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levocetirizine (Rx)Brand and Other Names:Xyzal

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 5mg

oral solution

  • 2.5mg/5mL
more...

Allergic Rhinitis

5 mg PO qDay (evening)

Chronic Urticaria

5 mg PO qDay (evening)

Renal Impairment

CrCl 50-80 mL/min: 2.5 mg PO qDay

CrCl 30-50 mL/min: 2.5 mg PO qOD

CrCl 10-30 mL/min: 2.5 mg PO 2x/wk

CrCl <10 mL/min: contraindicated

Dosage Forms & Strengths

tablet

  • 5mg

oral solution

  • 2.5mg/5mL
more...

Allergic Rhinitis

<6 months: Safety and efficacy not established

6 months to 5 years: 1.25 mg PO qDay (evening)

6-12 years: 2.5 mg PO qDay (evening)

>12 years: 5 mg PO qDay (evening)

Chronic Urticaria

<6 months: Safety and efficacy not established

6 months to 5 years: 1.25 mg PO qDay (evening)

6-12 years: 2.5 mg PO qDay (evening)

>12 years: 5 mg PO qDay (evening)

Renal Impairment

<12 years

  • Contraindicated

≥12 years

  • CrCl: 50-80 mL/min: 2.5 mg PO qDay
  • CrCl: 30-50 mL/min: 2.5 PO qODay
  • CrCl: 10-30 mL/min: 2.5 mg every 3-4 days
  • CrCl: <10 mL/min, hemodialysis: Contraindicated
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Interactions

Interaction Checker

levocetirizine and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Varies in incidence & severity with the individual drug; also individual patients vary in susceptibility

            1-10%

            Dry mouth

            Fatigue

            Nasopharyngitis

            Pharyngitis

            Frequency Not Defined

            CNS depression

            Drowsiness

            Sedation ranging from mild drowsiness to deep sleep (most frequent)

            Dizziness

            Lassitude

            Disturbed coordination

            Restlessness, insomnia, tremors, euphoria, nervousness, delirium, palpitation, seizures is less common

            Epigastric distress

            Anorexia

            Nausea

            Vomiting

            Diarrhea

            Constipation

            Cholestasis, hepatitis, hepatic failure, hepatic function abnormality, jaundice is rare

            Tachycardia, palpitation ECG changes (eg, widened QRS)

            Arrhythmias (eg, extrasystole, heart block)

            Hypotension

            Hypertension

            Dizziness, sedation, and hypotension may occur in geriatric patients

            Dryness of mouth, nose, and throat

            Dysuria

            Urinary retention

            Impotence

            Vertigo

            Visual disturbances

            Blurred vision

            Diplopia; tinnitus

            Acute labyrinthitis

            Insomnia

            Tremors

            Nervousness

            Irritability

            Facial dyskinesia

            Tightness of the chest

            Thickening of bronchial secretions

            Wheezing

            Nasal stuffiness

            Sweating

            Chills

            Early menses

            Toxic psychosis

            Headache

            Faintness

            Paresthesia

            Agranulocytosis

            Hemolytic anemia

            Leukopenia

            Thrombocytopenia

            Pancytopenia

            Postmarketing Reports

            Skin/Allergy: Hypersensitivity and anaphylaxis, angioedema, fixed drug eruption, pruritus, rash, and urticaria

            Neurologic: Convulsion, paraesthesia, dizziness, aggression and agitation, hallucinations, depression, movement disorders (including dystonia and oculogyric crisis), tic, myoclonus, extrapyramidal symptoms

            Ocular: Visual disturbances, blurred vision

            Cardiovascular: Palpitations, tachycardia

            Pulmonary: Dyspnea

            Gastrointestinal: Nausea, vomiting, hepatitis

            Genitourinary: Dysuria

            Musculoskeletal: Myalgia, arthralgia

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            Warnings

            Contraindications

            Documented hypersensitivity

            Lower respiratory disease, eg, asthma (controversial)

            Preemies and neonates

            Nursing women

            Hypersensitivity to levocetirizine or cetirizine

            ESRD with CrCl <10 mL/min or HD patients

            Children with renal impairment

            Cautions

            Caution in narrow angle glaucoma, prostatic hypertrophy, stenosing peptic ulcer, pyloroduodenal obstruction, or bladder neck obstruction

            May impair mental alertness

            Avoid alcohol or other CNS depressants

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            Pregnancy & Lactation

            Pregnancy Category: B

            Lactation: expected to be excreted in breast milk, avoid

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
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            Pharmacology

            Mechanism of Action

            Histamine H1-receptor antagonist

            Absorption

            Peak Plasma Time: 0.5hr (oral solution); 0.9 hr (tablet)

            Peak Plasma Concentration (5 mg x1 dose): 270 ng/mL

            Onset: 1 hr (allergic rhinitis); 1 day (seasonal/perennial)

            Distribution

            Protein Bound: >90%

            Vd: 0.4 L/kg

            Metabolism

            Metabolism: CYP3A4 and other isoforms

            Elimination

            Half-Lfe: 8 hr

            Total Body Clearance: 0.63 mL/kg/min

            Excretion: urine: 85%; feces 13%

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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Add or Remove Plans
            Plans for
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            Non-Medicare PlansMedicare Plans

            Select a box to add or remove a plan.

            Select a class to view formulary status for similar drugs

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