Details
| Stereochemistry | ABSOLUTE |
| Molecular Formula | C21H25ClN2O3 |
| Molecular Weight | 388.888 |
| Optical Activity | UNSPECIFIED |
| Defined Stereocenters | 1 / 1 |
| E/Z Centers | 0 |
| Charge | 0 |
SHOW SMILES / InChI
SMILES
OC(=O)COCCN1CCN(CC1)[C@H](C2=CC=CC=C2)C3=CC=C(Cl)C=C3
InChI
InChIKey=ZKLPARSLTMPFCP-OAQYLSRUSA-N
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
| Molecular Formula | C21H25ClN2O3 |
| Molecular Weight | 388.888 |
| Charge | 0 |
| Count |
|
| Stereochemistry | ABSOLUTE |
| Additional Stereochemistry | No |
| Defined Stereocenters | 1 / 1 |
| E/Z Centers | 0 |
| Optical Activity | UNSPECIFIED |
Levocetirizine dihydrochloride is the R enantiomer of cetirizine hydrochloride, a racemic compound with antihistaminic properties. Levocetirizine is a third-generation non-sedative antihistamine indicated for the relief of symptoms associated with seasonal and perennial allergic rhinitis and uncomplicated skin manifestations of chronic idiopathic urticaria. It was developed from the second-generation antihistamine cetirizine. Levocetirizine was approved by the United States Food and Drug Administration on May 25, 2007 and is marketed under the brand XYZAL. Its principal effects are mediated via selective inhibition of H1 receptors. The antihistaminic activity of levocetirizine has been documented in a variety of animal and human models. In vitro binding studies revealed that levocetirizine has an affinity for the human H1-receptor 2-fold higher than that of cetirizine (Ki = 3 nmol/L vs. 6 nmol/L, respectively). The clinical relevance of this finding is unknown.
CNS Activity
Sources: https://www.ncbi.nlm.nih.gov/pubmed/18781943http://www.medscape.com/viewarticle/724851_3
Curator's Comment: Levocetirizine is highly (91–93%) protein bound. It can cross the blood-brain barrier, but typically occupy only 30–50% of the H1 receptors in the cerebral cortex, compared to more than 90% of peripheral H1 receptors
Approval Year
Targets
| Primary Target | Pharmacology | Condition | Potency |
|---|---|---|---|
Target ID: CHEMBL231 Sources: https://www.ncbi.nlm.nih.gov/pubmed/18336052 |
3.0 nM [Ki] | ||
Target ID: CHEMBL231 |
6.0 nM [Ki] |
Conditions
| Condition | Modality | Targets | Highest Phase | Product |
|---|---|---|---|---|
| Palliative | XYZAL Approved UseLevocetirizine dihydrochloride tablet is a histamine H1-receptor antagonist indicated for: The relief of symptoms associated with seasonal and perennial allergic rhinitis (1.1, 1.2) The treatment of the uncomplicated skin manifestations of chronic idiopathic urticaria (1.3) 1.1 Seasonal Allergic Rhinitis Levocetirizine dihydrochloride tablets are indicated for the relief of symptoms associated with seasonal allergic rhinitis in adults and children 6 years of age and older. 1.2 Perennial Allergic Rhinitis Levocetirizine dihydrochloride tablets are indicated for the relief of symptoms associated with perennial allergic rhinitis in adults and children 6 years of age and older. 1.3 Chronic Idiopathic Urticaria Levocetirizine dihydrochloride tablets are indicated for the treatment of the uncomplicated skin manifestations of chronic idiopathic urticaria in adults and children 6 years of age and older. Launch Date2007 |
|||
| Palliative | XYZAL Approved UseLevocetirizine dihydrochloride tablet is a histamine H1-receptor antagonist indicated for: The relief of symptoms associated with seasonal and perennial allergic rhinitis (1.1, 1.2) The treatment of the uncomplicated skin manifestations of chronic idiopathic urticaria (1.3) 1.1 Seasonal Allergic Rhinitis Levocetirizine dihydrochloride tablets are indicated for the relief of symptoms associated with seasonal allergic rhinitis in adults and children 6 years of age and older. 1.2 Perennial Allergic Rhinitis Levocetirizine dihydrochloride tablets are indicated for the relief of symptoms associated with perennial allergic rhinitis in adults and children 6 years of age and older. 1.3 Chronic Idiopathic Urticaria Levocetirizine dihydrochloride tablets are indicated for the treatment of the uncomplicated skin manifestations of chronic idiopathic urticaria in adults and children 6 years of age and older. Launch Date2007 |
|||
| Palliative | XYZAL Approved UseLevocetirizine dihydrochloride tablet is a histamine H1-receptor antagonist indicated for: The relief of symptoms associated with seasonal and perennial allergic rhinitis (1.1, 1.2) The treatment of the uncomplicated skin manifestations of chronic idiopathic urticaria (1.3) 1.1 Seasonal Allergic Rhinitis Levocetirizine dihydrochloride tablets are indicated for the relief of symptoms associated with seasonal allergic rhinitis in adults and children 6 years of age and older. 1.2 Perennial Allergic Rhinitis Levocetirizine dihydrochloride tablets are indicated for the relief of symptoms associated with perennial allergic rhinitis in adults and children 6 years of age and older. 1.3 Chronic Idiopathic Urticaria Levocetirizine dihydrochloride tablets are indicated for the treatment of the uncomplicated skin manifestations of chronic idiopathic urticaria in adults and children 6 years of age and older. Launch Date2007 |
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| Primary | XYZAL Approved UseFor the temporary relief of nasal decongestiom due to the commomn cold, hay fever or other upper respiratpry allergies. Temporarily relieves nasal stuffiness. Decongests nasal passages: shrinks swollen membranes. Temporarily restores freer breathing through the nose. Helps decongest sinus openings and passages; temporarily relieves sinus congestion and pressure. Promotes nasal and/or sinus drainage. temporarily relieves sinus congestion and pressure. Launch Date2007 |
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| Primary | XYZAL Approved UseFor the temporary relief of nasal decongestiom due to the commomn cold, hay fever or other upper respiratpry allergies. Temporarily relieves nasal stuffiness. Decongests nasal passages: shrinks swollen membranes. Temporarily restores freer breathing through the nose. Helps decongest sinus openings and passages; temporarily relieves sinus congestion and pressure. Promotes nasal and/or sinus drainage. temporarily relieves sinus congestion and pressure. Launch Date2007 |
|||
| Primary | XYZAL Approved UseUnknown |
Cmax
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
512.25 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/11564134 |
10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered: |
LEVOCETIRIZINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
0.27 μg/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/11758635 |
5 mg single, oral dose: 5 mg route of administration: Oral experiment type: SINGLE co-administered: |
LEVOCETIRIZINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
0.17 μg/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/11758635 |
5 mg single, oral dose: 5 mg route of administration: Oral experiment type: SINGLE co-administered: |
LEVOCETIRIZINE blood | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
AUC
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
4136.4 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/11564134 |
10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered: |
LEVOCETIRIZINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
2.31 μg × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/11758635 |
5 mg single, oral dose: 5 mg route of administration: Oral experiment type: SINGLE co-administered: |
LEVOCETIRIZINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
0.97 μg × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/11758635 |
5 mg single, oral dose: 5 mg route of administration: Oral experiment type: SINGLE co-administered: |
LEVOCETIRIZINE blood | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
T1/2
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
7.76 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/11564134 |
10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered: |
LEVOCETIRIZINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
7.05 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/11758635 |
5 mg single, oral dose: 5 mg route of administration: Oral experiment type: SINGLE co-administered: |
LEVOCETIRIZINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
6.83 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/11758635 |
5 mg single, oral dose: 5 mg route of administration: Oral experiment type: SINGLE co-administered: |
LEVOCETIRIZINE blood | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
Funbound
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
4.5% EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/11758635 |
5 mg single, oral dose: 5 mg route of administration: Oral experiment type: SINGLE co-administered: |
LEVOCETIRIZINE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
Doses
| Dose | Population | Adverse events |
|---|---|---|
20 mg 1 times / day multiple, oral Highest studied dose Dose: 20 mg, 1 times / day Route: oral Route: multiple Dose: 20 mg, 1 times / day Sources: |
unhealthy, 18–60 years Health Status: unhealthy Age Group: 18–60 years Sources: |
|
5 mg 1 times / day steady, oral Recommended Dose: 5 mg, 1 times / day Route: oral Route: steady Dose: 5 mg, 1 times / day Sources: |
unhealthy, 48-64 years Health Status: unhealthy Age Group: 48-64 years Sex: M Sources: |
Disc. AE: Hepatotoxicity... AEs leading to discontinuation/dose reduction: Hepatotoxicity (2 patients) Sources: |
5 mg 1 times / day steady, oral Recommended Dose: 5 mg, 1 times / day Route: oral Route: steady Dose: 5 mg, 1 times / day Sources: |
unhealthy, > 12 years Health Status: unhealthy Age Group: > 12 years Sex: M+F Sources: |
Disc. AE: Somnolence, Fatigue... AEs leading to discontinuation/dose reduction: Somnolence (2.3%) Sources: Fatigue (2.3%) Asthenia (2.3%) |
AEs
| AE | Significance | Dose | Population |
|---|---|---|---|
| Hepatotoxicity | 2 patients Disc. AE |
5 mg 1 times / day steady, oral Recommended Dose: 5 mg, 1 times / day Route: oral Route: steady Dose: 5 mg, 1 times / day Sources: |
unhealthy, 48-64 years Health Status: unhealthy Age Group: 48-64 years Sex: M Sources: |
| Asthenia | 2.3% Disc. AE |
5 mg 1 times / day steady, oral Recommended Dose: 5 mg, 1 times / day Route: oral Route: steady Dose: 5 mg, 1 times / day Sources: |
unhealthy, > 12 years Health Status: unhealthy Age Group: > 12 years Sex: M+F Sources: |
| Fatigue | 2.3% Disc. AE |
5 mg 1 times / day steady, oral Recommended Dose: 5 mg, 1 times / day Route: oral Route: steady Dose: 5 mg, 1 times / day Sources: |
unhealthy, > 12 years Health Status: unhealthy Age Group: > 12 years Sex: M+F Sources: |
| Somnolence | 2.3% Disc. AE |
5 mg 1 times / day steady, oral Recommended Dose: 5 mg, 1 times / day Route: oral Route: steady Dose: 5 mg, 1 times / day Sources: |
unhealthy, > 12 years Health Status: unhealthy Age Group: > 12 years Sex: M+F Sources: |
Overview
| CYP3A4 | CYP2C9 | CYP2D6 | hERG |
|---|---|---|---|
OverviewOther
| Other Inhibitor | Other Substrate | Other Inducer |
|---|---|---|
Drug as perpetrator
Drug as victim
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022064s000_ClinPharmR.pdf#page=20 Page: 20.0 |
likely | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022064s000_ClinPharmR.pdf#page=20 Page: 20.0 |
likely | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022064s000_ClinPharmR.pdf#page=20 Page: 20.0 |
no | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022064s000_ClinPharmR.pdf#page=20 Page: 20.0 |
no | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022064s000_ClinPharmR.pdf#page=20 Page: 20.0 |
no | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022064s000_ClinPharmR.pdf#page=20 Page: 20.0 |
weak | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2007/022064s000_ClinPharmR.pdf#page=19 Page: 19.0 |
yes |
Tox targets
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
Page: 107.0 |
PubMed
| Title | Date | PubMed |
|---|---|---|
| Levocetirizine improves health-related quality of life and health status in persistent allergic rhinitis. | 2006-10 |
|
| Lichenoid eruption associated with the use of nebivolol. | 2006-09 |
|
| Stereoselective pharmacokinetics of cetirizine in the guinea pig: role of protein binding. | 2006-09 |
|
| Pathophysiology of nasal obstruction and meta-analysis of early and late effects of levocetirizine. | 2006-08 |
|
| Facial thermography is a sensitive tool to determine antihistaminic activity: comparison of levocetirizine and fexofenadine. | 2006-08 |
|
| Gateways to clinical trials. | 2006-06 |
|
| Chiral separation of cetirizine by capillary electrophoresis. | 2006-06 |
|
| Gateways to clinical trials. | 2006-05 |
|
| Effects of levocetirizine as add-on therapy to fluticasone in seasonal allergic rhinitis. | 2006-05 |
|
| Levocetirizine is an effective treatment in patients suffering from chronic idiopathic urticaria: a randomized, double-blind, placebo-controlled, parallel, multicenter study. | 2006-04 |
|
| Levocetirizine in patients with chronic idiopathic urticaria: results of a multicenter clinical practice study. | 2006-04 |
|
| Gateways to clinical trials. | 2006-03-17 |
|
| Gateways to clinical trials. | 2006-03 |
|
| Levocetirizine in the treatment of chronic idiopathic urticaria: a randomized, double-blind, placebo-controlled study. | 2006-03 |
|
| Changes in pH differently affect the binding properties of histamine H1 receptor antagonists. | 2006-01-20 |
|
| Fixed drug eruption due to levocetirizine. | 2006-01-06 |
|
| A review of the evidence from comparative studies of levocetirizine and desloratadine for the symptoms of allergic rhinitis. | 2006-01 |
|
| Effect of levocetirizine on the contraction induced by histamine on isolated rabbit bronchioles from precision-cut lung slices. | 2006 |
|
| Levocetirizine as treatment for symptoms of seasonal allergic rhinitis. | 2006 |
|
| Levocetirizine for treatment of immediate and delayed mosquito bite reactions. | 2006 |
|
| Levocetirizine: a review of its use in the management of allergic rhinitis and skin allergies. | 2006 |
|
| Familial aquagenic urticaria and bernard-soulier syndrome. | 2006 |
|
| Gateways to clinical trials. | 2005-12 |
|
| Desloratadine and levocetirizine improve nasal symptoms, airflow, and allergic inflammation in patients with perennial allergic rhinitis: a pilot study. | 2005-12 |
|
| Histamine H1 receptor occupancy and pharmacodynamics of second generation H1-antihistamines. | 2005-09 |
|
| Fixed drug eruption: a novel side-effect of levocetirizine. | 2005-09 |
|
| Efficacy and safety of levocetirizine on symptoms and health-related quality of life of children with perennial allergic rhinitis: a double-blind, placebo-controlled randomized clinical trial. | 2005-08 |
|
| A new antihistamine levocetirizine inhibits eosinophil adhesion to vascular cell adhesion molecule-1 under flow conditions. | 2005-08 |
|
| Levocetirizine: pharmacokinetics and pharmacodynamics in children age 6 to 11 years. | 2005-08 |
|
| A review of the evidence from comparative studies of levocetirizine and desloratadine for the symptoms of allergic rhinitis. | 2005-07 |
|
| A treatment for allergic rhinitis: a view on the role of levocetirizine. | 2005-07 |
|
| Levocetirizine has a longer duration of action on improving total nasal symptoms score than fexofenadine after single administration. | 2005-07 |
|
| Prediction of genotoxicity of chemical compounds by statistical learning methods. | 2005-06 |
|
| Potential of levocetirizine in the relief of nasal congestion. | 2005-06 |
|
| Costs associated with persistent allergic rhinitis are reduced by levocetirizine. | 2005-06 |
|
| Levocetirizine in children: evidenced efficacy and safety in a 6-week randomized seasonal allergic rhinitis trial. | 2005-05 |
|
| Bacillus clausii effects in children with allergic rhinitis. | 2005-05 |
|
| Levocetirizine in 1-2 year old children: pharmacokinetic and pharmacodynamic profile. | 2005-04 |
|
| Population pharmacokinetics of levocetirizine in very young children: the pediatricians' perspective. | 2005-03 |
|
| Levocetirizine improves nasal symptoms and airflow in patients with persistent allergic rhinitis: a pilot study. | 2005-01 |
|
| Retrospective population pharmacokinetics of levocetirizine in atopic children receiving cetirizine: the ETAC study. | 2005-01 |
|
| [Patient report: allergic rhinitis]. | 2005 |
|
| Quantitative determination of cetirizine enantiomers in guinea pig plasma, brain tissue and microdialysis samples using liquid chromatography/tandem mass spectrometry. | 2005 |
|
| Pharmacological management of allergic rhinitis in the elderly: safety issues with oral antihistamines. | 2005 |
|
| Chronic urticaria: clinical aspects and focus on a new antihistamine, levocetirizine. | 2004-12-31 |
|
| Gateways to clinical trials. | 2004-11 |
|
| H1 histamine receptor mediates inflammatory responses in human keratinocytes. | 2004-11 |
|
| Levocetirizine improves quality of life and reduces costs in long-term management of persistent allergic rhinitis. | 2004-10 |
|
| Modern histamine H1-receptor antagonists in the unified airway. | 2004-09 |
|
| Chronic urticaria: aetiology, management and current and future treatment options. | 2004 |
Patents
Sample Use Guides
Allergic Rhinitis: 5 mg once daily; alternatively, 2.5 mg once daily may be adequate for some patients. Chronic Idiopathic Urticaria: 5 mg once daily; alternatively, 2.5 mg once daily may be adequate for some patients.
Route of Administration:
Oral
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/11809864
Equilibrium binding experiments on CHO cells expressing H1 receptor were performed using [3H]mepyramine as a radiolabel ligand.
| Substance Class |
Chemical
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C29578
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N0000175587
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130018-77-8
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