levocetirizine

(redirected from Zyzal)

levocetirizine

(lee-vo-se-teer-i-zeen) ,

Xyzal

(trade name)

Classification

Therapeutic: antihistamines
Pharmacologic: piperazines
Pregnancy Category: B

Indications

Management of seasonal/perennial allergic rhinitis.Management of chronic idiopathic urticaria.

Action

Antagonizes the effects of histamine at H1 receptor sites; does not bind to or inactivate histamine.

Therapeutic effects

Decreased symptoms of histamine excess (rhinitis, itching).

Pharmacokinetics

Absorption: Well absorbed following oral administration.
Distribution: Unknown.
Metabolism and Excretion: Excreted mostly unchanged by the kidneys (85%).
Half-life: 8 hr.

Time/action profile

ROUTEONSETPEAKDURATION
POrapid0.9 hr24 hr

Contraindications/Precautions

Contraindicated in: Hypersensitivity to levocetirizine or cetirizine; Severe renal impairment (CCr <10 mL/min); Pediatric: Pediatric patients with impaired renal function; Lactation: Lactation.
Use Cautiously in: Geriatric: Consider age related ↓ in renal function and concurrent disease states; Obstetric: Use only if clearly needed; Pediatric: Children <6 mo (safety not established).

Adverse Reactions/Side Effects

Central nervous system

  • drowsiness
  • fatigue
  • weakness

Gastrointestinal

  • dry mouth

Genitourinary

  • urinary retention

Interactions

Drug-Drug interaction

↑ levels of ritonavir.↑ CNS depression may occur with alcohol, opioid analgesics, or sedative hypnotics.

Route/Dosage

Oral (Adults and Children ≥12 yr) 5 mg once daily in the evening; some patients may respond to 2.5 mg once daily.

Renal Impairment

Oral (Children 6–11 yr) 2.5 mg once daily in the evening.
Oral (Children 6 mo–5 yr) 1.25 mg (oral solution) once daily in the evening.

Renal Impairment

(Adults and Children ≥12 yr) CCr 50–80 mL/min—2.5 mg once daily; CCr 30–50 mL/min—2.5 mg every other day; CCr 10–30 mL/min—2.5 mg twice weekly (every 3–4 days).

Availability (generic available)

Tablets : 5 mg
Oral solution: 2.5 mg/5 mL

Nursing implications

Nursing assessment

  • Assess allergy symptoms (rhinitis, conjunctivitis, hives) before and periodically during therapy.
  • Assess lung sounds and character of bronchial secretions. Maintain fluid intake of 1500–2000 mL/day to decrease viscosity of secretions.
  • Lab Test Considerations: May cause false-negative result in allergy skin testing.
    • May cause transient ↑ in serum bilirubin and transaminases.

Potential Nursing Diagnoses

Ineffective airway clearance (Indications)
Risk for injury (Adverse Reactions)

Implementation

  • Oral: Administer once daily in the evening without regard to food. Solution is clear and colorless; administer undiluted.

Patient/Family Teaching

  • Instruct patient to take medication as directed. Do not increase doses; may cause increased drowsiness.
  • May cause drowsiness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
  • Advise patient to avoid taking alcohol or other CNS depressants concurrently with this drug.
  • Advise patient that good oral hygiene, frequent rinsing of mouth with water, and sugarless gum or candy may minimize dry mouth. Patient should notify dentist if dry mouth persists >2 wk.

Evaluation/Desired Outcomes

  • Decrease in allergic symptoms.
  • Resolution of uncomplicated skin manifestations of chronic idiopathic urticaria.

levocetirizine

a low-sedating antihistamine.
indications This drug is used to treat perennial or seasonal rhinitis, allergy symptoms, and chronic idiopathic urticaria.
contraindications Breastfeeding, end-stage renal disease, dialysis, and known hypersensitivity to this drug, cetirizine, or hydroxyzine prohibit its use. Children from 6 to 11 years of age with renal disease should not take this drug.
adverse effects Adverse effects of this drug include asthenia, dry mouth, increased liver function tests, and transient rash. Common side effects include drowsiness and fatigue.