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Levocetirizine

XYZAL

Pronunciation: lee-voe-se-TIR-i-zeen

Levocetirizine ballicule: receptor binding, kinetics and half-life diagram
Mechanism of action: Levocetirizine ballicule
Levocetirizine XYZAL mascot mnemonic cartoon
Visual mnemonic: Levocetirizine mascot
“Wise owl Left sittin’”

What it isSecond-generation H1 antagonist and active cetirizine enantiomer; allergic rhinitis and urticaria.

Why this oneIt removes cetirizine's inactive enantiomer but offers little practical efficacy advantage over the parent drug.

What limits itSedation is more common than with loratadine or fexofenadine; renal clearance requires adjustment in impairment.

Levocetirizine molecular structure (skeletal formula)
Molecular structure: Levocetirizine

FDA-approved for

FDA label

FDA dosingPopulationStartTargetMax
Allergy symptom reliefAdults & children ≥12 yr5 mg QHS5 mg (or 2.5 mg for less severe) QHS5 mg/24h
Allergy symptom reliefChildren 6–11 yr2.5 mg QHS2.5 mg QHS2.5 mg/24h

Renal Do not use in consumers with kidney disease (OTC labeling).

Hepatic Undefined

Instructions

Available strengths

Pregnancy Undefined

Lactation Undefined

Cost

Levocetirizine (XYZAL)
What pharmacies pay · NADAC 9/30/26
Strength#/mogeneric $CostPlus
5 mgtab30 qd$4.04/mooffered
2.5 mg/5 mLsolper unit$0.17/mLoffered

Generic entry2010

NO BOXED WARNINGS

Principal riskSedation, more than loratadine

Classes and tags

Clinical profile

Therapeutic safety burden1 / 4
Overdose danger1 / 4
Weight-gain liability1 / 4
Sedation liability1 / 4
QT / Torsades0 / 4
Direct muscarinic antagonism0 / 4
Embryofetal risk1 / 4

Legacy pregnancy categoryB

Defining liabilityGenerally tolerated at therapeutic doses; clinically important risks are agent-specific and increase with interactions or organ impairment.

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Memory aids: interaction avatars

Levocetirizine Box: minimal PK interactions avatar mnemonic
Box: minimal PK interactions

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