levocetirizine

Contraindicated in:

Hypersensitivity to levocetirizine or cetirizine;
Severe renal impairment (CCr <10 mL/min).

Use Cautiously in:

OB: Other 2nd-generation antihistamines preferred in pregnancy;
Lactation: Other 2nd-generation antihistamines preferred in breastfeeding;
Pedi: Children <6 mo (safety and effectiveness not established);
Geri: Consider age related ↓ in renal function and concurrent disease states in older adults.

Adv. Reactions/Side Effects ⬆ ⬇

Derm: acute generalized exanthematous pustulosis

GI: dry mouth

GU: urinary retention

Neuro: drowsiness, fatigue, weakness

Interactions ⬆ ⬇

Drug-drug:

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

Availability ⬆ ⬇

(Generic available)

Tablets : 5 mg ^OTC
Oral solutiontutti-frutti, grape, and bubble gum flavors: 2.5 mg/5 mL^OTC

Route/Dosage ⬆ ⬇

PO (Adults and Children ≥12 yr): 5 mg once daily in the evening; some patients may respond to 2.5 mg once daily.
PO (Children 6–11 yr): 2.5 mg once daily in the evening.
PO (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).

US Brand Names ⬆ ⬇

~~Xyzal,~~ Xyzal Allergy 24HR

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).

Classifications ⬆ ⬇

Therapeutic Classification: allergy, cold and cough remedies

Pharmacologic Classification: antihistamines

Pharmacokinetics ⬆ ⬇

Absorption: Well absorbed following oral administration.

Distribution: Unknown.

Metabolism/Excretion: Excreted mostly unchanged by the kidneys (85%).

Half-Life: 8 hr.

Time/Action Profile ⬆ ⬇

ROUTE	ONSET	PEAK	DURATION
PO	rapid	0.9 hr	24 hr

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.
Rep: Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

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Indications ⬇

Contraind./Precautions ⬆ ⬇