Levocetirizine is an antihistamine used to relieve symptoms of seasonal allergic rhinitis, perennial allergic rhinitis, and chronic urticaria. These symptoms can include sneezing, coughing, a runny nose, and itching of the eyes, throat, or nose.

In the United States, levocetirizine is available as 5 mg tablets and as an oral solution containing 2.5 mg per 5 mL. It is sold as generic levocetirizine dihydrochloride and under the brand name Xyzal.

The recommended dose and length of treatment depend on the formulation, age, kidney function, and the condition being treated. Levocetirizine should be taken according to the package directions or as instructed by a doctor or pharmacist.

What it's used for

Levocetirizine is used to relieve symptoms associated with the following conditions:

Seasonal allergic rhinitis, which may be triggered by pollen from certain plants during specific times of the year;
Perennial allergic rhinitis, which may be triggered by allergens such as dust mites and can occur throughout the year;
Chronic idiopathic urticaria, a condition that causes hives and itching of the skin.

This medication can be used in children and adults according to age-specific dosing recommendations and medical guidance.

How to take

Levocetirizine contains levocetirizine dihydrochloride as its active ingredient. Montelukast sodium is a separate medication that may also be prescribed for conditions such as asthma and allergic rhinitis.

Levocetirizine should be taken according to the following formulations:

1. Levocetirizine 5 mg tablets

Each tablet contains 5 mg of levocetirizine. The generally recommended doses are:

Children 6 to 11 years old: 2.5 mg, or half of a scored 5 mg tablet, once daily in the evening;
Adolescents 12 years and older and adults: 5 mg, or 1 tablet, once daily in the evening. A 2.5 mg dose may be sufficient for less severe symptoms;
Adults 65 years and older: a doctor should be consulted before use, especially if kidney function is reduced;
People with kidney problems: the dose should be adjusted by a doctor based on the degree of kidney impairment.

The tablets should be swallowed with water and can be taken with or without food.

The length of treatment depends on how long symptoms last and the condition being treated.

2. Levocetirizine oral solution 2.5 mg/5 mL

Each 5 mL of oral solution contains 2.5 mg of levocetirizine. Recommended doses vary by age and the condition being treated:

Children 6 months to 5 years old: when used for an approved indication in this age group, the recommended dose is 2.5 mL, equivalent to 1.25 mg, once daily in the evening;
Children 6 to 11 years old: 5 mL, equivalent to 2.5 mg, once daily in the evening;
Adolescents 12 years and older and adults: 10 mL, equivalent to 5 mg, once daily in the evening. A 5 mL dose, equivalent to 2.5 mg, may be sufficient for less severe symptoms;
Adults 65 years and older: a doctor should be consulted before use, especially if kidney function is reduced;
People with kidney impairment: the dose should be determined by a doctor based on kidney function.

The oral solution should be measured with the dosing device provided with the medication and can be taken with or without food.

The length of treatment depends on how long symptoms last and the condition being treated.

Possible side effects

The most common side effects of levocetirizine include drowsiness, fatigue, dry mouth, and headache.

Less commonly, other reactions may occur, including abdominal pain, nausea, vomiting, dizziness, blurred vision, changes in heart rate, liver problems, or behavioral changes.

When montelukast is prescribed separately, it can cause additional side effects such as abdominal pain, headache, and upper respiratory symptoms.

Less commonly, montelukast may also cause sleep disturbances, sleepwalking, irritability, anxiety, agitation, depression, nosebleeds, hives, and muscle or joint pain. Serious neuropsychiatric reactions have also been reported with montelukast.

Who should not take it

Levocetirizine should not be used by anyone who has had an allergic reaction to levocetirizine, cetirizine, or any ingredient in the medication.

People with epilepsy or a history of seizures should use levocetirizine with medical guidance. Levocetirizine is also contraindicated in people with end-stage kidney disease or those undergoing hemodialysis, and children with impaired kidney function require medical evaluation before treatment.

Some levocetirizine tablets contain lactose. People with certain hereditary disorders involving galactose intolerance, lactase deficiency, or glucose-galactose malabsorption should check the inactive ingredients and consult a doctor or pharmacist before taking the medication.

Levocetirizine should be used during pregnancy only after discussing the potential benefits and risks with a healthcare professional. Its use while breastfeeding should also be discussed with a healthcare professional.

Alcohol should be avoided while taking levocetirizine because it can further reduce alertness. Driving or operating machinery should also be avoided until it is known how the medication affects alertness and coordination.

Levocetirizine: Uses, How to Take, Dosing & Side Effects