Levocetirizine Dosing in Children
For children aged 6-11 years, administer 2.5 mg (½ tablet) once daily in the evening; for children aged 12 years and older, administer 5 mg once daily in the evening. 1
Age-Based Dosing Recommendations
Children 6-11 Years
Children 12 Years and Older (up to 64 years)
- Administer 5 mg once daily in the evening 1
- For less severe symptoms, 2.5 mg once daily may be appropriate 1
- Do not exceed 5 mg in 24 hours 1
Children Under 6 Years
- Do not use the standard tablet formulation 1
- For children aged 1-2 years (12-24 months), research supports 0.125 mg/kg twice daily when using oral solution formulations 2, 3
- This twice-daily dosing in very young children is necessary due to rapid oral clearance that increases with body weight and age 4, 5
Special Populations
Renal Impairment
- Do not use levocetirizine in children with kidney disease 1
- This is a critical contraindication that must be screened for before prescribing 1
Elderly Patients (65+ years)
- Consult a physician before use 1
Pharmacokinetic Considerations in Young Children
Dosing Rationale for Infants and Toddlers
- Very young children (12-24 months) require weight-based dosing of 0.125 mg/kg twice daily due to higher weight-normalized clearance compared to adults 4, 2, 5
- Peak plasma levels occur at approximately 1 hour after administration in toddlers 2
- Elimination half-life in young children is approximately 4.1 hours, necessitating twice-daily dosing 2
- This dosing achieves similar drug exposure (AUC) as the adult dose of 5 mg once daily 5
Safety Profile in Young Children
- Long-term safety (18 months) has been demonstrated in children as young as 12 months at 0.125 mg/kg twice daily 3
- Adverse event rates are similar to placebo, with most events related to upper respiratory infections or gastroenteritis 3
- No significant effects on growth, development, or laboratory parameters were observed 3
Clinical Efficacy
Seasonal Allergic Rhinitis
- In children aged 6-12 years with seasonal allergic rhinitis, levocetirizine 5 mg once daily demonstrated 94.1% relative improvement over placebo in total symptom scores 6
- Efficacy is sustained over 6 weeks of continuous treatment 6
- Nasal congestion improved by 77.5% relative to placebo 6
Common Pitfalls to Avoid
- Never use in children with renal impairment - this is an absolute contraindication 1
- Do not use standard tablets in children under 6 years - they require liquid formulations with different dosing 1
- Avoid once-daily dosing in children under 2 years - twice-daily administration is necessary due to rapid clearance 4, 2
- Do not exceed recommended maximum doses - 2.5 mg/24 hours for ages 6-11, and 5 mg/24 hours for ages 12+ 1
- Screen for kidney disease before prescribing - this is easily overlooked but critical 1