From the Guidelines
Levocetirizine is recommended at a dosage of 5 mg once daily for adults and children 12 years and older with allergic rhinitis and urticaria. This dosage is based on the guidelines for evaluation and management of urticaria in adults and children, which suggest that levocetirizine is one of the nonsedating H1 antihistamines that can be taken once daily 1. The medication is effective in blocking histamine receptors that trigger allergy symptoms and provides 24-hour relief with minimal sedation compared to older antihistamines.
Some key points to consider when prescribing levocetirizine include:
- The medication should be taken consistently, preferably in the evening, to ensure optimal relief from symptoms
- Patients with kidney impairment require dose adjustments based on creatinine clearance
- Common side effects include drowsiness, dry mouth, and fatigue
- The medication can be taken with or without food, though taking it with food may reduce stomach discomfort
- For severe symptoms, the medication should be taken regularly rather than as needed, and improvement is typically seen within a few days of consistent use
It's also important to note that responses and tolerance to levocetirizine can vary between individuals, and patients should be offered the choice of at least two nonsedating H1 antihistamines 1. Additionally, adjustments to the timing of medication can be helpful to ensure that the highest drug levels are obtained when urticaria is anticipated. If symptoms persist after 2-3 weeks of treatment, patients should consult their healthcare provider to discuss alternative treatment options.
From the Research
Recommended Treatment and Dosage for Allergic Rhinitis and Urticaria using Levocetirizine
- The recommended dosage of Levocetirizine for the treatment of allergic rhinitis and chronic idiopathic urticaria is 5 mg once daily 2, 3, 4, 5.
- Studies have shown that Levocetirizine is effective in reducing symptoms of seasonal allergic rhinitis (SAR), perennial allergic rhinitis (PAR), and chronic idiopathic urticaria (CIU) in adults and children aged 6 years and older 2, 3, 4, 5.
- Levocetirizine has been shown to be well-tolerated, with a low potential for drug interactions and a lack of effect on cognition, psychomotor function, and the cardiovascular system 2, 3.
Efficacy of Levocetirizine in Allergic Rhinitis and Urticaria
- Levocetirizine has been shown to be effective in reducing symptom scores for sneezing, rhinorrhea, and ocular/nasal pruritus in patients with moderate to severe PAR 5.
- In patients with SAR, Levocetirizine has been shown to be effective in reducing symptoms of sneezing, rhinorrhea, and itchy nose 4, 5.
- In patients with CIU, Levocetirizine has been shown to be effective in reducing overall CIU symptoms, pruritus severity, and duration 5.
Safety and Tolerability of Levocetirizine
- Levocetirizine has been shown to be well-tolerated, with the most commonly reported adverse events including headache, pharyngitis, influenza, fatigue, and somnolence 5.
- There is a serious concern about the possibility of febrile seizures in infants treated with Levocetirizine 5.
- Studies have shown that increasing the dosage of Levocetirizine up to 4-fold can improve symptoms of chronic urticaria without compromising safety in approximately three-quarters of patients with difficult-to-treat chronic urticaria 6.