Zykids Forte Special Precautions

Montelukast: Eosinophilic conditions: In rare cases, patients on therapy with anti-asthma agents including montelukast may present with systematic eosinophilia, sometimes presenting with clinical features of vasculitis consistent with Churg-Strauss syndrome, a condition which is often treated with systemic corticosteroid therapy. These events usually, but not always, have been associated with the reduction of oral corticosteroid therapy.
Physicians should be alert to eosinophilia, vasculitis rash, worsening pulmonary symptoms, cardiac complications, and/or neuropathy presenting in their patients. A causal association between Montelukast and these underlying conditions has not been established.
Patients with known aspirin sensitivity should continue avoidance of aspirin or non-steroidal anti-inflammatory agents while taking Montelukast.
Neuropsychiatric events have been reported in adults, adolescents, and children.
Levocetirizine: Caution should be taken in patients with predisposing factors of urinary retention (e.g., spinal cord lesion, prostatic hyperplasia) as levocetirizine may increase the risk of urinary retention.
Caution should be taken in patients with epilepsy and patients at risk of convulsion as levocetirizine may cause seizure aggravation. Response to allergy skin tests are inhibited by antihistamines and a wash-out period (of 3 days) is required before performing them.
Pruritus may occur when levocetirizine is stopped even if those symptoms were not present before treatment initiation. The symptoms may resolve spontaneously. In some cases, the symptoms may be intense and may require treatment to be restarted. The symptoms should resolve when the treatment is restarted. Avoid concurrent use of alcohol with Levocetirizine.
Renal Impairment: Levocetirizine is known to be substantially excreted by the kidneys and the risk of adverse reactions to this drug may be greater in patients with impaired renal function. Dosage adjustment may be required in patients with impaired renal function. Hence, this combination should be used with caution in such patients.
Hepatic Impairment: As Levocetirizine is mainly excreted unchanged by the kidneys, it is unlikely that the clearance of Levocetirizine is significantly decreased in patients with solely hepatic impairment. But Montelukast is mainly excreted through bile; Caution must be exercised while prescribing this combination in patients with impaired hepatic function.