levocetirizine (OTC)

Brand and Other Names:Xyzal Allergy 24HR Tablets, Xyzal Allergy 24HR Oral Solution, more...Xyzal
  • Print

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 5mg

oral solution

  • 2.5mg/5mL
more...

Allergic Rhinitis

Indicated for relief of symptoms associated with seasonal and perennial allergic rhinitis

5 mg PO qDay in evening

Some patients may respond to 2.5 mg/day

Chronic Urticaria

Indicated for uncomplicated skin manifestations of chronic idiopathic urticaria

5 mg PO qDay in evening

Dosage Modifications

Renal impairment

  • CrCl 50-80 mL/min: 2.5 mg PO qDay
  • CrCl 30-50 mL/min: 2.5 mg PO every other day
  • CrCl 10-30 mL/min: 2.5 mg PO 2x/wk (ie, q3-4 days)
  • CrCl <10 mL/min and or hemodialysis: Contraindicated

Hepatic impairment

  • No dose adjustment required

Dosage Forms & Strengths

tablet

  • 5mg

oral solution

  • 2.5mg/5mL
more...

Allergic Rhinitis

Indicated for relief of symptoms associated with seasonal and perennial allergic rhinitis

<6 months: Safety and efficacy not established

6 months to 5 years: 1.25 mg PO qDay in evening

6-12 years: 2.5 mg PO qDay in evening

>12 years: 5 mg PO qDay in evening; some patients may respond to 2.5 mg/day

Chronic Urticaria

Indicated for uncomplicated skin manifestations of chronic idiopathic urticaria

<6 months: Safety and efficacy not established

6 months to 5 years: 1.25 mg PO qDay in evening

6-12 years: 2.5 mg PO qDay in evening

>12 years: 5 mg PO qDay in evening

Dosage Modifications

Renal impairment

  • Aged ≥12 years
    • CrCl 50-80 mL/min: 2.5 mg PO qDay
    • CrCl 30-50 mL/min: 2.5 mg PO every other day
    • CrCl 10-30 mL/min: 2.5 mg PO 2x/wk (ie, q3-4 days)
    • CrCl <10 mL/min and or hemodialysis: Contraindicated
  • Aged 6 months to 11 years
    • Any degree of renal impairment: Contraindicated

Hepatic impairment

  • No dose adjustment required
Next:

Interactions

Interaction Checker

and levocetirizine

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 
            Previous
            Next:

            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, acute generalized exanthematous pustulosis, and urticaria

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

            Ocular: Visual disturbances, blurred vision

            Cardiovascular: Palpitations, tachycardia

            Pulmonary: Dyspnea

            Gastrointestinal: Nausea, vomiting, hepatitis

            Genitourinary: Dysuria

            Musculoskeletal: Myalgia, arthralgia

            Previous
            Next:

            Warnings

            Contraindications

            Documented hypersensitivity

            Lower respiratory disease, eg, asthma (controversial)

            Preemies and neonates

            Nursing women

            Hypersensitivity to levocetirizine or cetirizine

            ESRD (CrCl <10 mL/min) or patients undergoing hemodialysis

            Children aged 6 month to 11 years 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

            Previous
            Next:

            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...
            Previous
            Next:

            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%

            Previous
            Next:

            Images

            Previous
            Next: