Recommended Dosage of Xyzal (Levocetirizine) for Allergy Symptom Relief
The recommended dosage of Xyzal (levocetirizine) for adults and children 12-64 years of age is 5 mg (1 tablet) once daily in the evening for allergy symptom relief. 1
Dosage Recommendations by Age Group
Adults and Children 12-64 years:
- Standard dose: 5 mg (1 tablet) once daily in the evening
- For less severe symptoms: 2.5 mg (½ tablet) once daily may be appropriate
- Maximum dose: Do not exceed 5 mg in 24 hours 1
Children 6-11 years:
- 2.5 mg (½ tablet) once daily in the evening
- Maximum dose: Do not exceed 2.5 mg in 24 hours 1
Special Populations:
- Adults 65 years and older: Consult a doctor before use 1
- Children under 6 years: Not recommended 1
- Patients with kidney disease: Do not use 1
Clinical Efficacy
Levocetirizine has demonstrated significant efficacy in treating various allergic conditions:
- Effectively relieves nasal symptoms including sneezing, rhinorrhea, and nasal pruritus 2
- Shows improvement in nasal congestion after 6 weeks of continuous treatment 2
- Provides both rapid onset (within first week) and long-term relief (up to 6 months) for persistent allergic rhinitis 2
Dosing Considerations for Specific Conditions
Persistent Allergic Rhinitis:
- Continuous daily dosing (5 mg once daily) shows better long-term symptom control compared to on-demand dosing, particularly after 15 weeks of treatment 3
- Continuous treatment demonstrates improved quality of life and decreased nasal inflammation 3
Chronic Urticaria:
- For difficult-to-treat urticaria cases, doses up to 20 mg daily (4 times the standard dose) may be considered, though this exceeds FDA-approved dosing 4
- Approximately 75% of patients with difficult-to-treat chronic urticaria respond to higher than conventional doses without compromised safety 4
Important Precautions and Contraindications
- Renal impairment: Strictly contraindicated in patients with kidney disease 1
- Sedation risk: While levocetirizine has lower sedative effects compared to first-generation antihistamines, some patients may still experience somnolence (reported in approximately 8.3% of patients) 5
- Pregnancy: Use during pregnancy, especially in the first trimester, should be avoided unless clearly needed 6
Administration Pearls
- Taking the medication in the evening is recommended to minimize impact of any potential sedative effects during daytime activities
- Levocetirizine can be taken with or without food
- For optimal symptom control in persistent allergic rhinitis, continuous rather than on-demand use is preferred 3
Common Side Effects
The most commonly reported adverse events with levocetirizine 5 mg daily include:
- Headache (23.8%)
- Pharyngitis (19.4%)
- Influenza (14.6%)
- Fatigue (8.3%)
- Somnolence (8.3%) 5
Levocetirizine has minimal interaction with liver enzymes and is primarily excreted unchanged in urine, which contributes to its favorable safety profile 7.