Levocetirizine+montelukast fdc

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Levocetirizine+montelukast fdc

  1. 1. LEVOCETIRIZINE + MONTELUKAST FIXED DOSE COMB P. K. MITRA/EURODRUG
  2. 2. • Rhinitis: Symptomatic disorder of the nose characterized by itching, nasal discharge, sneezing and nasal airway obstruction • Allergic rhinitis: Induction of rhinitis symptoms after allergen exposure by an IgE-mediated immune reaction; accompanied by inflammation of the nasal mucosa and nasal airway hyperreactivity. • Seasonal rhinitis: Conjunctivitis, Hay fever • Perennial rhinitis • Idiopathic rhinitis • Food induced rhinitis
  3. 3. Allergic rhinitis co-morbidities • Conjunctivitis • Sinusitis • Otitis Media • Cough • Asthma
  4. 4. ALLERGIC RHINITIS AND ITS IMPACT ON ASTHMA ARIA JACI 2001:56: 813-824
  5. 5. Perennial rhinitis: an independent risk factor for asthma (European Community Respiratory Health Survey) Adapted from Leynaert B et al. J Allergy Clin Immunol 1999; 104:301 Asthma (%) Atopic Non atopic no rhinitis, N=5198 rhinitis, N=1412 OR=11 OR=17 0 5 10 15 20 25
  6. 6. Intermittent Symptoms • < 4 days / week • or < 4 weeks Persistent Symptoms • > 4 days / week • or > 4 weeks Mild • Sleep: normal • Daily activities (incl. sports): normal • Work-school activities: normal • Severe symptoms: no Moderate- severe • Sleep: disturbed • Daily activities: Restricted • Work and school activities: disrupted • Severe symptoms: yes Allergic rhinitis classification
  7. 7. Allergy skin prick testing Skin prick test / positive result
  8. 8. MANAGEMENT OF ALLERGIC RHINITIS
  9. 9. Leukotrienes – The major culprits • Causes smooth muscle contraction, • Increases vascular permeability, • Helps in migration of leukocytes (eosinophiles) to areas of inflammation, • Causes airways obstructions • Releases Histamines • Triggers mucus secretions and accumulation of mucous • Results in inflammation
  10. 10. Environmental control • House dust mites • Pets • Cockroaches • Molds • Pollen 1. Allergens 2. Pollutants and Irritants
  11. 11. Oral antihistamines • First generation agents Chlorpheniramine Pheniramine Diphenydramine Promethazine Tripolidine Hydroxyzine Azatadine • Newer agents Acrivastine Azelastine Cetirizine Desloratadine/Fexofenadin Levocetirizine/Loratadine Mizolastine
  12. 12. • First line treatment for mild allergic rhinitis • Effective for – Rhinorrhea – Nasal pruritus – Sneezing • Possible additional anti-allergic and anti-inflammatory effect • Minimal or no sedative effects • Once daily administration • Rapid onset and 24 hour duration of action Newer generation oral antihistamines
  13. 13. Anti-leukotriene agents CysLT1 Receptor Antagonists Montelukast * Pranlukast * Zafirlukast (Accolate-Astra) 5-Lipoxygenase Inhibitors Zileuton (Zyflo-Abbott) * Approved for allergic rhinitis
  14. 14. nucleus cytosolic phospholipase A2 arachidonic acid 5-lipoxygenase activating protein leukotriene A4 5-lipoxygenase leukotriene C4 synthase leukotriene C4 leukotriene C4 leukotriene D4 leukotriene E4 CysLT1 receptor mast cells basophils eosinophils macrophages + Cysteinyl-leukotriene production and the CysLT1 receptor
  15. 15. LEVOCETIRIZINE-5 MG + MONTELUKAST-10MG FDC MARKET
  16. 16. COMPETITORS AT A GLANCE BRAND COMPANY PACKIN G MRP/10’s MONTAIR- LC CIPLA 10’s 130.00 XARIA GLENMARK 10’s 86.00 NUKAST ZUVENTUS 10’s 119.00 XYZAL-M UCB 10’s 150.00 LEZYNCET-M UNICHEM 10’s 86.00 L-MONTUS FOURTS 10’s 119.00 MONTAS-L INTAS 10’s 138.00 ODIMONT-LC ZYDUS 10’s 122.00 MONTILAST CADILA 10’s 86.00 MONTEC-LC SUN PHARMA 10’s 86.00 ZENOM-M MARS 10’s 75.00
  17. 17. BRANDS COMPANY LAUNCH DATE MAT MARCH 2011 VAL(Cr) MAR CUM UNITS ('000) UNIT GROWTH LEVO+MONTE FDC – IMS ORG’2011 200510 106.97 5125.92 69.89 MONTAIR-LC CIPLA 200708 20.00 669.30 60.60 MONTEK-LC SUN* 200604 17.40 938.71 54.01 L MONTUS FOURTS INDIA 200603 15.62 582.52 22.88 MONTICOPE MANKIND 200905 10.93 830.24 126.07 MONTEMAC-L MACLEODS PHARMA 200808 8.97 495.11 37.83 ODIMONT-LC ZYDUS CADILA* 200707 6.95 230.09 36.15 LEVOKAST TTK HEALTHCARE LTD 200809 5.48 238.28 28.04 XYZAL-M UCB PHARMA 200908 3.62 112.39 200.22 LEVOCET-M HETERO HEALTHCARE* 200912 3.18 294.75 891.63 XARIA GLENMARK PHARMA 200912 2.91 132.64 2571.61
  18. 18. MARKET REALITY • Major prescribers are Chest-Phy, Phys and ENT specialists. • Levo+Monte FDC Mkt is growing by 70 % ( units ) – Phenomenal ! • As per 2011 ORG, Montair-LC (Cipla) was the largest selling brand and growing by 60% • As per 2011 ORG, major 30 brands were growing !
  19. 19. THANQTHANQ P. K. MITRAP. K. MITRA MANAGER-MARKETING SERVICESMANAGER-MARKETING SERVICES EURODRUG LABORATORIES -INDIAEURODRUG LABORATORIES -INDIA

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