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levocetirizine dihydrochloride


Pharmacologic class: Histamine1 (H1)-receptor antagonist

Therapeutic class: Antihistamine

Pregnancy risk category B


Exerts principal antihistaminic effects via selective inhibition of H1 receptors


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


• Hypersensitivity to drug, its components, or cetirizine

• End-stage renal disease

• Hemodialysis

• Renal impairment (children ages 6 to 11)


Use cautiously in:

• renal impairment

• pregnant patients

• elderly patients

• breastfeeding patients (use not recommended)

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


• 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)


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.


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


(trade name)


Therapeutic: antihistamines
Pharmacologic: piperazines
Pregnancy Category: B


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


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).


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

POrapid0.9 hr24 hr


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


  • dry mouth


  • urinary retention


Drug-Drug interaction

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


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)


  • 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.


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.
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References in periodicals archive ?
Levocetirizine was given at a dosage of 5 mg at night during the same time.
Xyzal contains the active ingredient levocetirizine dihydrochloride, which Sanofi said provides 24-hour relief from runny nose; sneezing; itchy, watery eyes; and itching of the nose or throat.
The company said Xyzal is an antihistamine that contains the active ingredient levocetirizine dihydrochloride, which has a well-established safety and efficacy profile.
Second most common group of drugs was antihistamines and most common antihistamines used were CPM, Levocetirizine and Fexofenadine.
The effectiveness of levocetirizine and desloratadine in up to 4 times conventional doses in difficult-to-treat urticaria.
Shalaka, "Formulation and evaluation of sublimed fast melt tablets of levocetirizine dihydrochloride," International Journal of Pharmaceutical Sciences, vol.
We prescribed clobetasol-salicylic acid 6% ointment to the patient along with levocetirizine.
Sixty-three children (aged 7-12 years) with moderate-to-severe perennial allergic rhinitis were randomly assigned to receive, in open-label fashion, levocetirizine (an antihistamine) with or without (control) Lactobacillus johnsonii EM1 ([10.
in 1/3 doses, maximum dose: 100 mg/day Ciproheptadine 2/4 mg/dose, PO, in 3 2-6 years: 2 mg/dose, doses PO, in 3 doses 7-17 years: 2-4 mg/dose, PO, in 3 doses Cetirizine 5-10 mg PO, single <30 kg: 5 mg, single dose dose >30 kg: 10 mg, single dose Loratadine 10 mg PO, single dose 2-5 years: 5 mg PO, single dose 6 years: 10 mg PO, single dose Desloratidine 5 mg PO, single dose >12 years: 5 mg PO, single dose Levocetirizine 5 mg PO, single dose 6-12 years: 2,5 mg PO, single dose >12 years: 5 mg PO, single dose Fexofenadine 60 mg PO, dose, in 2 6-11 years: 30 mg PO, doses dose, in 2 doses >11 years: 60 mg PO, dose, in 2 doses Ranitidine 150 mg/dose, in 2 1,5/2 mg/kg, dose, PO doses in 2 doses
Levocetirizine (Xyzal), the L-isomer of cetirizine (Zyrtec), is an antihistamine.
A direct comparison of the efficacy of antihistamines in SAR and PAR: Randomised, placebo-controlled studies with levocetirizine and loratadine using an environmental exposure unit--the Vienna Challenge Chamber (VCC).