Before prescribing levocetirizine, review allergy history, renal function, and concurrent sedatives to prevent accumulation and CNS depression.
Absolute contraindications include prior hypersensitivity to levocetirizine, cetirizine, or hydroxyzine, and end-stage renal disease (eGFR <10 mL/min/1.73 m²) because the drug is renally eliminated. Relative contraindications involve moderate renal impairment, pregnancy/breastfeeding considerations, and concomitant CNS depressants that can amplify sedation.
Known hypersensitivity to levocetirizine, cetirizine, hydroxyzine, or formulation excipients
End-stage renal disease (creatinine clearance <10 mL/min) or patients on hemodialysis
Moderate renal impairment (creatinine clearance 11–50 mL/min)—reduce dose to every other day to limit accumulation
Concomitant CNS depressants (opioids, benzodiazepines, alcohol)—monitor for additive sedation
Pregnancy and lactation—limited human data; use only when benefits outweigh risks
Elderly patients with polypharmacy—adjust based on renal function and sedation risk