Last Updated December 20th, 2021

Therapeutic Indications for Levocetirizine

levocitirizine for allegic rhinitisLevocetirizine is a third generation antihistamine drug, it has been developed from the second generation cetirizine thus has fewer side effects. It contains Levocetirizine dihydrochloride. A non-sedating and an antagonist for histamine receptor, Levocetirizine has anti-inflammatory and antihistamine properties. Consequently, it is an anti-allergic agent and used in the management and treatment of the following conditions:

  • Perennial rhinitis due to allergy.
  • Hay fever symptoms such as a runny nose, redness, tearing and itching of eyes and sneezing.
  • Idiopathic Urticaria that is chronic (Hives).

Do I need a prescription?

Levocetirizine can be bought from drug stores and online drug stores. But it is mandatory to have a doctor’s prescription.


The dosage required may vary depending on age, how severe the condition is, how one reacts to the first dose and medical history. The recommended dosage is as follows:

  • Chronic Idiopathic Urticaria

    Adults and children 12 years and older – 5 mg. (1 tablet) once a day in the evening.
    Children 6 to 11 years – 2.5 mg. (1/2 tablet) once a day in the evening.
    Children 6 months to 5 years – 1.25 mg. once a day in the evening.

  • Allergic Rhinitis

    Adults and children 12 years and older – 5 mg. (1 tablet) once a day in the evening.
    Children 6 to 11 years – 2.5 mg. (1/2 tablet) once a day in the evening.
    Children 6 months to 5 years – 1.25 mg. once a day in the evening.

In patients that have hepatic and renal impairment the dose is adjusted as follows:

  • Mild renal impairment with creatinine clearance of 50 to 80 ml per minute: 2.5 mg once a day.
  • Moderate renal impairment with creatinine clearance of 30 to 50 ml per minute: 2.5 mg once every other day.
  • A renal impairment that is severe with creatinine clearance of 10 to 30 ml per minute: 2.5 mg once a day every 3 to 4 days.
  • Patients with an end-stage renal disease are not to be given Levocetirizine.
  • Children of 6 months to 11 years with renal impairment should not use Levocetirizine.

Chemical Composition

Levocetirizine tablets contain:

  • Levocetirizine dihydrochloride 5 mg. This is equivalent to 4.2 mg of levocetirizine as the active ingredient.
  • Lactose monohydrate, microcrystalline cellulose, magnesium stearate, hypromellose, titanium dioxide and macrogol 400.

Mechanism of Action (MOA)

levocetirizine medicine

Levocetirizine is an active enantiomer of cetirizine and has antihistamine properties. It works by selectively inhibiting H1 receptors. It competes for binding sites with histamine at the peripheral H1 receptor sites found on the surface of effector cells. As result, it prevents the cells of the body from releasing histamine.

Production of histamine results in allergies thus when it is not released the allergy symptoms that include a runny nose, sneezing, red eyes, eyes being itchy and skin itching are relieved.

Levocetirizine also has anti-angiogenic activities. Histamine plays an important role during angiogenesis when an allergic reaction starts. Thus blocking of the action of histamine regulates how the proangiogenic factors are expressed preventing angiogenesis. This ends up preventing the occurrence of allergic reactions.


The use of Levocetirizine is not recommended in a number of conditions, inform your doctor if you have any of these conditions as it may affect the prescription dose. These conditions include:

  • Allergic to any of the active ingredients of Levocetirizine or cetirizine
  • End-stage renal disease. The creatinine clearance is lower than 10 ml per minute, thus not allowed to use the drug
  • Hemodialysis
  • Children 6 months to 11 years having renal impairment
  • Urinary retention caused by spinal cord lesions, injury and enlarged prostate
  • Diseases of the lower respiratory like asthma
  • Neonates and preemies
  • Nursing women
  • Stenosis peptic ulcer
  • Pyloro-duodenal obstruction
  • Narrow-angle glaucoma
  • Avoid the use of alcohol and CNS depressants
  • Problems of the gallbladder

Side effects of Levocetirizine

Use of Levocetirizine may cause a number of unwanted effects apart from the desired effects. Some of the side effects occur at the start of the dose but with the body adjusting, they go away. Some of the effects are common and less serious while others are rare but very serious. In the case that the side effects do not go away, report to your doctor as some may need medical attention.

Some of the more common side effects include:

  • Muscle aches
  • Unusual drowsiness
  • A sore throat
  • A runny nose
  • A headache
  • Somnolence
  • Nasopharyngitis
  • Fever
  • Xerostomia
  • Pharyngitis
  • A cough
  • Asthenia
  • Urinary retention
  • Epistaxis
  • Dry mouth
  • Abdominal pain

Less common side effects include:

  • Diarrhea
  • Congestion
  • Otitis media
  • Body ache
  • Redness and swelling inside the ear
  • Tender and swollen neck glands
  • Changes in voice
  • Anaphylaxis
  • Seizures
  • Syncope
  • Severe hypotension
  •  Hallucinations
  • Suicidal ideation
  • Nausea or vomiting
  • Rash and itching
  • Tingling sensation or skin numbness

Rare side effects include:

  • Depression
  • Confusion
  • Aggression
  • Increase in weight
  • Skin swelling
  • Hives
  • Movement disorders
  • Fits
  • Abnormal liver function
  • Swelling of hands, lower legs, arms, ankles, and feet
  • Reduced volume of urine
  • Blood in the urine

Very rare side effects include:

levocetirizine caused skin reaction

  • Blood platelet reduction increases the risk of bruising and bleeding
  • Fainting
  • Blurry vision
  • Painful urination
  • Changes in taste sensation
  • Bedwetting
  • Localized skin reaction
  • An allergic reaction that causes swelling face and throat and causes difficulty in breathing
  • Shaking
  • Jerky movements and muscle disorders
  • Circular eye movements
  • Tic
  • Cholestasis
  • Glomerulonephritis
  • Acute generalized exanthematous pustulosis (AGEP)
  • Myoclonus
  • Tremors
  • Epigastric distress
  • Anorexia
  • Jaundice
  • Tachycardia and palpitations
  • Arrhythmias

If you accidentally take an overdose of Levocetirizine, report to your doctor or rush to the nearest emergency center and take with you the label or package of the drug. An overdose of the drug may result in hypersensitive reaction to the drug.

Symptoms include swollen throat, face and lips, and difficulty in breathing. Other symptoms of overdose include restlessness, dizziness, and confusion.

Drug interactions

Levocetirizine may interact with a number of drugs both prescription and over the counter drugs (OTC). Tell your doctor of any medication you are currently using including vitamin supplements and herbal medications as it might affect the dose being prescribed.

These drugs and products may lower the effectiveness of the drug by interfering with its working or worsen some of the side effects of the drug. These products and drugs include:

  • Alcohol, it aggravates being drowsy and thus reduces mental alertness.
  • Asthma or COPD drug theophylline, when used together, increases the amount of Levocetirizine in the body thus higher chances of side effects occurring.
  • Ritonavir a HIV drug increases the amount of Levocetirizine raising chances of side effects.
  • Alprazolam
  • Clobazam
  • Codeine
  • Aspirin
  • Benardryl (diphenhydramine)
  • Cymbalta
  • Fexofenadine
  • Hydrocodone
  • Lyrica (pregabalin)
  • Vitamin B12, C and, D3.
  • Prednisone
  • Cetirizine
  • Xanax
  • Butalbital
  • Doxylamine
  • Kava
  • Promethazine
  • Sodium oxybate
  • Thalidomide
  • Trimethobenzamide
  • Sleeping pills
  • Tranquilizers
  • Antidepressants
  • Anxiety medications, seizures or mental illness

The list above does not include all the drugs that interact with Levocetirizine. A total of 584 drugs interact with Levocetirizine.

What to Do If You Skip a Dose

When you skip a dose, take it as soon as you realize it. In the case that you realize it near the time of the next dose, you can skip the dose and then take the following dose at the right time and continue with the normal schedule. Do not double the dose to compensate for the skipped one.

You can set a reminder or have a family member remind you in case you skip doses frequently.


A number of precautions are necessary while using Levocetirizine. They include:

  • Pregnancy:There is not much information whether it may harm the growing fetus and so, it should not be used during pregnancy unless the benefits outweigh the risks.
  • Lactating Mothers: Levocetirizine should not be used by breastfeeding mothers as there is no information whether it passes into breast milk. But the drug is a racemic form of cetirizine that has been excreted in breast milk and thus a possibility that Levocetirizine could be excreted too. Cetirizine when used in large doses or prolonged duration may cause drowsiness in the nursing infant, reduce the supply of milk, more so in mothers before lactation is established or when used together with a sympathomimetic.
  • Do not take the drug if you are hypersensitive to the active ingredients.
  • Alcohol should not be taken while using Levocetirizine. It may increase the effect of alcohol on some sensitive individuals impairing judgment.
  • Levocetirizine should not be used together with the Central Nervous System (CNS) depressants as it lowers mental alertness and addition in the CNS impairment.
  • The drug should not be used if you having severe kidney condition with very low clearance.
  • Levocetirizine should be used with precaution in the elderly.
  • If you suffer from epilepsy or have a condition that may cause fits, inform your doctor about it as special care should be taken while using Levocetirizine is such cases.
  • You should not operate heavy machinery or drive while using Levocetirizine as it causes exhaustion and drowsiness in some individuals.
  • If you experience urinary retention while using Levocetirizine, it is advised that you report to your doctor and discontinue the use of the drug.
  • The drug should be stored at room temperature and not in damp or moist places.
  • If allergic reactions occur while taking the drug call your doctor to report or go to the nearby emergency center. Symptoms of allergies to the drug include itching, hives, rash, swelling of the face, tongue, throat, and lips.

Different Brands and Manufacturing Companies of the Drug

Levocetirizine tablets are manufactured by Dr. Reddy’s Laboratories Ltd. The drug is a 5 mg tablet. Brands of the drug include:

  • Xyzal Allergy 24 hr. tablets
  • Xyzal Allergy 24 hr. oral solution
  • Zyzal

Substitutes of the Drug

Drugs with the same active ingredient and work as Levocetirizine include:

  • Levocet 5 mg tablet – Hetero Drugs Ltd
  • Teczine 5mg tablet – Sun Pharmaceutical Industries Ltd
  • Levosis 5 mg tablet – Systopic Laboratories Pvt Ltd
  • Vozet 5 mg tablet – Dr. Reddy’s Laboratories Ltd
  • Lecope 5 mg tablet – Mankind Pharma Ltd
  • Lcz 5 mg tablet – Rapross Pharmaceuticals Pvt Ltd
  • 1 Al 5 mg tablet – FCD Ltd
  • Hhlevo 5 mg tablet – Hedge and Hedge Pharmaceutical LLP
  • Lezyncet 5 mg tablet – Unichem Laboratories Ltd
  • Zevor 5 mg tablet –Abbott
  • Safecet 5 mg tablet – Talent India
  • Okacet 5 mg tablet – Cipla Ltd
  • Levorid 5 mg Tablet – Cipla Ltd

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