Home Drug Guide Levocetirizine Dihydrochloride

Drug Guide

Generic Name

Levocetirizine Dihydrochloride

Brand Names Xyzal, Xyzal Allergy 24hr

Classification

Therapeutic: Antihistamine, allergic rhinitis and urticaria treatment

Pharmacological: Selective peripheral H1-antihistamine

FDA Approved Indications

Relief of symptoms associated with allergic rhinitis (seasonal and perennial)
Relief of symptoms of uncomplicated chronic idiopathic urticaria

Mechanism of Action

Levocetirizine is a selective antagonist of peripheral H1 receptors, which prevents the effects of histamine released during allergic reactions, thereby reducing allergy symptoms.

Dosage and Administration

Adult: 5 mg once daily, with or without food.

Pediatric: 2.5 mg once daily for children 2-6 years; 5 mg for children 6 years and older.

Geriatric: Typically 5 mg once daily; adjust based on renal function.

Renal Impairment: Reduce dose in patients with renal impairment; dosage varies based on creatinine clearance.

Hepatic Impairment: No specific dose adjustments recommended.

Pharmacokinetics

Absorption: Rapidly absorbed, peak plasma levels in approximately 1 hour.

Distribution: Crosses the blood-brain barrier minimally, low penetration into the CNS.

Metabolism: Metabolized minimally by the liver; primarily excreted unchanged.

Excretion: Excreted mainly via the kidneys (about 85%), with some in feces.

Half Life: Approximately 22 hours.

Contraindications

Known hypersensitivity to levocetirizine or other piperazine derivatives.

Precautions

Use with caution in patients with renal impairment; dose adjustment required.
Potential for somnolence; caution when performing activities requiring mental alertness.

Adverse Reactions - Common

Headache (Common)
Somnolence (Common)
Pharyngitis (Common)
Fatigue (Common)

Adverse Reactions - Serious

Anaphylaxis (Rare)
Severe skin reactions such as Stevens-Johnson syndrome (Rare)
Drowsiness that impairs ability to perform tasks (Uncommon)

Drug-Drug Interactions

CNS depressants (enhanced sedative effect)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for effectiveness in symptom relief; assess for excessive somnolence.

Diagnoses:

Ineffective airway clearance due to sedation

Implementation: Administer as prescribed; instruct patient to avoid activities requiring alertness until response is known.

Evaluation: Assess reduction in allergy symptoms and adverse effects.

Patient/Family Teaching

Take medication as directed, with or without food.
Do not exceed recommended dose.
Be cautious when engaging in activities requiring alertness.
Report any signs of allergic reactions or severe side effects.

Special Considerations

Black Box Warnings: N/A

Genetic Factors: None specified.

Lab Test Interference: None noted.

Overdose Management

Signs/Symptoms: Sedation, drowsiness, and dizziness; in severe cases, agitation or hallucinations.

Treatment: Supportive care; activated charcoal if ingestion was recent; dialysis may be considered in severe cases, especially in renal impairment.

Storage and Handling

Storage: Store at room temperature, away from moisture and light.

Stability: Stable under recommended storage conditions.