How does it work?

Xyzal tablets and solution both contain the active ingredientlevocetirizine dihydrochloride, which is a type of medicine called anon-sedating antihistamine. (NB. Levocetirizine is also available without a brand name, ie as the generic medicine.) Levocetirizine works by preventing the actions ofhistamine.

Histamineis a substance produced by the body as part of its defence mechanisms. It isstored in cells called mast cells, in almost all tissues of the body. When thebody reacts to a foreign substance (known as an allergen, eg flower pollen),the mast cells stimulated by the allergen release their stores of histamine.

Thereleased histamine then binds to its receptors (H-1 receptors), causing a chainreaction that results in allergic symptoms. It causes an increase in blood flowto the area of the allergy, and the release of other chemicals that add to theallergic response.

All thisresults in the symptoms of an allergic reaction. In hayfever, histamine causesinflammation of the nose, eyes, skin or airways and results in itchy wateryeyes, a runny nose, sneezing and nasalcongestion.

Levocetirizineworks by blocking histamine receptors. It does not prevent the actual releaseof histamine from mast cells, but prevents it binding to its receptors. This inturn prevents the release of other allergy chemicals and increased blood supplyto the area, and provides relief from the typical symptoms ofhayfever.

Levocetirizinecan also be used to relieve the symptoms of a condition called chronicidiopathic urticaria. This is a chronic itchy rash, similar to nettle rash, butwith no apparant cause. Blocking the actions of histamine relieves the itchingand reduces the rash associated with thiscondition.

Levocetirizineis called a non-sedating antihistamine as it does not enter the brain insignificant amounts, and is therefore unlikely to cause drowsiness. However,some people may experience some slight sleepiness orfatigue.

What is it used for?

• Hayfever (seasonal allergic rhinitis).
• Hayfever that occurs throughout the year due to allergies, eg pets, dust mites (perennial allergic rhinitis).
• Ongoing itchy rash with no known cause (chronic idiopathic urticaria).

Warning!

• Although levocetirizine is a non-sedating antihistamine, some people may experience some sleepiness, which may affect your ability to drive or operate machinary. You should make sure you know how this medicine affects you before you perform potentially hazardous activites.
• It is recommended that you avoid drinking excessive amounts of alcohol while taking this medicine.
• If you are due to have any skin prick tests to diagnose allergies you should stop taking your antihistamines at least 48 hours before the tests. This is because antihistamines can prevent or lessen the skin reactions that indicate an allergy, and so can make the test results unreliable.

Use with caution in

• Decreased kidney function.

Not to be used in

• Severely decreased kidney function.
• Allergy to medicines that contain piperazine derivatives (your doctor will know more about this - tell them if you are allergic to any medicines).
• Xyzal tablets should not be used in children under six years old.
• Xyzal solution should not be used in children under two years old.
• Xyzal tablets contain lactose and may not be suitable for people with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption.
• Xyzal solution contains maltitol and may not be suitable for people with rare hereditary problems of fructose intolerance.

This medicine should not be used if you are allergic to one orany of its ingredients. Please inform your doctor or pharmacist if you havepreviously experienced such anallergy.If you feel you haveexperienced an allergic reaction, stop using this medicine and inform yourdoctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy orbreastfeeding. However, other medicines may be safely used in pregnancy orbreastfeeding providing the benefits to the mother outweigh the risks to theunborn baby. Always inform your doctor if you are pregnant or planning apregnancy, before using any medicine.

• The safety of this medicine for use during pregnancy has not been established. It should therefore be used with caution during pregnancy, and only if the benefits to the mother outweigh any potential risks to the developing baby. Seek further medical advice from your doctor.
• This medicine may pass into breast milk. It should be used with caution by breastfeeding mothers and only if the expected benefit to the mother is greater than any possible risk to the nursing infant. Seek further medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individualpeople in different ways. The following are some of the side effects that areknown to be associated with this medicine. Just because a side effect is statedhere does not mean that all people using this medicine will experience thator any side effect.

Common (affect between 1 in 10 and 1 in 100 people)

• Headache.
• Dry mouth.
• Fatigue.
• Sleepiness.

Uncommon (affect between 1 in 100 and 1 in 1000 people)

• Weakness or loss of strength (asthenia).
• Abdominal pain.

Very rare

• Shortness of breath.
• Nausea.
• Weight gain.
• Agitation or aggression.
• Visual disturbances.
• Palpitations.
• Liver problems.
• Allergic reactions.

The side effects listed above may not include all of the sideeffects reported by the medicine'smanufacturer.For moreinformation about any other possible risks associated with this medicine,please read the information provided with the medicine or consult your doctoror pharmacist.

How can this medicine affect other medicines?

There have been no studies on the effects of taking thismedicine with any others, but the related antihistamine cetirizine does notinteract significantly with other medicines. Since levocetirizine is arelatively new medicine, make sure you always tell your doctor or pharmacistthat you are taking it if you buy or are prescribed any other medicines, sothat they can check that thecombination is safe. This includes over-the-countermedicines and herbal medicines.

In the unlikely event that this medicine makes you feel sleepy, this may be enhanced if you also take any other medicines that can cause drowsiness, for example sleeping tablets, tricyclic antidepressants such as amitriptyline, or strong opioid painkillers such as morphine.

Other medicines containing the same active ingredient

Levocetirizine tablets are also available without a brand name, ie as the generic medicine.