Alamast

Generic Name: Pemirolast Potassium
Class: Antiallergic Agents
VA Class: OP300
Chemical Name: 9-Methyl-3-(1H-tetrazol-5-yl)-4H-pyrido[1,2a]pyrimidin-4-one potassium salt
Molecular Formula: C₁₀H₇KN₆O
CAS Number: 100299-08-9

Introduction

Mast-cell stabilizer.¹

Uses for Alamast

Allergic Conjunctivitis

Prevention of ocular itching associated with allergic conjunctivitis.¹

Alamast Dosage and Administration

Administration

Ophthalmic Administration

Apply topically to the eye as an ophthalmic solution.¹ Not for injection or oral use.¹

Avoid contamination of the solution container.¹

Dosage

Available as pemirolast potassium; dosage expressed in terms of the salt.¹

Initiate therapy before and continue throughout pollen season.^{4 5 6 7}

Pediatric Patients

Allergic Conjunctivitis

Ophthalmic

Children ≥3 years of age: 1 or 2 drops of a 0.1% solution in the affected eye(s) 4 times daily.¹

Symptomatic response (i.e., decreased itching) may be evident within a few days following initiation but frequently requires up to 4 weeks of therapy.^{1 2 3}

Adults

Allergic Conjunctivitis

Ophthalmic

1 or 2 drops of a 0.1% solution in the affected eye(s) 4 times daily.¹

Symptomatic response (i.e., decreased itching) may be evident within a few days following initiation but frequently requires up to 4 weeks of therapy.^{1 2 3}

Cautions for Alamast

Contraindications

• 
  

  Known hypersensitivity to pemirolast or any ingredient in the formulation.¹

  
  

Warnings/Precautions

Specific Populations

Pregnancy

Category C.¹

Lactation

Distributed into milk in rats; not known whether distributed into human milk.¹ Caution if used in nursing women.¹

Pediatric Use

Safety and efficacy not established in children <3 years of age.¹

Common Adverse Effects

Headache, rhinitis, cold/flu symptoms.¹

Interactions for Alamast

No formal drug interaction studies to date.⁸

Alamast Pharmacokinetics

Absorption

Bioavailability

Following topical application to both eyes (0.1% solution 4 times daily for 2 weeks), peak plasma concentrations were attained within about 25 minutes, but were substantially lower than those following a single (10 mg) oral dose.¹

Elimination

Elimination Route

10–15% of topical ophthalmic dose excreted unchanged in urine.¹

Half-life

About 4.5 hours.¹

Stability

Storage

Ophthalmic

Solution

15–25°C.¹

ActionsActions

• 
  

  Suppresses the release of mediators from cells involved in hypersensitivity reactions, including mast cells, and decreases chemotaxis and activation of eosinophils.¹

  
  


• 
  

  Reportedly blocks calcium channels in mast cell membranes.¹

  
  

Advice to Patients

• 
  

  Importance of learning and adhering to proper administration techniques to avoid contamination of the product.¹

  
  


• 
  

  Importance of removing soft contact lenses prior to administration of each dose.¹ Delay reinsertion for 10 minutes after administration if eyes are not red; do not wear contact lenses if eye(s) are red.¹ Not indicated for contact lens-related irritation.¹

  
  


• 
  

  Importance of reporting any worsening of symptoms or new-onset ocular pain/discomfort.⁸

  
  


• 
  

  Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.¹

  
  


• 
  

  Importance of informing patients of other important precautionary information.¹ (See Cautions.)

  
  

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Pemirolast Potassium

Routes	Dosage Forms	Strengths	Brand Names	Manufacturer
Ophthalmic	Solution	0.1%	Alamast (with lauralkonium chloride)	Vistakon

Disclaimer

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions September 2005. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

References

1. Santen Incorporated. Alamast (pemirolast potassium) ophthalmic solution prescribing information. Napa, CA; 2000. From Santen web site.

2. Anon. New drugs for allergic conjunctivitis. Med Lett Drugs Ther. 2000; 42:39-40. [PubMed 10825920]

3. Schwartz EM, Abelson MB, McGarr PJ et al. A placebo controlled evaluation of the ocular efficacy and safety of 0.1% pemirolast potassium ophthalmic in subjects with acute seasonal allergic conjunctivitis. Invest Ophthalmol Vis Sci. 1998; 39:S66.

4. Ciprandi G, Buscaglia S, Cerqueti PM et al. Drug treatment of allergic conjunctivitis: a review of the evidence. Drugs. 1992; 43:154-76. [IDIS 360840] [PubMed 1372215]

5. Morrow GL, Abbott RL. Conjunctivitis. Am Fam Physician. 1998; 57:735-46. [IDIS 418448] [PubMed 9490996]

6. Titi MJ. A critical look at ocular allergy drugs. Am Fam Physician. 1996; 53:2637-42. [IDIS 367250] [PubMed 8644576]

7. Galindez OA, Kaufman HE. Coping with the itchy-burnies: the management of allergic conjunctivitis. Ophthalmology. 1996; 103:1335-6. [IDIS 373485] [PubMed 8841290]

8. Santen, Napa, CA: Personal communication.

a. Alamast (pemirolast potassium) ophthalmic solution prescribing information. In: PDR.net [database online]. Montvale, NJ: Thomson Healthcare; 2004.

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