Levocetirizine: Clinical Indications
Levocetirizine is a second-generation antihistamine used for treating allergic rhinitis (both seasonal and persistent) and chronic idiopathic urticaria, providing 24-hour relief of sneezing, runny nose, itchy nose or throat, and itchy, watery eyes. 1, 2
Primary Clinical Uses
Levocetirizine is licensed and recommended as first-line therapy for:
- Allergic rhinitis (seasonal and persistent/perennial) - relieves sneezing, rhinorrhea, nasal pruritus, and ocular symptoms 1, 2
- Chronic idiopathic urticaria - reduces pruritus, wheal number, and wheal size with well-established efficacy and safety profile 1
Mechanism and Clinical Benefits
- Acts exclusively as a selective histamine H1-receptor antagonist, providing rapid onset and long duration (24 hours) of antihistaminic effect 1
- Long-term therapy (6 months) reduces comorbidities including asthma in patients with persistent allergic rhinitis 1
- Available as original prescription strength (5 mg) for once-daily dosing 2
Critical Safety Considerations and Dose Adjustments
Renal impairment requires mandatory dose reduction:
- Reduce dose by half in moderate renal insufficiency (creatinine clearance 10-20 mL/min) 1, 3
- Avoid completely in severe renal insufficiency (creatinine clearance <10 mL/min) 1
Pregnancy and special populations:
- Avoid during pregnancy, especially first trimester, due to limited safety data 1, 3
- May cause sedation, though typically less than first-generation antihistamines 3
- In school-age children, attention to dosing and scheduling is needed as sedation may affect school performance 3