Brief overview
- Active ingredients: cetirizine (as cetirizine dihydrochloride) + pseudoephedrine (as pseudoephedrine hydrochloride)
- Manufacturer: Johnson & Johnson GmbH
- Prescription only: no
Important side effects
As is typical for medicines, Reactine duo also has certain side effects, although not everybody gets them. Here is an overview of the most important side effects:
Very common side effects (affecting more than 1 in 10 users):
Common side effects of Reactine duo (affecting up to 1 in 10 users):
- Insomnia
- drowsiness or dizziness (somnolence)
- Nausea
- nervousness
- Balance problems
- Dizziness
- fast heartbeat
- Dry mouth
- Feeling of weakness
- Throat inflammation
- Fatigue
Occasional side effects (affecting up to 1 in 100 users):
- Abdominal pain
- Anxiety @
- Skin discomfort
- Palpitations
- Diarrhea
- Agitation
- malaise
- itching and skin rash (rarely it is a hypersensitivity reaction)
When should you stop taking Reactine duo right away?
Stop taking the medication immediately if you notice one or more of the following symptoms:
- high blood pressure, palpitations, rapid heartbeat, or arrhythmia
- Nausea
- (increased) headache or other neurological symptoms
If you experience any of the following side effects, stop taking Reactine duo and seek medical attention right away:
- acute abdominal pain or bleeding in the rectum (possible symptoms of colitis due to reduced blood flow = ischemic colitis)
- pustules on the skin (possibly accompanied by fever) or reddening of the skin all over the body
- sudden loss of vision
Reactine duo: action
Reactine duo contains the two active ingredients cetirizine and pseudoephedrine:
Pseudoephedrine has a vasoconstrictor effect. This helps to reduce the swelling of the nasal mucosa in allergic rhinitis.
This effect is also used in “normal” colds: However, Reactine duo is not used for colds – other medicines containing pseudoephedrine are available for this purpose.
Interactions
If you take Reactine duo together with other medicines or certain foods or alcohol, the substances may influence each other in their effects and side effects. Below you can find the most important interactions related to Reactine duo.
Before using Reactine duo be sure to tell your doctor or pharmacist about all other medications you are currently using, have used in the recent past, or plan to use.
Interaction with cardiovascular medications
Reactine duo may weaken the antihypertensive effect of beta-blockers as well as the effect of a-methyldopa, mecamylamine, reserpine, veratrum alkaloids and guanethidine.
Experts generally advise caution in combined use of antihypertensive drugs and Reactine duo.
Interaction with antidepressants
Avoid combination with medications for depression (antidepressants). This is especially true for monoamine oxidase inhibitors (MAO inhibitors): Under no circumstances should these be taken together with Reactine duo – otherwise blood pressure could rise dangerously.
The effect of MAO inhibitors continues for some time after discontinuation. Therefore, the use of the allergy medication is also contraindicated in the first two weeks after stopping MAO therapy.
Interaction with sympathomimetics
If you want to use other sympathomimetics in addition, caution is advised. These include, for example, appetite suppressants and amphetamine-like stimulants (psychostimulants).
It is not advisable to use the allergy medication together with other remedies for a blocked nose. These include, for example, the sympathomimetics phenylpropanolamine, phenylephrine and ephedrine.
It is also not recommended to take Reactine duo together with salbutamol tablets. This sympathomimetic is prescribed by physicians for treatment of asthma and COPD.
Interaction with other medications
Simultaneous use with other allergy medications (antihistamines) should be done with caution.
Combination with the following agents is not advisable, because otherwise blood pressure may increase due to vasoconstriction:
- Bromocriptine, cabergoline, pergolide, lisuride (e.g., in Parkinson’s disease).
- Linezolid (antibiotic)
- Dihydroergotamine,Ergotamine (e.g. for migraine)
If you are taking antacids or proton pump inhibitors due to heartburn, you should be careful when using Reactine duo. Heartburn medications increase the absorption of pseudoephedrine into the body.
If you take Reactine duo together with sedatives, it may further impair your alertness and responsiveness.
Experts advise caution when taking substances that have a depressant effect on the central nervous system (CNS depressants) at the same time.
Like the ingredient pseudoephedrine, painkillers and anti-inflammatory drugs from the group of non-steroidal anti-inflammatory drugs (NSAIDs) can also increase blood pressure. High blood pressure patients should bear this in mind when using Reactine duo in addition to NSAIDs.
Interaction with food and alcohol
Cetirizine and pseudoephedrine are not recognizably affected in their absorption by food.
However, in combination with alcohol, your alertness and ability to react may be additionally reduced. Therefore, do not take Reactine duo together with alcohol.
You can read more about possible interactions in the package leaflet or find out from your doctor or at your pharmacy.
Fields of application
Reactine duo is approved in Germany to relieve symptoms of allergic rhinitis (allergic rhinitis) with a blocked, swollen nose. This can be hay fever, for example. Also a house dust allergy, animal hair allergy and mold allergy are possible triggers of allergic rhinitis with a stuffy nose.
Is a prescription required?
Reactine duo does not require a prescription. So, you can buy the medicine at the pharmacy without a doctor’s prescription.
Reactine duo: pregnancy and lactation period
During breastfeeding Reactine Duo should be used with caution. Cetirizine and pseudoephedrine – the active ingredients of the drug – pass into breast milk. Therefore, breastfeeding mothers should use the medication only if a health care professional considers it necessary.
Always discuss the use of any medication during pregnancy and breastfeeding with your gynecologist first.
Restrictions for children and the elderly
Children under 12 years of age who suffer from allergic rhinitis with a blocked nose should not take Reactine duo. The reason: the drug’s tolerability and effectiveness have not been scientifically proven in this age group.
Reactine duo is also not recommended for people older than 60 years. Here, too, there is a lack of evidence that the drug is effective and well tolerated. In addition, there is a lack of recommendations on the appropriate dosage.
Dosage and intake
Dosage of Reactine duo
The recommended dosage for adolescents 12 years of age and older and adults up to 60 years of age is two sustained-release tablets per day (i.e., within 24 hours):
Take one sustained-release tablet in the morning and the second in the evening, each time with a glass of water. The tablets can be taken independently of meals. This means that you can take one sustained-release tablet before or after meals or during meals.
However, make sure you take the sustained-release tablet as a whole – you must not bite, break, or chew it.
Follow the recommended dosage and dosing intervals exactly, as they are also given in the package leaflet. If you suspect that the effect of the medicine is too strong or too weak, please contact your doctor or pharmacist.
Recommended duration of treatment
Do not take Reactine duo for more than 14 days. Stop taking the medicine as soon as your symptoms have subsided.
Procedure in case of overdose
If you have taken a larger amount than the prescribed dose you may develop increased side effects. If this happens, tell your doctor or health care professional – even if you do not (yet) have symptoms of overdose. He or she will know what to do if this happens.
Basically, an overdose of Reactine duo can only be treated symptomatically. For this purpose, affected persons may have to drink activated charcoal dissolved in water to bind the amount of active ingredient in the stomach.
If the active ingredients of Reactine duo (cetirizine and pseudoephedrine) have already passed into the blood, they can hardly be filtered out by dialysis.
What to do if you miss a dose
If you miss a dose, do not take a double dose the next time! Instead, you should continue taking it as described in the dosing instructions.
When must you not take Reactine duo?
The following describes when you must not take Reactine duo because it could be dangerous for your health.
Allergies:
- Do not take the medicine if you have an allergy to cetirizine dihydrochloride, pseudoephedrine hydrochloride, ephedrine, hydroxyzine, or other piperazine derivatives.
- Also contraindicated if there is hypersensitivity to other ingredients of the drug.
Eye, kidney, or liver problems:
- People with elevated intraocular pressure or glaucoma should not take this medicine.
- Also, if you cannot empty your bladder or can barely empty it (urinary retention), use is “forbidden” (contraindicated).
- Also a contraindication for Reactine duo is severe kidney weakness (severe renal insufficiency).
Cardiovascular disease:
- You should not take Reactine Duo if you have severe cardiovascular disease such as coronary artery disease, arrhythmia, or high blood pressure.
- The same applies if you have had a stroke with cerebral hemorrhage in the past or are at increased risk for such a stroke.
- Also the drug is contraindicated in case of uncontrolled hyperthyroidism as well as a tumor of the adrenal medulla.
Other contraindications:
- You must not take Reactine duo together with dihydroergotamine.
- Also, you must not use the allergy medication during or within two weeks after treatment with monoaminooxidase (MAO) inhibitors (against depression) (risk of a strong increase in blood pressure!).
- Taking the drug is also contraindicated during pregnancy.
Warnings for certain patients
In case of vasoconstriction
People with cardiac arrhythmias, palpitations, or a history of heart attack should use Reactine duo with caution.
In general, people with cardiovascular disease should take the drug only under medical supervision. This is particularly advisable in cases of coronary heart disease and hypertension.
The vasoconstrictive effect of pseudoephedrine can be dangerous for people who are prone to increased blood clotting. This is the case, for example, with inflammatory bowel disease.
Do not take the medication if you have an increased risk of stroke due to bleeding in the brain (hemorrhagic stroke). This risk may increase further if you are also taking other vasoconstrictor agents. These include bromocriptine, pergolide, lisuride, cabergoline, ergotamine, and other drugs that help with nasal swelling (such as phenylpropanolamine, phenylephrine, ephedrine).
People with epilepsy or an increased risk of convulsions should discuss the use of the drug with their doctor in advance.
Especially in children, the elderly, as well as in case of overdose, the ingredient pseudoephedrine can stimulate the central nervous system to such an extent that convulsions or cardiovascular collapse with a drop in blood pressure occur.
In diseases of the gastrointestinal tract and metabolism.
Experts advise caution when taking Reactine duo to people who have a narrowing stomach ulcer (stenosing peptic ulcer) or a narrowed stomach outlet.
Anyone with thyroid disease should take medications containing pseudoephedrine (such as Reactine duo) only as directed by a doctor. This is also recommended for people with diabetes mellitus.
For difficult urination
The active ingredient cetirizine promotes urinary retention. Therefore, people with a tendency to urinary retention – for example, due to a damaged spinal cord – should only use the drug with caution.
The same applies if the neck of the urinary bladder is narrowed.
Caution, risk of abuse!
Because of its stimulating effect on the central nervous system, pseudoephedrine is sometimes misused. However, when taken regularly, the body becomes accustomed to the active ingredient (development of tolerance) and no longer responds as well to it.
In order to still achieve the desired effect, affected people then often take too high a dose. This can result in severe side effects.
If the intake is suddenly interrupted after abusive use, depression may develop.
Trafficability and ability to operate machinery
The second active ingredient of Reactine duo – cetirizine – did not affect alertness, vigilance or driving ability in clinical studies at the recommended dose.
However, if you become drowsy or drowsy during use, it is advisable not to take an active part in road traffic, not to carry out work without a safe stop, and not to operate machinery.
Effects on allergy and doping tests
If you want to take an allergy test, you should not take Reactine duo in the three days before. This is because the ingredient cetirizine may affect the test result.
Taking medicines containing pseudoephedrine (such as Reactine duo) may cause the result of a doping test to be positive, as pseudoephedrine is one of the substances banned in sports.
Frequently asked questions about Reactine duo
How fast does Reactine duo work?
Reactine duo: From what age is it suitable?
Children and adolescents 12 years and older can take Reactine duo.
This text answers the most important questions users have about Reactine duo. It does not claim to be complete. All information about the drug can be found in the package insert.
