Generic name: levocetirizine

Brand names: Xyzal, Xyzal Allergy 24HR Tablets, Xyzal Allergy 24HR Oral Solution

Drug class: Antihistamines, 2nd Generation

What is levocetirizine, and what is it used for?

Levocetirizine is a second generation antihistamine drug available over the counter (OTC), used to relieve allergy symptoms, including sneezing, runny nose, watery eyes, hives, and itching. Second generation antihistamines are considered to have a better side effect profile than first generation antihistamines.

Levocetirizine works by blocking the activity of histamine, a natural chemical in the body that causes allergy symptoms. Histamine is released by mast cells and basophils, types of immune cells, in response to allergen exposure. Levocetirizine is a histamine H1 receptor antagonist that binds to histamine H1 receptors in the brain and spinal cord, preventing their activation by histamine and the resultant allergic reaction.

Levocetirizine is used to treat adults and pediatric patients to relieve allergic symptoms from:

Warnings

  • Do not take levocetirizine if you are allergic to levocetirizine, cetirizine, or any of the ingredients of levocetirizine
  • Do not administer levocetirizine to patients with end-stage renal disease or patients undergoing hemodialysis
  • Do not administer levocetirizine to pediatric patients of 6 months to 11 years of age with renal impairment

What are the side effects of levocetirizine?

Side effects of levocetirizine include:

Rare side effects of levocetirizine reported include:

Postmarketing side effects of Levocetirizine reported include:

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

What are the dosages of levocetirizine?

Dosages of Levocetirizine

Adult and Pediatric Dosages:

Tablet

  • 5 mg

Oral Solution

  • 2.5 mg/5 ml

Dosage Considerations

Adult:

Allergic Rhinitis

  • Indicated for the relief of symptoms associated with seasonal and perennial allergic rhinitis
  • 5 mg orally daily in the evening
  • Some patients may respond to 2.5 mg/day

Chronic Hives (Urticaria)

  • Indicated for uncomplicated skin manifestations of chronic idiopathic hives
  • 5 mg orally daily in the evening

Dosage Modifications

Renal impairment

  • Creatinine Clearance 50-80 mL/min: 2.5 mg orally each day
  • Creatinine Clearance 30-50 mL/min: 2.5 mg orally every other day
  • Creatinine Clearance 10-30 mL/min: 2.5 mg orally 2 times/week (every 3-4 days)
  • Creatinine Clearance less than 10 mL/min and or hemodialysis: Contraindicated

Hepatic impairment

  • No dose adjustment required

Pediatric:

Allergic Rhinitis

  • Indicated for the relief of symptoms associated with seasonal and perennial allergic rhinitis
  • Infants under 6 months: Safety and efficacy not established
  • Infants over 6 months to Children 5 years: 1.25 mg orally each day in the evening
  • Children 6-12 years: 2.5 mg orally each day in the evening
  • Children over 12 years: 5 mg orally each day in the evening; some patients may respond to 2.5 mg/day

Chronic Hives (Urticaria)

  • Indicated for uncomplicated skin manifestations of chronic idiopathic hives
  • Infants under 6 months: Safety and efficacy not established
  • Infants over 6 months to Children 5 years: 1.25 mg orally each day in the evening
  • Children 6-12 years: 2.5 mg orally each day in the evening
  • Children over 12 years: 5 mg orally each day in the evening

Dosage Modifications

Renal impairment

Children 12 years or older:

  • Creatinine Clearance 50-80 mL/min: 2.5 mg orally each day
  • Creatinine Clearance l 30-50 mL/min: 2.5 mg orally every other day
  • Creatinine Clearance 10-30 mL/min: 2.5 mg orally 2 times/week (every 3-4 days)
  • Creatinine Clearance less than 10 mL/min and or hemodialysis: Contraindicated

Infants 6 months to children 11 years:

  • Any degree of renal impairment: contraindicated

Hepatic impairment

  • No dose adjustment required

Overdose

Symptoms of overdose can include drowsiness in adults and initially restlessness and agitation, followed by drowsiness in pediatric patients. There is no known specific antidote to levocetirizine. In case of overdose, get medical help or contact a Poison Control Center immediately.

What drugs interact with levocetirizine?

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

Levocetirizine has no known severe interactions with other drugs.

Serious interactions of levocetirizine include:

  • isocarboxazid
  • tranylcypromine

Moderate interactions of levocetirizine include:

Mild interactions of levocetirizine include:

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.

Pregnancy and breastfeeding

Levocetirizine is a pregnancy category B drug.

  • Use of levocetirizine during pregnancy may be acceptable
  • Either animal studies show no risk but human studies are not available or animal studies show minor risks and human studies were done and showed no risk
  • Levocetirizine is expected to be excreted in breast milk and not recommended for nursing mothers.

What else should I know about levocetirizine?

  • Levocetirizine may impair mental alertness or physical abilities. Avoid performing tasks that require mental alertness, including driving and operating heavy machinery.
  • Levocetirizine may cause central nervous system depression, avoid use of alcohol or other CNS depressants.
  • Long term use may result in rebound itching several days after stopping levocetirizine.
  • Use levocetirizine with caution if the patient has narrow angle glaucoma, prostatic hyperplasia, stenosing peptic ulcer, pyloroduodenal obstruction or bladder obstruction.

 

Summary

Levocetirizine is a second generation antihistamine drug available over the counter (OTC), used to relieve allergy symptoms, including sneezing, runny nose, watery eyes, hives, and itching. Side effects of levocetirizine include dry mouth, fatigue, runny or stuffy nose, sore throat, central nervous system (CNS) depression, drowsiness, sedation, dizziness, mental or physical weariness, disturbed coordination, restlessness, inability to sleep (insomnia), and others. Symptoms of overdose can include drowsiness in adults and initially restlessness and agitation, followed by drowsiness in pediatric patients.

Treatment & Diagnosis

QUESTION

Allergies can best be described as: See Answer

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Medically Reviewed on 2/25/2022
References
https://www.rxlist.com/consumer_levocetirizine_xyzal/drugs-condition.htm

https://reference.medscape.com/drug/xyzal-levocetirizine-343385

https://go.drugbank.com/drugs/DB06282

https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/022064s038,022157s020lbl.pdf