Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Pathumwan, Bangkok, 10330, Thailand.
Department of Otolaryngology, Sawan Pracharak Hospital, Atthakawi Road, Tambon Paknam Pho, Amphoe Mueang Nakhon Sawan, Nakhon Sawan, 60000, Thailand.
Drugs. 2017 Feb;77(2):175-186. doi: 10.1007/s40265-016-0682-0.
As a substrate of P-glycoprotein, levocetirizine should not cause sedative effects. However, while cetirizine, a mixture of levocetirizine and dextrocetirizine, can slightly penetrate the blood brain barrier, the sedative effects of levocetirizine are still under study.
The aim of this study was to investigate the sedative effects of levocetirizine.
An electronic literature search was performed using Medline and EMBASE from January 01, 2001 through August 6, 2015. Randomized controlled trials (RCTs) comparing levocetirizine with other antihistamines or placebo for patients with allergy and healthy subjects were selected. Primary outcome was risk ratio between levocetirizine and comparators. Secondary outcome was change in psychomotor speed. Data were pooled for meta-analysis using a fixed-effect model.
Forty-eight studies of 18,014 patients met the inclusion criteria. When compared to placebo, levocetirizine produced modest sedative effects (RR: 1.67; 95% CI 1.17, 2.38). However, when compared to other second-generation antihistamines, sedative effects of levocetirizine did not differ (RR: 1.23; 95% CI 0.96, 1.58). In subgroup analysis, there was no difference between the sedative effects of levocetirizine and fexofenadine (RR: 1.7; 95% CI 0.59, 4.88), desloratadine (RR: 1.58; 95% CI 0.9, 2.77), loratadine (RR: 1.56; 95% CI 0.28, 8.56), bilastine (RR: 1.17; 95% CI 0.48, 2.84), olopatadine (RR: 1.09; 95% CI 0.81, 1.47), azelastine (RR: 0.19; 95% CI 0.01, 3.68) and rupatadine (RR: 1.47; 95% CI 0.14, 15.72). When compared to first-generation antihistamines, levocetirizine had less sedative effects and less change of reaction time (mean difference: -250.76 s; 95% CI -338.53, -162.98).
Levocetirizine has modest sedative effects with a risk ratio of 1.67 when compared with placebo. The sedative effects observed for levocetirizine are not different from other second-generation antihistamines.
左西替利嗪是 P 糖蛋白的底物，不应引起镇静作用。然而，虽然西替利嗪是左西替利嗪和右旋西替利嗪的混合物，可轻微穿透血脑屏障，但左西替利嗪的镇静作用仍在研究中。
本研究旨在研究左西替利嗪的镇静作用。
通过 Medline 和 EMBASE 进行电子文献检索，检索时间为 2001 年 1 月 1 日至 2015 年 8 月 6 日。选择了比较左西替利嗪与其他抗组胺药或安慰剂治疗过敏和健康受试者的随机对照试验（RCT）。主要结局为左西替利嗪与对照药物的风险比。次要结局为精神运动速度变化。使用固定效应模型对数据进行荟萃分析。
符合纳入标准的 18014 例患者的 48 项研究。与安慰剂相比，左西替利嗪产生适度的镇静作用（RR：1.67；95%CI 1.17，2.38）。然而，与其他第二代抗组胺药相比，左西替利嗪的镇静作用并无差异（RR：1.23；95%CI 0.96，1.58）。在亚组分析中，左西替利嗪与非索非那定（RR：1.7；95%CI 0.59，4.88）、地氯雷他定（RR：1.58；95%CI 0.9，2.77）、氯雷他定（RR：1.56；95%CI 0.28，8.56）、比拉斯汀（RR：1.17；95%CI 0.48，2.84）、奥洛他定（RR：1.09；95%CI 0.81，1.47）、氮卓斯汀（RR：0.19；95%CI 0.01，3.68）和鲁帕他定（RR：1.47；95%CI 0.14，15.72）的镇静作用无差异。与第一代抗组胺药相比，左西替利嗪的镇静作用较小，反应时间变化较小（平均差异：-250.76s；95%CI -338.53，-162.98）。
与安慰剂相比，左西替利嗪具有适度的镇静作用，风险比为 1.67。观察到的左西替利嗪镇静作用与其他第二代抗组胺药无差异。
