levocetirizine

levocetirizine

levocetirizine dihydrochloride

Xyzal

Pharmacologic class: Histamine₁ (H₁)-receptor antagonist

Therapeutic class: Antihistamine

Pregnancy risk category B

Action

Exerts principal antihistaminic effects via selective inhibition of H₁ receptors

Availability

Oral solution: 2.5 mg/5 ml (0.5 mg/ml)

Tablets: 5 mg

Indications and dosages

➣ Symptoms of allergic rhinitis (seasonal and perennial); uncomplicated skin manifestations of chronic idiopathic urticaria

Adults and children ages 12 and older: 5 mg P.O. daily in evening

Children ages 6 to 11: 2.5 mg P.O. daily in evening; don't exceed recommended dosage.

Dosage adjustment

• Renal impairment.

• Hepatic impairment

Contraindications

• Hypersensitivity to drug, its components, or cetirizine

• End-stage renal disease

• Hemodialysis

• Renal impairment (children ages 6 to 11)

Precautions

Use cautiously in:

• renal impairment

• pregnant patients

• elderly patients

• breastfeeding patients (use not recommended)

• children younger than age 6 (safety and efficacy not established).

Administration

• Give with or without food.

Adverse reactions

CNS: somnolence, fatigue, asthenia

EENT: epistaxis (children), nasopharyngitis, pharyngitis

GI: dry mouth

Respiratory: cough (children)

Other: pyrexia (children)

Interactions

Drug-drug. Ritonavir: increased levocetirizine blood level and half-life, decreased clearance

Drug-behaviors. Alcohol use: increased risk of impaired CNS function

Patient monitoring

• Stay alert for excessive CNS depression.

• Closely monitor renal function tests in patients with renal impairment.

Patient teaching

• Tell patient drug can be taken with or without food.

• Instruct patient to avoid alcohol and other depressants, such as sleeping pills, unless prescriber approves.

• Caution patient to avoid hazardous activities until drug's effects on concentration and alertness are known.

• Advise female patient to notify prescriber if she is pregnant or intends to become pregnant.

• Tell breastfeeding patient to discontinue breastfeeding during therapy.

• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs and behaviors mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved