Xyzal (Levocetirizine) - Oral

What Is Xyzal?

Xyzal (levocetirizine) is an oral medication used to treat allergy symptoms or chronic hives. It is available as a tablet and oral solution, both by prescription and over-the-counter (OTC).

Xyzal is in a drug class called antihistamines. It works by blocking histamine, a substance that the body produces in response to allergens. Histamine causes symptoms such as sneezing, itchy eyes, and runny nose. By blocking histamine, Xyzal helps prevent these symptoms. Xyzal can also be used to treat chronic hives.

Drug Facts

Generic Name: Levocetirizine

Brand Name(s): Xyzal

Drug Availability: Prescription and OTC

Administration Route: Oral

Therapeutic Classification: Antihistamine

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Levocetirizine

Dosage Form(s): Tablet, oral solution

What Is Xyzal Used For?

The Food and Drug Administration (FDA) approved Xyzal for use in adults and children for:

  • Symptom relief from perennial (year-round) and seasonal allergies: Symptoms may include runny nose, sneezing, watery eyes, and itchy eyes, nose, and throat. For perennial allergies, prescription Xyzal can be used in adults, infants, and children 6 months and older. However, the OTC liquid formulation is indicated for use in adults and children 2 years and older. For seasonal allergies, Xyzal can be used in adults and children 2 years and older.
  • Chronic idiopathic urticaria, or CIU: CIU is a condition that causes hives for at least six weeks with no known cause. For this indication, Xyzal can be used in adults and children 6 months and older.
Xyzal (Levocetirizine) Drug Information: A person with holding a tissue against the nose area

Verywell / Dennis Madamba

How to Take Xyzal

Take Xyzal exactly as directed by your healthcare provider. Read the prescription label and instruction sheets for prescription Xyzal. If you are taking OTC Xyzal, follow the dosing instructions on the package.

When using Xyzal, remember the following:

  • Do not take (or give your child) more than the recommended dose. It is important to note that children absorb double what an adult does.
  • Taking extra medicine does not make it more effective and can cause side effects such as drowsiness, more severe.
  • Do not drive or operate machinery until you know how Xyzal affects you.
  • Do not drink alcohol while taking Xyzal, and do not take medications that cause central nervous system depression (a slowing down of the nervous system, which can cause severe drowsiness and slowed breathing), such as anxiety medications, opioid pain medications, or sleep medications.
  • Take Xyzal in the evening. You can take Xyzal with or without food.
  • When using the liquid form of Xyzal, measure the liquid carefully with a medication measuring device. Do not use a kitchen measuring device.

Contact your healthcare provider if you have a fever or if symptoms worsen or do not improve.

Storage

Store Xyzal at room temperature (between 68 and 77 degrees F) away from heat, direct light, and moisture. Keep the bottle tightly closed. Keep Xyzal out of reach and out of sight of children and pets.

Off-Label Uses

Healthcare providers may prescribe Xyzal for off-label uses, meaning for conditions not specifically indicated by the FDA. One such off-label use for prescription Xyzal is to treat atopic dermatitis, a form of eczema.

How Long Does Xyzal Take to Work?

Xyzal starts working about one hour after taking it. However, you may need to take it daily, for a period of time, to keep symptoms from coming back. It is often recommended to start taking allergy medication at least two weeks before you expect symptoms to start. Talk to your healthcare provider about when to start taking Xyzal and when to stop.

What Are the Side Effects of Xyzal?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Like other medications, Xyzal can cause side effects. Tell your healthcare provider about any side effects you experience while taking this medication.

Common Side Effects

Common side effects of Xyzal in adults and children include:

  • Cold symptoms
  • Dry mouth
  • Excess sleepiness
  • Fatigue (tiredness)
  • Sore throat
  • Trouble urinating
  • Weakness

Common side effects that are more likely to occur in children include:

Severe Side Effects

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or you think you have a medical emergency. Serious side effects and their symptoms can include the following:

  • Hypersensitivity reaction or anaphylaxis: Symptoms can include rash, hives, swelling around the lips, tongue, and face, and difficulty breathing.
  • Seizures
  • Fainting
  • Severely low blood pressure
  • Thoughts of suicide: Stop taking Xyzal and report any changes in mood or behavior, or suicidal thoughts, to your healthcare provider right away.
  • Hallucinations: Hearing, seeing, feeling, smelling, or tasting things that are not there

Long-Term Side Effects

While many people tolerate Xyzal well, long-term or delayed side effects are possible. Some long-term side effects can be mild, such as:

  • Cough
  • Infection
  • Joint pain
  • Nosebleeds
  • Numbness and tingling
  • Sore throat
  • Weakness
  • Weight gain

Moderate long-term side effects can include:

Severe long-term side effects may include:

  • Acute generalized exanthematous pustulosis (a rare skin reaction that causes pustules (bumps that contain pus) and redness
  • Glomerulonephritis (kidney inflammation and damage)
  • Hemolytic anemia (a condition where red blood cells are destroyed faster than they are made)
  • Seizures
  • Thoughts of suicide

Report Side Effects

Xyzal may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication. If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Xyzal Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For hay fever:
    • For oral dosage form (Children's Xyzal® Allergy 24HR solution):
      • Adults and children 12 years of age and older—5 or 10 milliliters (mL) once a day taken in the evening. Do not take more than 10 mL in 24 hours.
      • Children 6 to 11 years of age—5 mL once a day taken in the evening. Do not take more than 5 mL in 24 hours.
      • Children 2 to 5 years of age—2.5 mL once a day taken in the evening. Do not take more than 2.5 mL in 24 hours.
      • Children younger than 2 years of age—Use and dose must be determined by your doctor.
    • For oral dosage form (levocetirizine dihydrochloride solution):
      • Adults and children older than 2 years of age—5 milligrams (mg) or 10 milliliters (mL) (1 teaspoon) once a day taken in the evening.
      • Children 6 months to 2 years of age—At first, 1.25 mg or 2.5 mL (1/2 teaspoon) once a day taken in the evening. Your doctor may adjust your dose as needed.
      • Children younger than 6 months of age—Use and dose must be determined by your doctor.
    • For oral dosage form (tablets):
      • Adults and children 12 years of age and older—5 milligrams (mg) (1 tablet) once a day taken in the evening. Some patients may be given 2.5 mg (1/2 tablet) once a day taken in the evening. Do not take more than 5 mg per day.
      • Children 6 to 11 years of age—2.5 mg (1/2 tablet) once a day taken in the evening. Do not take more than 2.5 mg per day.
      • Children younger than 6 years of age—Use and dose must be determined by your doctor.
  • For hives:
    • For oral dosage form (levocetirizine dihydrochloride solution):
      • Adults and children 12 years of age and older—5 milligrams (mg) or 10 milliliters (mL) (2 teaspoons) once a day taken in the evening. Some patients may be given 2.5 mg or 5 mL (1 teaspoon) once a day taken in the evening.
      • Children 6 to 11 years of age—2.5 mg or 5 mL (1 teaspoon) once a day taken in the evening. Do not take more than 2.5 mg per day.
      • Children 6 months to 5 years of age—At first, 1.25 mg or 2.5 mL (1/2 teaspoon) once a day taken in the evening. Do not take more than 1.25 mg per day.
      • Children younger than 6 months of age—Use and dose must be determined by your doctor.
    • For oral dosage form (tablets):
      • Adults and children 12 years of age and older—5 milligrams (mg) (1 tablet) once a day taken in the evening. Some patients may be given 2.5 mg (1/2 tablet) once a day taken in the evening. Do not take more than 5 mg per day.
      • Children 6 to 11 years of age—2.5 mg (1/2 tablet) once a day taken in the evening. Do not take more than 2.5 mg per day.
      • Children younger than 6 years of age—Use and dose must be determined by your doctor.

Modifications

You may need to use caution when taking Xyzal if you are 65 or older, especially if you have kidney, liver, or heart problems, or take certain other medications. Consult your healthcare provider before taking Xyzal.

People with mild or moderate kidney problems should consult their healthcare provider before using Xyzal, as the kidneys mostly processed the drug. You should not take this medication if you have a creatinine clearance (CrCl) less than 10 milliliters/minute or are on hemodialysis.

Most people with liver problems can take Xyzal at the regular dose for their age. Check with your healthcare provider.

Because there is not enough data on use during pregnancy, the prescribing information recommends that Xyzal should only be used in pregnancy if needed. Consult your healthcare provider if you are pregnant or planning to become pregnant. Xyzal should not be used while breastfeeding.

Missed Dose

If you miss a dose of Xyzal, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and take the next dose at the regular time. Do not take two doses together.

Overdose: What Happens If I Take Too Much Xyzal?

Overdosing on Xyzal may cause drowsiness in adults. In children, a Xyzal overdose may initially cause the child to be agitated and restless, followed by drowsiness.

What Happens If I Overdose on Xyzal?

If you think you or someone else may have overdosed on Xyzal, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Xyzal, call 911 immediately.

Precautions

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It is very important that your doctor check your or your child's progress to make sure this medicine is working properly. Urine tests may be needed to check for unwanted effects.

If your symptoms do not improve within a few days or if they become worse, check with your doctor.

This medicine may cause incomplete emptying of the bladder (urinary retention). Check with your doctor right away if you have a decrease in the frequency of urination or urine volume, difficulty in passing urine (dribbling), or painful urination.

This medicine may make you tired or drowsy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

Check with your doctor before using this medicine with alcohol or other medicines that affect the central nervous system (CNS). The use of alcohol or other medicines that affect the CNS with levocetirizine may worsen the side effects of this medicine, such as dizziness, poor concentration, drowsiness, unusual dreams, and trouble with sleeping. Some examples of medicines that affect the CNS are antihistamines or medicine for allergies or colds, sedatives, tranquilizers, or sleeping medicines, medicine for depression, medicine for anxiety, prescription pain medicine or narcotics, medicine for attention deficit and hyperactivity disorder, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or non-prescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn't Take Xyzal?

Xyzal is not appropriate for everyone. You should not take this medication if you are allergic to levocetirizine or any of the inactive ingredients in Xyzal. Moreover, you should not take Xyzal if you are allergic to cetirizine (the ingredient in Zyrtec) or hydroxyzine (the ingredient in Atarax or Vistaril).

Other people who should not take Xyzal include:

Xyzal may be prescribed with caution in some people, only if the healthcare provider determines it is safe. This includes:

  • People with mild or moderate kidney problems
  • People who drink alcohol
  • People who take drugs that cause central nervous system depression (such as medicines for anxiety, sleep, or pain)
  • People at risk for urinary retention (difficulty urinating and emptying the bladder)
  • People with prostatic hypertrophy (an enlarged prostate that can cause difficulty urinating)
  • People with spinal cord injury

What Other Medications May Interact With Xyzal?

Tell your healthcare provider about all medications you take, including prescription and OTC drugs, vitamins, or herbal supplements. 

Alcohol, marijuana, and medications that cause CNS depression should not be combined with Xyzal. Examples include:

  • Benzodiazepines used for anxiety, such as Ativan (lorazepam), Klonopin (clonazepam), Valium (diazepam), or Xanax (alprazolam)
  • Muscle relaxants like Flexeril (cyclobenzaprine) or Skelaxin (metaxalone)
  • Opioid pain medicines such codeine, oxycodone, OxyContin (oxycodone), Percocet (oxycodone/acetaminophen), Ultram (tramadol), or Vicodin (hydrocodone/acetaminophen)
  • Sleeping medications such as Ambien (zolpidem), Lunesta (eszopiclone), or Sonata (zaleplon)

Do not use Xyzal with other antihistamines, such as Benadryl (diphenhydramine) or Zyrtec (cetirizine).

Other drug interactions may occur with Xyzal. Consult your healthcare provider for a complete list of drug interactions.

What Medications Are Similar?

Xyzal is a second-generation antihistamine. It causes less drowsiness than older, first-generation antihistamines such as Benadryl (diphenhydramine). Other second-generation antihistamines include:

  • Allegra (fexofenadine)
  • Clarinex (desloratadine)
  • Claritin (loratadine)
  • Zyrtec (cetirizine)

Some of these antihistamines can also be found in combination products with pseudoephedrine, a decongestant. The decongestant helps nasal stuffiness, making it easier to breathe through your nose. These combination drugs that contain pseudoephedrine are found behind the counter in most states, but some states may require a prescription. This is because pseudoephedrine can be used as an ingredient to make methamphetamine (also known as meth), an illegal drug. Xyzal is not available in combination with pseudoephedrine. Examples of antihistamine/decongestant combination products include:

  • Allegra-D (fexofenadine and pseudoephedrine)
  • Clarinex-D (desloratadine and pseudoephedrine)
  • Claritin-D (loratadine and pseudoephedrine)
  • Zyrtec-D (cetirizine and pseudoephedrine)

This list is a list of drugs also used for allergies. It is NOT a list of drugs recommended to take with Xyzal. Ask your pharmacist or a healthcare provider if you have questions.

Frequently Asked Questions

  • What is Xyzal used for?

    Xyzal can be used in adults and children to relieve symptoms of allergies (year-round or seasonal allergies), or for chronic idiopathic urticaria. Chronic idiopathic urticaria is a condition where hives are present on the body most days for at least six weeks, with no known cause.

  • How does Xyzal work?

    Xyzal works by blocking histamine, which is a substance the body produces in response to allergens. Histamine causes symptoms such as sneezing, itchy eyes, and a runny nose. By blocking histamine, Xyzal helps prevent these symptoms.

  • What drugs should not be taken with Xyzal?

    Xyzal should not be taken with other antihistamines or combined with alcohol, marijuana, or other drugs that cause the central nervous system to slow down, such as anxiety medicines, sleep medicines, or muscle relaxants. Before taking Xyzal, talk to your healthcare provider to ensure it is safe for you to use with the other medications you take.

  • How long does it take for Xyzal to work?

    Xyzal starts to work about one hour after taking it. You may need to take it daily for some time to keep symptoms from returning. It is often recommended to start taking allergy medicine at least two weeks before you expect symptoms to appear. Consult your healthcare provider about when to begin taking Xyzal and when to stop.

  • What are the side effects of Xyzal?

    Common side effects include tiredness and sleepiness, weakness, dry mouth, sore throat, cold symptoms, and trouble urinating. Children are also likely to experience cough, ear infection, vomiting and diarrhea, fever, and nosebleeds.

How Can I Stay Healthy While Taking Xyzal?

Consult your healthcare provider about the best treatment for your allergies. It may be helpful to schedule an appointment with an allergist or immunologist, who can perform allergy testing and recommend the best treatment for you. If you are at risk of a severe allergic reaction, carry an epinephrine injection with you at all times. Wear a medical alert identification if you have ever had a severe allergic reaction.

In addition to taking Xyzal, you can also incorporate non-pharmacological measures to help prevent allergy symptoms:

  • Monitor pollen and mold counts. You can use various apps to do this, along with general news and weather reports.
  • Close the windows and doors at home and in your car when you have allergy symptoms.
  • Take a shower (washing both your body and hair) and put on clean clothes after spending time outside.
  • Wear an N95 mask when outside.
  • Use an air purifier and a humidifier.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. DailyMed. Label: Xyzal- levocetirizine dihydrochloride tablet; Xyzal- levocetirizine dihydrochloride solution.

  2. Prescribers’ Digital Reference. Levocetirizine dihydrochloride - drug summary.

  3. Epocrates. Levocetirizine-adult dosing.

  4. Epocrates. Levocetirizine-entire monograph.

  5. American College of Allergy, Asthma & Immunology. Seasonal allergies.

By Karen Berger, PharmD
Karen Berger, PharmD, is a community pharmacist and medical writer/reviewer.