Maxilot (Levocetirizine) Indications
Maxilot (levocetirizine) is indicated for the symptomatic treatment of allergic rhinitis (both seasonal and persistent) and chronic idiopathic urticaria. 1, 2
Primary Indications
Allergic Rhinitis
- Seasonal Allergic Rhinitis (SAR): Levocetirizine 5 mg once daily effectively reduces nasal symptoms including rhinorrhea, sneezing, nasal pruritus, and ocular pruritus in patients with grass pollen and other seasonal allergies. 3, 4
- Persistent Allergic Rhinitis (PER): Levocetirizine is specifically indicated for persistent allergic rhinitis (symptoms >4 days/week for >4 consecutive weeks), with demonstrated efficacy over 6 months of continuous treatment. 1, 5
- Perennial Allergic Rhinitis (PAR): Effective for year-round allergic symptoms from indoor allergens. 2
Chronic Idiopathic Urticaria
- Levocetirizine is licensed as first-line therapy for chronic idiopathic urticaria, with well-established efficacy and safety profile. 6, 2
Mechanism and Clinical Benefits
- Selective H1-receptor antagonism: Levocetirizine acts exclusively as a selective antagonist of histamine H1 receptors, providing rapid onset and long duration of antihistaminic effect. 1, 2
- Symptom control: Effectively manages all major allergic rhinitis symptoms including sneezing, itching, rhinorrhea, and to a lesser extent, nasal congestion. 3, 4
- Quality of life improvement: Demonstrated significant improvements in health-related quality of life, work productivity, and sleep quality in patients with allergic rhinitis. 5, 4
- Comorbidity reduction: Long-term therapy (6 months) reduces comorbidities including asthma in patients with persistent allergic rhinitis. 1
Dosing and Administration
- Standard adult dose: 5 mg once daily, taken in the evening. 3, 4
- Pediatric use: Approved for children from 6 months of age, with established safety profile in this population. 1
- Renal impairment: Dose must be reduced by half in moderate renal insufficiency (creatinine clearance 10-20 mL/min) and avoided in severe renal insufficiency (creatinine clearance <10 mL/min). 1
Important Safety Considerations
- Pregnancy: Should be avoided during pregnancy, especially in the first trimester, due to limited safety data. 6, 1
- Sedation potential: May cause sedation, though typically less than first-generation antihistamines, with reported somnolence rates of 0.7-1.7% in clinical trials. 1, 4
- Renal dosing required: Requires careful dose adjustment in patients with renal impairment. 1
Clinical Context
- Second-generation antihistamine: Part of the latest generation of oral H1-receptor antagonists with minimal sedation, no cardiovascular effects, and low potential for drug interactions. 1, 2
- Comparative efficacy: Allergen challenge studies suggest superior efficacy compared to desloratadine, loratadine, or fexofenadine. 2
- Treatment duration: Can be used continuously for long-term management (up to 6 months studied), with continuous therapy showing better symptom control than on-demand use. 5, 7