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Xyzal

Last reviewed on RxList: 7/24/2017
Xyzal Side Effects Center

Medical Editor: John P. Cunha, DO, FACOEP

Last reviewed on RxList 7/24/2017

Xyzal (levocetirizine dihydrochloride) is an antihistamine indicated for the relief of symptoms associated with seasonal allergic rhinitis in adults and children 2 years of age and older. Xyzal is available over-the-counter. Common side effects of Xyzal include:

Tell your doctor if you have serious side effecs of Xyzal including:

  • lightheadedness,
  • nosebleeds (especially in a child),
  • pain or fullness in your ear,
  • hearing problems,
  • depression,
  • agitation,
  • aggression,
  • hallucinations,
  • numbness or tingling around your lips or mouth,
  • yellowing of your skin or eyes (jaundice),
  • painful or difficult urination,
  • dark-colored urine,
  • foul-smelling stools,
  • fever,
  • stomach pain, or
  • loss of appetite

Xyzal is administered orally in the form of tablets or oral solution. The recommended dose of Xyzal for adults and children 12 years of age and older is 5 mg (1 tablet or 2 teaspoons [10 mL] oral solution) once daily in the evening. Xyzal may interact with alcohol, other medicines that can make you drowsy (cold or allergy medicine, sedatives, narcotics, sleeping pills, muscle relaxers, medicine for seizures, depression or anxiety), ritonavir, or theophylline. Tell your doctor all medications and supplements you use. Xyzal should be used during pregnancy only if clearly needed. Tell your doctor if you are pregnant or plan to become pregnant during treatment with Xyzal. Xyzal is not expected to harm a fetus. Xyzal passes into breast milk and may harm a nursing baby. Breastfeeding while taking Xyzal is not recommended.

Our Xzyal Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Xyzal Consumer Information

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using levocetirizine and call your doctor at once if you have a serious side effect such as:

  • feeling like you might pass out;
  • nosebleed (especially in a child);
  • pain or fullness in your ear, hearing problems;
  • depression, agitation, aggression, hallucinations;
  • numbness or tingling around your lips or mouth;
  • jaundice (yellowing of your skin or eyes);
  • painful or difficult urination;
  • dark-colored urine, foul-smelling stools; or
  • fever, stomach pain, loss of appetite.

Other common side effects may include:

  • drowsiness, weakness;
  • tired feeling;
  • stuffy nose, sinus pain, sore throat, cough;
  • vomiting, diarrhea, constipation;
  • dry mouth; or
  • weight gain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Read the entire detailed patient monograph for Xyzal (Levocetirizine Dihydrochloride)

Xyzal Professional Information

SIDE EFFECTS

Use of XYZAL has been associated with somnolence, fatigue, asthenia, and urinary retention [see WARNINGS AND PRECAUTIONS].

Clinical Trials Experience

The safety data described below reflect exposure to XYZAL in 2708 patients with allergic rhinitis or chronic idiopathic urticaria in 14 controlled clinical trials of 1 week to 6 months duration.

The short-term (exposure up to 6 weeks) safety data for adults and adolescents are based upon eight clinical trials in which 1896 patients (825 males and 1071 females aged 12 years and older) were treated with XYZAL 2.5, 5, or 10 mg once daily in the evening.

The short-term safety data from pediatric patients are based upon two clinical trials in which 243 children with allergic rhinitis (162 males and 81 females 6 to 12 years of age) were treated with XYZAL 5 mg once daily for 4 to 6 weeks, one clinical trial in which 114 children (65 males and 49 females 1 to 5 years of age) with allergic rhinitis or chronic idiopathic urticaria were treated with XYZAL 1.25 mg twice daily for 2 weeks, and one clinical trial in which 45 children (28 males and 17 females 6 to 11 months of age) with symptoms of allergic rhinitis or chronic urticaria were treated with XYZAL 1.25 mg once daily for 2 weeks.

The long-term (exposure of 4 or 6 months) safety data in adults and adolescents are based upon two clinical trials in which 428 patients (190 males and 238 females) with allergic rhinitis were exposed to treatment with XYZAL 5 mg once daily. Long term safety data are also available from an 18-month trial in 255 XYZAL-treated subjects 12-24 months of age.

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trial of another drug and may not reflect the rates observed in practice.

Adults And Adolescents 12 Years Of Age And Older

In studies up to 6 weeks in duration, the mean age of the adult and adolescent patients was 32 years, 44% of the patients were men and 56% were women, and the large majority (more than 90%) was Caucasian.

In these trials 43% and 42% of the subjects in the XYZAL 2.5 mg and 5 mg groups, respectively, had at least one adverse event compared to 43% in the placebo group.

In placebo-controlled trials of 1-6 weeks in duration, the most common adverse reactions were somnolence, nasopharyngitis, fatigue, dry mouth, and pharyngitis, and most were mild to moderate in intensity. Somnolence with XYZAL showed dose ordering between tested doses of 2.5, 5 and 10 mg and was the most common adverse reaction leading to discontinuation (0.5%).

Table 1 lists adverse reactions that were reported in greater than or equal to 2% of subjects aged 12 years and older exposed to XYZAL 2.5 mg or 5 mg in eight placebo-controlled clinical trials and that were more common with XYZAL than placebo.

Table 1 : Adverse Reactions Reported in ≥ 2%* of Subjects Aged 12 Years and Older Exposed to XYZAL 2.5 mg or 5 mg Once Daily in Placebo-Controlled Clinical Trials 1-6 Weeks in Duration

Adverse Reactions XYZAL 2.5 mg
(n = 421)
XYZAL 5 mg
(n = 1070)
Placebo
(n = 912)
Somnolence 22 (5%) 61 (6%) 16 (2%)
Nasopharyngitis 25 (6%) 40 (4%) 28 (3%)
Fatigue 5 (1%) 46 (4%) 20 (2%)
Dry Mouth 12 (3%) 26 (2%) 11 (1%)
Pharyngitis 10 (2%) 12 (1%) 9 (1%)
*Rounded to the closest unit percentage

Additional adverse reactions of medical significance observed at a higher incidence than in placebo in adults and adolescents aged 12 years and older exposed to XYZAL are syncope (0.2%) and weight increased (0.5%).

Pediatric Patients 6 To 12 Years Of Age

A total of 243 pediatric patients 6 to 12 years of age received XYZAL 5 mg once daily in two short-term placebo controlled double-blind trials. The mean age of the patients was 9.8 years, 79 (32%) were 6 to 8 years of age, and 50% were Caucasian. Table 2 lists adverse reactions that were reported in greater than or equal to 2% of subjects aged 6 to 12 years exposed to XYZAL 5 mg in placebo-controlled clinical trials and that were more common with XYZAL than placebo.

Table 2 : Adverse Reactions Reported in ≥ 2%* of Subjects Aged 6-12 Years Exposed to XYZAL 5 mg Once Daily in Placebo-Controlled Clinical Trials 4 and 6 Weeks in Duration

Adverse Reactions XYZAL 5 mg
(n = 243)
Placebo
(n = 240)
Pyrexia 10 (4%) 5 (2%)
Cough 8 (3%) 2 ( < 1%)
Somnolence 7 (3%) 1 ( < 1%)
Epistaxis 6 (2%) 1 ( < 1%)
*Rounded to the closest unit percentage

Pediatric Patients 1 To 5 Years Of Age

A total of 114 pediatric patients 1 to 5 years of age received XYZAL 1.25 mg twice daily in a two week placebo-controlled double-blind safety trial. The mean age of the patients was 3.8 years, 32% were 1 to 2 years of age, 71% were Caucasian and 18% were Black. Table 3 lists adverse reactions that were reported in greater than or equal to 2% of subjects aged 1 to 5 years exposed to XYZAL 1.25 mg twice daily in the placebo-controlled safety trial and that were more common with XYZAL than placebo.

Table 3 : Adverse Reactions Reported in ≥ 2%* of Subjects Aged 1-5 Years Exposed to XYZAL 1.25 mg Twice Daily in a 2-Week Placebo-Controlled Clinical Trial

Adverse Reactions XYZAL 1.25 mg Twice Daily
(n = 114)
Placebo
(n = 59)
Pyrexia 5 (4%) 1 (2%)
Diarrhea 4 (4%) 2 (3%)
Vomiting 4 (4%) 2 (3%)
Otitis Media 3 (3%) 0 (0%)
*Rounded to the closest unit percentage

Pediatric Patients 6 To 11 Months Of Age

A total of 45 pediatric patients 6 to 11 months of age received XYZAL 1.25 mg once daily in a two week placebo-controlled double-blind safety trial. The mean age of the patients was 9 months, 51% were Caucasian and 31% were Black. Adverse reactions that were reported in more than 1 subject (i.e. greater than or equal to 3% of subjects) aged 6 to 11 months exposed to XYZAL 1.25 mg once daily in the placebo-controlled safety trial and that were more common with XYZAL than placebo included diarrhea and constipation which were reported in 6 (13%) and 1 (4%) and 3 (7%) and 1 (4%) children in the XYZAL and placebo-treated groups, respectively.

Long-Term Clinical Trials Experience

In two controlled clinical trials, 428 patients (190 males and 238 females) aged 12 years and older were treated with XYZAL 5 mg once daily for 4 or 6 months. The patient characteristics and the safety profile were similar to that seen in the short-term studies. Ten (2.3%) patients treated with XYZAL discontinued because of somnolence, fatigue or asthenia compared to 2 ( < 1%) in the placebo group.

There are no long term clinical trials in children below 12 years of age with allergic rhinitis or chronic idiopathic urticaria.

Laboratory Test Abnormalities

Elevations of blood bilirubin and transaminases were reported in < 1% of patients in the clinical trials. The elevations were transient and did not lead to discontinuation in any patient.

Post-Marketing Experience

In addition to the adverse reactions reported during clinical trials and listed above, the following adverse reactions have also been identified during post-approval use of XYZAL. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Besides these reactions reported under treatment with XYZAL, other potentially severe adverse events have been reported from the post-marketing experience with cetirizine. Since levocetirizine is the principal pharmacologically active component of cetirizine, one should take into account the fact that the following adverse events could also potentially occur under treatment with XYZAL.

  • Cardiac disorders: severe hypotension
  • Gastrointestinal disorders: cholestasis
  • Nervous system disorders: extrapyramidal symptoms, myoclonus, orofacial dyskinesia, tic
  • Pregnancy, puerperium and perinatal conditions: stillbirth
  • Renal and urinary disorders: glomerulonephritis
  • Skin and subcutaneous tissue disorders: acute generalized exanthematous pustulosis (AGEP)

Read the entire FDA prescribing information for Xyzal (Levocetirizine Dihydrochloride)

Related Resources for Xyzal

Read the Xyzal User Reviews »

© Xyzal Patient Information is supplied by Cerner Multum, Inc. and Xyzal Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.

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