Xyzal (levocetirizine dihydrochloride) is a next-generation, prescription-strength antihistamine designed for the effective management of allergic conditions. As the active enantiomer of cetirizine, it offers a targeted mechanism of action with a high affinity for histamine H1-receptors, providing potent and sustained relief from symptoms. This medication is formulated for adults and children six years of age and older, delivering 24-hour control with a single daily dose. Its clinical profile is characterized by a rapid onset of action and a favorable side effect spectrum, making it a cornerstone in modern allergology and dermatology practice for both seasonal and perennial allergies, as well as chronic hives.

Features

• Active ingredient: Levocetirizine dihydrochloride 5 mg per tablet
• Formulation: Film-coated tablets for oral administration
• Pharmacological class: Second-generation, non-sedating antihistamine (H1-receptor antagonist)
• Duration of action: 24-hour symptomatic relief
• Approved for use in patients aged 6 years and above
• Prescription-only medication in most regions
• Low potential for drug interactions due to minimal hepatic metabolism
• Excipients include microcrystalline cellulose, lactose monohydrate, and magnesium stearate

Benefits

• Provides rapid and long-lasting relief from allergic rhinoconjunctivitis symptoms, including sneezing, rhinorrhea, nasal pruritus, and ocular itching.
• Effectively reduces the severity and frequency of wheals associated with chronic idiopathic urticaria, improving quality of life.
• Minimizes sedative effects compared to first-generation antihistamines, supporting daytime alertness and cognitive function.
• Once-daily dosing enhances adherence and convenience for chronic management.
• Demonstrated efficacy in both pediatric and adult populations through rigorous clinical trials.
• Low metabolic load and primarily renal excretion simplify use in patients with hepatic impairment.

Common use

Xyzal is indicated for the relief of symptoms associated with allergic rhinitis (seasonal and perennial) in adults and children 6 years of age and older. These symptoms include sneezing, runny nose, itchy nose/palate, and itchy/watery/red eyes. It is also indicated for the treatment of uncomplicated skin manifestations of chronic idiopathic urticaria in the same age group, reducing the occurrence and severity of hives. It may be used prophylactically by patients with known seasonal allergies when exposure to allergens is anticipated.

Dosage and direction

The recommended dose for adults and children 12 years and older is 5 mg (one tablet) once daily, taken in the evening. For children 6 to 11 years of age, the recommended dose is 2.5 mg (half a tablet) once daily in the evening. Administration may be with or without food. Tablets should be swallowed whole with a small amount of water. Dosage adjustment is necessary in patients with moderate to severe renal impairment (creatinine clearance less than 50 mL/min); consult prescribing information for specific guidance. Not recommended for children under 6 years of age.

Precautions

Patients should be advised that Xyzal may cause somnolence in some individuals; therefore, activities requiring mental alertness, such as driving or operating machinery, should be avoided until the individual’s response is known. Use with caution in patients with predisposing factors for urinary retention (e.g., prostatic hyperplasia) or glaucoma. Renal function should be assessed in elderly patients or those with suspected impairment prior to initiation. Patients with galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption should not take this medicine due to the lactose content. Pregnancy Category B: use only if clearly needed. Caution advised during breastfeeding.

Contraindications

Xyzal is contraindicated in patients with known hypersensitivity to levocetirizine, cetirizine, or any of the excipients. It is also contraindicated in patients with end-stage renal disease (creatinine clearance less than 10 mL/min) and in those undergoing dialysis. Not for use in children under 6 years of age.

Possible side effect

Most side effects are mild to moderate and transient. Common adverse reactions (≥2%) include somnolence (6%), nasopharyngitis (4%), fatigue (3%), dry mouth (3%), and pharyngitis (2%). Less frequently reported include headache, dizziness, and nausea. In children, pyrexia, cough, and somnolence were most commonly observed. As with any antihistamine, paradoxical CNS stimulation (e.g., agitation, insomnia) may occur rarely. Isolated cases of hypersensitivity reactions (rash, pruritus, urticaria, angioedema) have been reported.

Drug interaction

No clinically significant pharmacokinetic interactions have been observed with pseudoephedrine, azithromycin, ketoconazole, or erythromycin. However, concomitant use with CNS depressants (e.g., alcohol, benzodiazepines, opioids) may enhance sedative effects. Theoretical interactions with drugs that inhibit active renal secretion (e.g., probenecid) may increase levocetirizine plasma concentrations; monitor for increased adverse effects. No meaningful interactions with warfarin or theophylline have been noted.

Missed dose

If a dose is missed, it should be taken as soon as remembered, unless it is nearly time for the next scheduled dose. In that case, skip the missed dose and resume the usual dosing schedule. Do not double the dose to make up for a missed one.

Overdose

Symptoms of overdose may include drowsiness, agitation, restlessness, and in children initially agitation and restlessness followed by drowsiness. There is no specific antidote. Gastric lavage may be considered if performed soon after ingestion. General supportive and symptomatic treatment is recommended. Levocetirizine is not effectively removed by dialysis. Monitor vital signs and maintain airway patency.

Storage

Store at room temperature (15–30°C or 59–86°F) in the original blister package to protect from light and moisture. Keep out of reach of children. Do not use after the expiration date printed on the packaging.

Disclaimer

This information is for educational purposes only and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting any new medication or changing your treatment plan. Do not disregard professional medical advice or delay seeking it because of something you have read here. Individual responses to medication may vary.

Reviews

Clinical studies and post-marketing surveillance demonstrate high patient satisfaction with Xyzal, particularly regarding its 24-hour efficacy and low sedative profile. In randomized controlled trials, it showed significant improvement over placebo in Total Symptom Scores for allergic rhinitis and in reducing hive number and pruritus severity for urticaria. Many users report improved sleep quality and daytime functioning due to controlled nighttime symptoms without next-day drowsiness. Pediatric formulations are noted for their acceptability in children. As with all medications, a small subset of users may experience side effects; overall, it is considered a well-tolerated and effective option within its class.