Levocetirizine

Antihistamine drug From Wikipedia, the free encyclopedia

Levocetirizine

Levocetirizine, sold under the brand name Xyzal, among others, is a second-generation antihistamine used for the treatment of allergic rhinitis (hay fever) and long-term hives of unclear cause.[3] It is less sedating than older antihistamines.[4] It is taken by mouth.[3]

Quick Facts Clinical data, Trade names ...
Levocetirizine
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Clinical data
Trade namesXyzal, Levazyr, others
Other namesLevocetirizine dihydrochloride
AHFS/Drugs.comMonograph
MedlinePlusa607056
License data
Routes of
administration
By mouth
Drug classSecond generation antihistamines
ATC code
Legal status
Legal status
Pharmacokinetic data
BioavailabilityHigh
Protein binding91–92%[2]
MetabolismMinimal (less than 14%, primarily CYP3A4)[2]
Elimination half-life8 to 9 hours[2]
ExcretionUrine: 85%[2]
Feces: 12.9%[2]
Identifiers
  • 2-(2-{4-[(R)-(4-Chlorophenyl)(phenyl)methyl]piperazin-1-yl}ethoxy)acetic acid
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
PDB ligand
CompTox Dashboard (EPA)
Chemical and physical data
FormulaC21H25ClN2O3
Molar mass388.89 g·mol−1
3D model (JSmol)
  • Clc1ccc(cc1)[C@H](N2CCN(CCOCC(=O)O)CC2)c3ccccc3
  • InChI=1S/C21H25ClN2O3/c22-19-8-6-18(7-9-19)21(17-4-2-1-3-5-17)24-12-10-23(11-13-24)14-15-27-16-20(25)26/h1-9,21H,10-16H2,(H,25,26)/t21-/m1/s1 Y
  • Key:ZKLPARSLTMPFCP-OAQYLSRUSA-N Y
 NY (what is this?)  (verify)
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Common side effects include sleepiness, dry mouth, cough, vomiting, and diarrhea.[3] Use in pregnancy appears safe but has not been well studied and use when breastfeeding is of unclear safety.[5] It is classified as a second-generation antihistamine and works by blocking histamine H1-receptors.[6][3]

Levocetirizine was approved for medical use in the United States in 2007,[3] and is available as a generic medication.[4] In 2022, it was the 152nd most commonly prescribed medication in the United States, with more than 3 million prescriptions.[7][8]

Medical uses

Levocetirizine is used for allergic rhinitis.[9] This includes allergy symptoms such as watery eyes, runny nose, sneezing, hives, and itching.[10]

Side effects

Levocetirizine is referred to as a non-sedating antihistamine as it does not enter the brain in significant amounts and is therefore unlikely to cause drowsiness. Cardiac safety with repolarization may be better than some other antihistamines, as levocetirizine does not significantly prolong the QT interval in healthy individuals.[11][12][13] However, some people may still experience some slight sleepiness, headache, mouth dryness, lightheadedness, vision problems (mainly blurred vision), palpitations and fatigue.[14]

Pharmacology

Levocetirizine is an antihistamine. It acts as an inverse agonist that decreases activity at histamine H1 receptors. This in turn prevents the release of other allergy chemicals and increases the blood supply to the area, providing relief from the typical symptoms of hay fever. Levocetirizine, (R)-(-)-cetirizine, is essentially a chiral switch of (±)-cetirizine. This enantiomer, the eutomer, is more selective and the (S)-counterpart, the distomer, is inactive.[15][16]

Chemistry

Chemically, levocetirizine is the active levorotary enantiomer of cetirizine, also called the l-enantiomer of cetirizine. It is a member of the diphenylmethylpiperazine group of antihistamines.[citation needed]

History

Levocetirizine was first launched in 2001 by the Belgian pharmaceutical company UCB (Union Chimique Belge).[citation needed]

Society and culture

Summarize
Perspective

Availability

In January 2017, the US Food and Drug Administration approved an over-the-counter preparation.[17] Levocetirizine had previously received authorization by the FDA as a prescription drug in 2007, having already been brought to market throughout much of Europe.[citation needed] In India, a prescription-only drug containing levocetirizine hydrochloride and montelukast is sold as Crohist MK.[citation needed]

Brand names

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Different brands (Actavis, Glenmark, UCB) Levocetirizine tablets and oral solution
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Xyzal Tablets 5mg in Japan

Preparations of levocetirizine are sold under the following brand names:

  • Xyzal /ˈzˌzɑːl/ in Australia, Austria, Bulgaria, Croatia, Cyprus, Czech Republic, Finland, France, Hong Kong, Hungary, India, Ireland (also Rinozal), Italy, Japan, Lithuania, Netherlands, Poland, Portugal, Romania, Taiwan, Thailand, Turkey, The Philippines, Serbia, Singapore, Slovakia, Slovenia, South Africa, Switzerland and UK. In May 2007, the US Food and Drug Administration approved Xyzal, where it is co-marketed by Sanofi-Aventis.
  • Xazal in Spain.[18]
  • Zobral in Cyprus.
  • Levobert in India.
  • Xusal in Germany and Mexico.
  • Xozal in Greece.
  • Degraler in Chile.
  • Allevo in Egypt.
  • Zilola, Histisynt, and Xyzal (UCB) in Hungary.
  • Alcet, Curin, and Seasonix in Bangladesh.
  • Vozet and Uvnil in India.
  • T-Day Syrup in Pakistan.
  • Curin in Nepal.[19]
  • Zenaro in the Czech Republic and Slovakia.
  • Xuzal and Zival in Chile.
  • Cezera, Levosetil, Robenan, and Xyzal in Serbia.[20]
  • Rinozal and Xyzal in Ireland.
  • Xycet in Morocco.[21]

References

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