Levocetirizine Brand Names
Xyzal | Xyzal Allergy 24 Hour | Xyzal Children’s Allergy 24 Hour
What is Levocetirizine
Levocetirizine the R-enantiomer of cetirizine, is a selective piperazine low-sedating antihistamine (H1-blocker).
Studies have shown that the antihistaminic effects of racemic cetirizine reside in the R-enantiomer, levocetirizine, and not the S-enantiomer, dextrocetirizine.
Based on results of in vitro studies, levocetirizine has demonstrated a 2-fold and 30-fold greater affinity for H1-receptors compared to cetirizine and dextrocetirizine, respectively.
Levocetirizine and cetirizine have been found to have similar efficacy in the inhibition of histamine-induced wheal response, flare response, and nasal resistance.
Levocetirizine is effective in the treatment of seasonal allergic rhinitis, perennial allergic rhinitis, and chronic idiopathic urticaria.
In 1 study, cetirizine demonstrated a longer itch response in patients with chronic idiopathic urticaria when compared to levocetirizine.
Levocetirizine was found to be superior in suppression of histamine-induced skin reactions when compared to loratadine and desloratadine.
Despite reports of drowsiness with levocetirizine, controlled trials did not show it to cause adverse cognitive or psychomotor effects.
Levocetirizine was initially FDA-approved in 2007 and prescription use is approved in adult and pediatric patients as young as 6 months of age; the FDA subsequently approved the nonprescription use of the drug in 2017 for adult and pediatric patients as young as 2 years of age.
Indications
- allergic rhinitis
- atopic dermatitis
- chronic idiopathic urticaria
- perennial allergies
- seasonal allergies
For the management of symptoms of seasonal allergies or perennial allergies, including allergic rhinitis
Side Effects
- acute generalized exanthematous pustulosis (AGEP)
- agitation
- anaphylactoid reactions
- angioedema
- arthralgia
- asthenia
- blurred vision
- cholestasis
- constipation
- cough
- depression
- diarrhea
- dizziness
- drowsiness
- dysgeusia
- dyskinesia
- dyspnea
- dystonic reaction
- dysuria
- elevated hepatic enzymes
- epistaxis
- fatigue
- fever
- glomerulonephritis
- hallucinations
- hemolytic anemia
- hepatitis
- hypotension
- infection
- insomnia
- myalgia
- myoclonia
- nasal congestion
- nausea
- palpitations
- paresthesias
- pharyngitis
- pruritus
- rash
- seizures
- sinus tachycardia
- suicidal ideation
- syncope
- thrombocytopenia
- tremor
- urinary retention
- urticaria
- vertigo
- visual impairment
- vomiting
- weight gain
- xerostomia
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- bladder obstruction
- breast-feeding
- coadministration with other CNS depressants
- dialysis
- driving or operating machinery
- ethanol ingestion
- geriatric
- hydroxyzine hypersensitivity
- infants
- neonates
- pregnancy
- prostatic hypertrophy
- renal failure
- renal impairment
- urinary retention
Interactions
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Codeine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Pentazocine
- Acetaminophen; Propoxyphene
- Acetaminophen; Tramadol
- Alfentanil
- Alprazolam
- Amitriptyline; Chlordiazepoxide
- Amobarbital
- Amoxapine
- Anticholinergics
- Apomorphine
- Aripiprazole
- Asenapine
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Oxycodone
- Atropine; Difenoxin
- Atropine; Diphenoxylate
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- atypical antipsychotic
- Baclofen
- Barbiturates
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Belladonna; Opium
- Benzhydrocodone; Acetaminophen
- Benzodiazepines
- Brexpiprazole
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Buprenorphine
- Buprenorphine; Naloxone
- Buspirone
- Butabarbital
- Butorphanol
- Cannabidiol
- Capsaicin; Metaxalone
- Carbidopa; Levodopa
- Carbidopa; Levodopa; Entacapone
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Cariprazine
- Carisoprodol
- Cenobamate
- Chloral Hydrate
- Chlordiazepoxide
- Chlordiazepoxide; Clidinium
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorthalidone; Clonidine
- Chlorzoxazone
- Clonazepam
- Clonidine
- Clorazepate
- Clozapine
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- COMT inhibitors
- Cyclobenzaprine
- Dantrolene
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Desloratadine
- Desloratadine; Pseudoephedrine
- Deutetrabenazine
- Dexmedetomidine
- Diazepam
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Dronabinol
- Droperidol
- Enflurane
- Entacapone
- Esketamine
- Estazolam
- Eszopiclone
- Ethanol
- Etomidate
- Fenfluramine
- Fentanyl
- Flibanserin
- Fluoxetine; Olanzapine
- Flurazepam
- Fospropofol
- Gabapentin
- General anesthetics
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guanfacine
- Haloperidol
- Halothane
- Heparin
- Heterocyclic antidepressants
- Homatropine; Hydrocodone
- Hydrochlorothiazide, HCTZ; Methyldopa
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydromorphone
- Ibuprofen; Oxycodone
- Iloperidone
- Isocarboxazid
- Isoflurane
- Ketamine
- Lemborexant
- Levodopa
- Levorphanol
- Lofexidine
- Lopinavir; Ritonavir
- Loratadine
- Loratadine; Pseudoephedrine
- Lorazepam
- Loxapine
- Lumateperone
- Lurasidone
- Maprotiline
- Melatonin
- Meperidine
- Meperidine; Promethazine
- Mephobarbital
- Meprobamate
- Metaxalone
- Methadone
- Methohexital
- Methyldopa
- Midazolam
- Mirtazapine
- Molindone
- Monoamine oxidase inhibitors
- Morphine
- Morphine; Naltrexone
- Nabilone
- Nalbuphine
- Nefazodone
- Olanzapine
- Ombitasvir; Paritaprevir; Ritonavir
- Opiate Agonists
- Orphenadrine
- Oxazepam
- Oxycodone
- Oxymorphone
- Paliperidone
- Pentazocine
- Pentazocine; Naloxone
- Pentobarbital
- Perampanel
- Phenelzine
- Phenobarbital
- Pimavanserin
- Pimozide
- Pramipexole
- Pregabalin
- Primidone
- Propofol
- Propoxyphene
- Quazepam
- Quetiapine
- Ramelteon
- Rasagiline
- Remifentanil
- Risperidone
- Ritonavir
- Ropinirole
- Rotigotine
- Safinamide
- Secobarbital
- Sedating H1-blockers
- Selegiline
- Sevoflurane
- Sincalide
- Skeletal Muscle Relaxants
- Sodium Oxybate
- Sufentanil
- Suvorexant
- Tapentadol
- Tasimelteon
- Temazepam
- Tetrabenazine
- Thalidomide
- Theophylline, Aminophylline
- Thiopental
- Thiothixene
- Tolcapone
- Tramadol
- Tranylcypromine
- Trazodone
- Triazolam
- Tricyclic antidepressants
- Trospium
- Valerian, Valeriana officinalis
- Valproic Acid, Divalproex Sodium
- Zaleplon
- Ziprasidone
- Zolpidem
