate. July 2010. [Accessed on 13th October 2021] https://www.researchgate.net/publication/46157790_Safety_and_tolerability_of_levocetirizine_dihydrochloride_in_infants_and_children_with_allergic_rhinitis_or_chronic_urticaria
5. B Knorr, H H Nguyen, G L Kearns, C Villaran, M L Boza, T F Reiss, J D Rogers, J Zhang, P Larson, S Spielberg. Montelukast dose selection in children ages 2 to 5 years: comparison of population pharmacokinetics between children and adults. NIH National Library of Medicine, National center for biotechnology information. Pubmed.gov. June 2001. [Accessed on 13th October 2021] https://pubmed.ncbi.nlm.nih.gov/11402629/
6. RND Laboratories. Laboratories division. RND kast-L4 Syrup. [Accessed on 13th October 2021] http://www.rndlaboratories.com/laboratories_division.php
7. Cipla Ltd. Montair LC & Montair LC kid DT / Syrup (Montelukast sodium + Levocetirizine dihydrochloride). Ciplamed.com. [Revised in December 2020]. [Accessed on 13th October 2021] https://www.ciplamed.com/content/montair-lc-montair-lc-kid-dt-syrup
8. Cipla Ltd. Rid-AR Tablets & Rid-AR Kid DT/Syrup (Montelukast sodium + Levocetirizine dihydrochloride). Ciplamed.com. [Revised in November 2013]. [Accessed on 13th October 2021] https://www.ciplamed.com/content/rid-ar-tablets-rid-ar-kid-dtsyrup
9. Torrent Pharmaceuticals Ltd. Lezyncet-M. Torrentian.com. [Revised in April 2020]. [Accessed on 13th October 2021] https://www.torrentian.com/pisheet/Upload/PI_Sheet/2915.pdf
10. Centaur Pharma. MTnL Kid syrup. Centaurpharma.com. [Accessed on 13th October 2021] https://www.centaurpharma.com/downloads/peadiatrics/oth-respiratory/MTnL%20Kids%20Syrup.pdf
Written By Dr. R. Dinesh John Rajkumar, Pharm.D
Last updated on 06 Jan 2023 | 06:10 PM(IST)