About Apotex

Apotex, the supreme pharmaceutical company in Canada, is committed to enrich individual’s quality of life with cost effective and bioequivalent products worldwide. The products meet the global regulatory, quality and compliance requirements and standards. Apotex is committed to provide broad range of high-quality, affordable medicines, most of which have FDA approval that is a proof of entrusting the highest global standards.

It has been approximately two decades that Apotex Canadian brand is present in Iranian Market. And Apotex in Iran has been exclusively represented by Rasta Imen Daroo, through scientific promotional activities.

It has to be mentioned that the company is the member of United Nation Global Impact. Moreover, this brand is a well-known and trusted brand among patients and physicians.

Campaign Description

Apotex is committed to inform the society about health issues. In this regard “Allergy-Free Zone Campaign” was established aligned with the social responsibilities of business corporates; meaning that besides business related activities, the company aims to provide patients with supportive and awareness programs focusing on the disease education and suggesting solutions for better disease control.

This campaign was designed in cooperation with “Allergy and Hypersensitivity Information Center of Iran”. The idea originated from marketing department of Apotex, Iran with the purpose of establishing a creative and attractive manner of information release instead of traditional and routine frameworks. An artistic performance was an example of this thought. This idea attracted the audience in a way that they started asking questions about the disease after the performance and Apotex scientific team answered the questions.

The story of the performance was the traditional challenge between Good and Evil. At first two actors started their routine life demonstrating ups and downs and challenging with others. Then the allergen (evil) entered the stage trying to interrupt and affect the individuals. The actors attempted to show the effect of allergy by sneezing, itching and coughing. Afterwards, angels appeared in the role of saviors and suggested solutions to actors helping them with their allergy symptoms to return to their normal life.

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A Common Experience Named Allergy

Allergy and its symptoms are very familiar for us; we or at least one of our relatives have experienced its unfavorable impacts.

What is Allergy?

Allergy is a disorder caused by overreaction of immune system to a safe environmental agent called allergen. Non-allergic individuals may have no problem encountering allergens. For example, many people have no problem confronting with cats while some show allergic symptoms to cats (like sneezing, congestion and itching).

Immune system is continuously controlling body’s function acting like the security of a government. Our immune system protects us against external harmful substances (like pollens, bacteria and viruses) or even our own cells that might become dangerous for us (like cancer cells).

Immune system has to allow beneficial substances to enter the body as well. Allergy is caused by the error made by immune system attacking allergens causing inflammation and allergy symptoms.

There Are Two Types of Allergies

1. Immediate hypersensitivity reactions

Many of us are familiar with this type of reaction and it is usually called allergy. IgE immunoglobulin is the antibody causing the symptoms. This response is initiated within 30-60 minutes and is mostly related to food allergies and the inflammation of nasal mucosa. In this case skin allergy tests are taken and are observed in 10- 15 minutes.

2. Delayed hypersensitivity reactions

T immune cells are responsible for this reaction. This response is started within 24-48 hours after encountering to an allergen and is mostly related to Atopic Dermatitis (Eczema). In these cases skin allergy tests are taken and are ready to be observed in 2-4 days.

Allergic reactions are initiated in two steps:

1. Sensitizing Step: In this step immune system is reacted to allergen and antibodies are being produced. Allergic symptoms will not appear in this stage.

2. Symptomatic step: In further contacts, allergens stick to the IgE antibodies in the surface of the cell and allergy symptoms are appeared following the release of substances which cause allergy symptoms. Histamine is one of these factors that is known very well.

Allergy Symptoms

Allergy and its symptoms are very familiar for us; we or at least one of our relatives have experienced its unfavorable impacts.

The most common symptoms caused by allergic reactions are demonstrated in the below table.

Allergic Diseases

During recent 20-30 years, allergic reactions have shown increasing trend involving 1 out of 4 individuals in developed countries. There are different types of allergic symptoms in the matter of abundance and severity. Allergy involves the whole body; however the symptoms mostly appear in organs in direct contact with the environment like skin, respiratory system and GI tract. When allergens enter the blood (e.g. by insect bite or injection), cardiovascular system may get involved as well.

Respiratory Allergies

• Asthma: Is a chronic inflammatory disease which is caused by narrowing of respiratory airways leading to respiratory disorders. Nearly 300 million people around the world are dealing with this disease. Asthma symptoms include continuous period of wheezing, shortness of breath, chest tightness and coughing. In allergic asthma, which is the most common type of asthma, encountering with allergens like pollens, dust mites, pets and molds cause the symptoms to appear. Other asthma triggers include viral infections, sports, acid reflux, some medicines (especially aspirin) and psychological factors. In spite of Asthma being a serious disease, with a proper treatment, patients can have a normal life.

• Rhinitis: is a very common disorder caused by the inflammation or stimulation of nasal mucosa. Patients describe Rhinitis usually as the tightness of nose while others may describe it as rhinorrhea, sneezing, nasal itching or eye (ocular) symptoms.

The most common causes of nasal inflammation are viral infections and allergic reactions to aerial allergens. Encountering with allergens like pollens, dust mites, pets and molds stimulates the immune system to produce an antibody called IgE. Allergic rhinitis is categorized into two types, seasonal allergic rhinitis and permanent allergic rhinitis, according to patients being sensitized to seasonal allergens (e.g. pollens) or non-seasonal allergens (e.g. home dusts, mites and pets)

• Seasonal allergy is in fact the inflammation of nasal airways which occurs because of allergy to flower pollens. Patients who become sensitive to pollens of a special plant or flower may experience Hay Fever (spring allergy) every year in a definite time. This is why spring allergy is called allergic rhinitis as well. Patients may be allergic to different pollens or the allergy-causing plant pollinizes more than once that results in experiencing allergic symptoms more than once a year . In patients who are allergic to pollens, symptoms appear in a short time following the inhaling the allergen. The symptoms usually include sneezing, rhinorrhea and itching of the eye and/or nose which become more severe in pollination period. Of course in patients with severe allergic diseases the symptoms may appear by the first pollinations and continue even after this period.

The allergic inflammation damaging mucosal membrane may lead to sensitizing to stimulants like cigarette smoke, spicy perfumes, chemicals, etc., that is why allergic symptoms may continue even after the pollination time. Patients dealing with Hay Fever (Spring Allergy) may also have mild symptoms in lower respiratory tract like coughing and chest tightness. This type of allergy may progress to asthma.

Atopic Dermatitis:

Atopic dermatitis is a common disease. This abnormality initiates 3-6 months after birth and usually is typical for young children; however the symptoms may appear in any age. This complication happens along with other atopic diseases like asthma, spring allergies and food allergies.

Contact Allergy:

Unwanted dermal, oral and genital reactions caused by a direct contact with allergens are called contact allergies. There are two types of contact allergies; Contact Hives and Contact Dermatitis. Some of the most common allergens causing contact allergy include; Nickel, Cobalt, Potassium Dichromate, chemicals used in tire production, bio-germicides (used in makeup industry), permanent hair colors, some topical antibiotics and perfumes.

Hives: Hive is a common complication involving 10-20% of individuals during their life time around the world. Symptoms include skin inflammations (with itching surface in pinkish color) along with severe oral and genital inflammations in 50% of patients. Those inflammations appear and disappear in a short time without remaining any marks. Patients with severe hives may also deal will non-specific symptoms like tiredness, heat dissipation, pain and indigestion. Most patients will recover in a short time but a few might tolerate the inflammations in months, years or periodical symptom relapses. Severe hives disappear in 6 weeks and if prolonged is considered as chronic. Histamine is the main factor causing hives. In hive complication, cells release Histamine much easier than usual.

Angioedema

Angioedema is a deep temporary inflammation that can appear anywhere under or inside the skin. Dermal Angioedema usually involves more painful more persistent and itching inflammation than superficial hives and persistent for more days. Angioedema can also occur in oral and genital sub-mucosal membrane and in rare cases may also involve intestine and bladder leading; to painful nonvisible occlusions. Angioedema may appear following hives when histamine is released responding to the same treatments. Angioedema can also be a characteristic of anaphylaxis and may lead to death when appearing in throat.

Conjunctiva, the protective mucosal membrane covering the frontal part of the eyeball and inner surface of the eyelid is considered as a protection against external environment. There are lots of veins, immune cells and defensive factors in conjunctiva, helping to protect the eye against infections and foreign objects. Tears also have some defensive factors supporting eye protection. In the case these defensive responses are interrupted or replaced with auto-immune responses eye allergies may occur. The most important factor causing the eye allergy is called “Histamine” which is responsible for the symptoms like itching, burning sensation, light sensitivity, eye redness, and tearing and eyelid inflammation.

Eye allergy is common in youth (under 30). Also the occurrence of this type of allergy is more probable especially in people with family history of Hay Fever (allergic rhinitis) or dermal allergy (Atopic dermatitis) .

1-5% of populations in the world have food allergies. Diagnosis of allergy to a specific food allergen is the responsibility of an allergy specialist. Milk, egg, peanut, nuts and grains (mostly wheat), Soybeans, fish and shellfish usually are the most common cause of allergy. In some individuals cross-over reactions may occur due to similar proteins which are present in the food and pollen, making immune system to respond. Most patients who are allergic to pollens may tolerate the cross-over foods when cooked.

Allergy to insects:

The most common biting insects are; honey bee, red bee, yellow bee and honey-less bee. Sting poison of these insects stimulates the area causing inflammation, redness, itch and pain. In the case of allergy to the sting poison serious and persuasive reactions may occur (like anaphylaxis). Topical non-allergic reactions may persist for a week long. The bite location has to be washed with water and soap and the topical reactions might be relieved by topical analgesics. Inclusive allergic reactions are the combination of these symptoms: hives, angioedema, wheezing, breathe tightness, nausea, vomiting, diarrhea and fainting.

Drug Allergy:

Medicines may cause non-favorable side effects besides their therapeutic effects. Sometimes these side effects might be a real allergic reaction. Some of these medicines are: antibiotics (penicillin and amoxicillin groups), analgesics (ibuprofen, diclofenac, piroxicam, mefnamic acid and naproxen).

Workplace related allergies:

Nasal congestion, sneeze and running nose itch are some of the symptoms of rhinitis. The prevalence of workplace rhinitis is three times higher than workplace asthma and is usually along with itching, rhinorrhea and eye redness. Workplace dermatitis is a common type of workplace allergy leading to workdays loses by patient. The symptoms of severe workplace dermatitis include the red, inflammated, and itching skin. In chronic stage, the inflammated part becomes blistered, secretive, scabrous and cracked. The most common careers being vulnerable to this allergy types are: construction, plant and flower nurturing, nursing, beauty salons, printing offices.

Anaphylaxis:

Is an inclusive allergic reaction, having fast onset and could become sever. Rarely, it can cause long term consequences and even death. Estimations indicated that 3-30 out of100 individuals will deal with anaphylaxis crisis every year. In a descriptive manner, two organs are mostly involved in this over-reaction; 80% of skin might get involved (in symptoms like itching, hives, widespread redness and angioedema). Other organs dealing with anaphylaxis might be respiratory system (in the form of chronic rhinitis, asthma or upper-respiratory tract angioedema), GI system (in the form of nausea, vomiting, spasms and diarrhea) or cardiovascular system (palpitation, increasing heart rate or blood pressure drop)

The most common anaphylaxis triggers in children are food allergens and in adults are medicines. The third common cause of anaphylaxis is bee bites, including honey bee, and in fact the poison of the bite.

consider your question with IRAN ALERGY Scientific Association

FAQ

Can Cetirizine be used in Pregnancy?
Cetirizine might be used during pregnancy under the supervision of a specialist.
Does Cetirizine contain Corticosteroids?
No. The medicine’s API is Cetirizine Hydrochloride
Is Apo-Cetirizine available as Syrup dosage form in Iran?
No. Apotex brand only offers Apo-Cetirizine in the form of tablets in Iranian Market.
Can a Cetirizine tablet be divided into half?
Yes. Apo-Cetirizine 10 mg tablets may be divided into half.
Can cetirizine syrup used in infant allergies?
Depending on the consuming dose and physician’s opinion, cetirizine syrup might be used for infant allergies
Which one is more effective in seasonal allergies? Cetirizine or Loratadine?
According to evidences, both have similar efficacy, although cetirizine has faster onset of action.
What is the indication of using Cetirizine?
For controlling seasonal allergy, allergic rhinitis, severe itching and rash treatment
Does cetirizine cause drowsiness?
Antihistamines cause drowsiness in general; however, Apo-Cetrizine is the new generation of antihistamine that has less drowsiness effect.
What are side effects of Cetirizine?
Drowsiness and dry or irritated mouth/ throat might be side effects of this medicine.
May Cetirizine 10 mg tablets be used in daily doses?
Yes. There is no restriction for daily use.
Can Cetirizine 10 mg be used in breast feeding period to avoid seasonal allergy symptoms?
Under physician’s supervision it might be used during breast feeding.