Levocetirizine (Levocet, Xyzal) - Uses, Dose, Side effects, MOA, Brands

Levocetirizine (Levocet, Xyzal) is the active compound of cetirizine which is a second-generation antihistamine. It is used to relieve symptoms of allergies manifesting as urticaria or allergic rhinitis.

Levocetirizine Uses:

  • Chronic idiopathic urticaria:

    • It is used to treat adults and children patients 6 months and older who have simple cutaneous symptoms of chronic idiopathic urticaria.
  • Perennial allergic rhinitis:

    • It is also used to treat adults and children between the ages of 6 months and 2 years who are suffering from the symptoms of perennial allergic rhinitis.
  • Allergic rhinitis (OTC only):

    • It is also intended to relieve hay fever and other respiratory allergy symptoms in adults and children 2 years of age and older, such as rhinitis, sneezing, itchy/watery eyes, and itching of the throat and nose.

Levocetirizine (Levocet) Dose in Adults:

Levocetirizine (Levocet) Dose in the treatment of chronic idiopathic urticaria:

  • 5 mg are administered orally once daily in the evening. 2.5 mg used once daily may help some individuals feel better.
  • Adults receiving greater doses, up to 10 mg twice daily, showed clinical improvement in one clinical investigation.

Levocetirizine (Levocet) Dose in the treatment of Allergic rhinitis (OTC only):

  • 5 mg are administered orally once daily in the evening. With 2.5 mg once daily, some people with less severe symptoms may feel better.
  • The daily dose cap is set at 5 mg.

Levocetirizine (Levocet) Dose in Children:

Levocetirizine (Levocet) Dose in the treatment of perennial allergic rhinitis: Oral:

  • Infants ≥6 months and Children ≤5 years:

    • 2.5 mg are used once day in the evening.
    • The daily dosage cap is 1.25 mg.
    • It should be emphasised that in children older than 2 years, dose is determined by company labelling that has already received FDA approval (Xyzal prescription information January
  • Children ≥6 years and Adolescents: Note: Dosing according to manufacturer labelling previously approved by the FDA (Xyzal prescription information January 2016):

    • 6 to 11 years:
      • Once daily in the evening, take 5 mg. The daily dose cap is set at 2.5 mg.
    • ≥12 years:
      • Once daily in the evening, take 5 mg. 2.5 mg used once daily may help some individuals feel better.

Levocetirizine (Levocet) Dose in the treatment of Hay fever and other respiratory allergies

  • Children 2 to 5 years:

    • 2.5 mg taken in the evening once a day.
    • The daily dosing cap is 1.25 mg/day.
  • Children 6 to 11 years:

    • Once daily in the evening, take 5 mg.
    • The daily dose cap is set at 2.5 mg.
  • Children ≥12 years and Adolescents:

    • Once daily in the evening, take 5 to 5 mg.
    • The dose depends on how severe the symptoms are. The daily dose cap is set at 5 mg.

Levocetirizine (Levocet) Dose in the treatment of chronic urticaria: Oral:

  • Infants ≥6 months and Children ≤5 years:

    • Once daily in the evening, take 25 mg.
    • The daily dosing cap is 1.25 mg/day.
  • Children 6 to 11 years:

    • Once daily in the evening, take 5 mg.
    • The daily dose cap is set at 2.5 mg.
  • Children ≥12 years and Adolescents:

    • Once daily in the evening, take 5 mg.
    • 2.5 mg used once daily may help some individuals feel better.

Levocetirizine Pregnancy Category: B

  • Guidelines recommend that antihistamines be administered in the same manner as non-pregnant women.
  • Second-generation antihistamines should be given during pregnancy to address allergic responses and urticaria.
  • There is no information available on the usage of levocetirizine during pregnancy. There may be more effective drugs.
  • Cetirizine's active enantiomer is Levocetirizine.

Levocetirizine use during breastfeeding:

  • It is unknown if it is secreted in breastmilk.
  • The clinical benefits of breastfeeding must outweigh the risks for infant health before it can be continued.
  • Breast milk contains levocetirizine, which is an active enantiomer for cetirizine.

Levocetirizine (Levocet) Dose in Kidney Disease:

  • Chronic idiopathic urticaria and perennial allergic rhinitis:

    • CrCl 50 to 80 mL/minute:
      • 5 mg once a day
    • CrCl 30 to 50 mL/minute:
      • 5 mg once every other day
    • CrCl 10 to 30 mL/minute:
      • 5 mg twice a week i.e every 3 or 4 days.
    • CrCl <10 mL/minute, hemodialysis patients:
      • Its use  is contraindicated.
    • Hemodialysis: Nondialyzable
  • Allergic rhinitis (OTC):

    • Use is not recommended.

Dose in Liver disease:

No dosage adjustment is necessary.


Common Side Effects of Levocetirizine:

  • Gastrointestinal:

    • Diarrhea

Less Common Side Effects of Levocetirizine:

  • Central nervous system:

    • Drowsiness
    • Fatigue
  • Gastrointestinal:

    • Constipation
    • Vomiting
    • Xerostomia
  • Otic:

    • Otitis media
  • Respiratory:

    • Nasopharyngitis
    • Cough
    • Epistaxis
    • Pharyngitis
  • Miscellaneous:

    • Fever
  • Neuromuscular & skeletal:

    • Weakness

Contraindications to Levocetirizine:

  • Any known hypersensitivity to cetirizine, levocetirizine, or any other ingredient in the formulation is a strict no-no.
  • End-stage renal disease (CrCl >10 mL/minute).
  • Hemodialysis.
  • children and infants with renal impairment aged 6 months to 11 years

Warnings and precautions

  • CNS depression:

    • CNS depression can result, which could affect mental or physical abilities. 
    • It is important to warn patients about tasks that require mental alertness, such as driving or operating machinery.
  • Pruritus

    • Rebound pruritus may occur after cetirizine has been stopped. This is usually the case after prolonged (eg months or years) use.
  • Renal impairment

    • The kidneys are the main route of excretion for levocetirizine. Adults with mild to severe kidney impairment should not use this medication. You will need to adjust the dosage.
    • Patients with end-stage kidney disease (CrCl >10 mL/min), those on hemodialysis, babies, and kids 6 months to 11 years old with renal impairment are not advised to use it.
  • Urinary retention

    • It is possible to have urinary retention. Patients at higher risk for urinary retention, such as those with spinal cord lesions and prostatic hyperplasia, should be cautious. 
    • If urinary retention is observed, do not hesitate to call your doctor.

Levocetirizine: Drug Interaction

Risk Factor C (Monitor therapy)

Acetylcholinesterase Inhibitors

May diminish the therapeutic effect of Anticholinergic Agents. Anticholinergic Agents may diminish the therapeutic effect of Acetylcholinesterase Inhibitors.

Alcohol (Ethyl)

Alcohol's CNS depressing effect may be amplified by CNS depressants (Ethyl).

Alizapride

CNS depressants may have an enhanced CNS depressant impact.

Amantadine

May strengthen an anticholinergic agent's anticholinergic action.

Amezinium

Antihistamines may intensify Amezinium's stimulant effects.

Amphetamines

May lessen antihistamines' sedative effects.

Anticholinergic Agents

Other anticholinergic agents' negative or hazardous effects might be amplified.

Betahistine

Antihistamines may diminish the therapeutic effect of Betahistine.

Botulinum Toxin-Containing Products

May enhance the anticholinergic effect of Anticholinergic Agents.

Brexanolone

CNS Depressants may enhance the CNS depressant effect of Brexanolone.

Brimonidine (Topical)

May enhance the CNS depressant effect of CNS Depressants.

Bromopride

May enhance the CNS depressant effect of CNS Depressants.

Cannabidiol

May enhance the CNS depressant effect of CNS Depressants.

Cannabis

May enhance the CNS depressant effect of CNS Depressants.

Chloral Betaine

May enhance the adverse/toxic effect of Anticholinergic Agents.

Chlorphenesin Carbamate

May enhance the adverse/toxic effect of CNS Depressants.

CNS Depressants

Other CNS depressants' harmful or toxic effects might be exacerbated.

Dimethindene (Topical)

CNS depressants may have an enhanced CNS depressant impact.

Doxylamine

CNS depressants may have an enhanced CNS depressant impact. Management: The producer of the pregnancy-safe drug Diclegis (doxylamine/pyridoxine) particularly advises against combining it with other CNS depressants.

Dronabinol

CNS depressants may have an enhanced CNS depressant impact.

Esketamine

CNS depressants may have an enhanced CNS depressant impact.

Gastrointestinal Agents (Prokinetic)

Anticholinergic Agents may diminish the therapeutic effect of Gastrointestinal Agents (Prokinetic).

Glucagon

Anticholinergic Agents may enhance the adverse/toxic effect of Glucagon. Specifically, the risk of gastrointestinal adverse effects may be increased.

HydrOXYzine

May enhance the CNS depressant effect of CNS Depressants.

Itopride

Anticholinergic Agents may diminish the therapeutic effect of Itopride.

Kava Kava

CNS depressants' harmful or toxic effects could be increased.

Lofexidine

CNS depressants may have an enhanced CNS depressant impact. Management: Separate drug interaction monographs go into further detail about the medications indicated as exceptions to this book.

Magnesium Sulfate

CNS depressants' harmful or toxic effects could be increased.

MetyroSINE

The sedative effects of metyroSINE may be strengthened by CNS depressants.

Mianserin

May strengthen an anticholinergic agent's anticholinergic action.

Minocycline (Systemic)

CNS depressants' harmful or toxic effects could be increased.

Mirabegron

Anticholinergic drugs may make Mirabegron's harmful or hazardous effects worse.

Nabilone

CNS depressants' harmful or toxic effects could be increased.

Nitroglycerin

Nitroglycerin absorption may be decreased by anticholinergic agents. Anticholinergic medications specifically have the potential to impede or prevent the absorption of nitroglycerin by reducing the breakdown of sublingual nitroglycerin pills.

Piribedil

CNS Depressants may enhance the CNS depressant effect of Piribedil.

Pramipexole

CNS Depressants may enhance the sedative effect of Pramipexole.

Ramosetron

Anticholinergic Agents may enhance the constipating effect of Ramosetron.

ROPINIRole

The sedative effects of CNS depressants may increase those of ROPINIRole.

Rotigotine

Rotigotine's sedative effects may be boosted by CNS depressants.

Rufinamide

CNS depressants' harmful or toxic effects could be increased. Particularly, drowsiness and lightheadedness could be worsened.

Selective Serotonin Reuptake Inhibitors

Selective serotonin reuptake inhibitors may have a worsened or more hazardous effect when taken with CNS depressants. Particularly, there may be an increased risk of psychomotor impairment.

Tetrahydrocannabinol

May enhance the CNS depressant effect of CNS Depressants.

Tetrahydrocannabinol and Cannabidiol

May enhance the CNS depressant effect of CNS Depressants.

Thiazide and Thiazide-Like Diuretics

Anticholinergic Agents may increase the serum concentration of Thiazide and Thiazide-Like Diuretics.

Topiramate

Anticholinergic Agents may enhance the adverse/toxic effect of Topiramate.

Trimeprazine

May enhance the CNS depressant effect of CNS Depressants.

Risk Factor D (Consider therapy modification)

Benzylpenicilloyl Polylysine

Antihistamines may diminish the diagnostic effect of Benzylpenicilloyl Polylysine. Management: Suspend systemic H1 antagonists for benzylpenicilloyl-polylysine skin testing and delay testing until systemic antihistaminic effects have dissipated. A histamine skin test may be used to assess persistent antihistaminic effects.

Blonanserin

CNS Depressants may enhance the CNS depressant effect of Blonanserin.

Buprenorphine

The CNS depressing impact of buprenorphine may be enhanced by CNS depressants. Treatment: If a patient has a high risk of abusing or injecting themselves with buprenorphine, consider reducing the doses of other CNS depressants and avoiding such medications. Buprenorphine should be started at lower doses in individuals who are currently taking CNS depressants.

Chlormethiazole

May enhance the CNS depressant effect of CNS Depressants. Management: Monitor closely for evidence of excessive CNS depression. The chlormethiazole labeling states that an appropriately reduced dose should be used if such a combination must be used.

Droperidol

May enhance the CNS depressant effect of CNS Depressants. Management: Consider dose reductions of droperidol or of other CNS agents (eg, opioids, barbiturates) with concomitant use. Exceptions to this monograph are discussed in further detail in separate drug interaction monographs.

Flunitrazepam

CNS Depressants may enhance the CNS depressant effect of Flunitrazepam.

Hyaluronidase

Antihistamines may diminish the therapeutic effect of Hyaluronidase. Management: Patients receiving antihistamines (particularly at larger doses) may not experience the desired clinical response to standard doses of hyaluronidase. Larger doses of hyaluronidase may be required.

HYDROcodone

CNS Depressants may enhance the CNS depressant effect of HYDROcodone. Management: Avoid concomitant use of hydrocodone and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug.

Lemborexant

CNS depressants may have an enhanced CNS depressant impact. Management: Due to the possibility of additive CNS depressant effects when lemborexant and concurrent CNS depressants are administered concurrently, dosage modifications may be required. Effects of CNS depressants must be closely monitored.

Methotrimeprazine

The CNS depressing action of methotrimeprazine may be enhanced by CNS depressants. The CNS depressant action of CNS Depressants may be strengthened by methotrimeprazine. Management: Start concurrent methotrimeprazine therapy while reducing the adult dose of CNS depressants by 50%. Only once a clinically effective dose of methotrimeprazine has been established should additional CNS depressant dosage modifications be made.

Opioid Agonists

CNS Depressants may enhance the CNS depressant effect of Opioid Agonists. Management: Avoid concomitant use of opioid agonists and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug.

OxyCODONE

CNS Depressants may enhance the CNS depressant effect of OxyCODONE. Management: Avoid concomitant use of oxycodone and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug.

Perampanel

May enhance the CNS depressant effect of CNS Depressants. Management: Patients taking perampanel with any other drug that has CNS depressant activities should avoid complex and high-risk activities, particularly those such as driving that require alertness and coordination, until they have experience using the combination.

Pramlintide

May enhance the anticholinergic effect of Anticholinergic Agents. These effects are specific to the GI tract.

Secretin

Anticholinergic Agents may diminish the therapeutic effect of Secretin. Management: Avoid concomitant use of anticholinergic agents and secretin. Discontinue anticholinergic agents at least 5 half-lives prior to administration of secretin.

Sodium Oxybate

May enhance the CNS depressant effect of CNS Depressants. Management: Consider alternatives to combined use. When combined use is needed, consider minimizing doses of one or more drugs. Use of sodium oxybate with alcohol or sedative hypnotics is contraindicated.

Suvorexant

CNS Depressants may enhance the CNS depressant effect of Suvorexant. Management: Dose reduction of suvorexant and/or any other CNS depressant may be necessary. Use of suvorexant with alcohol is not recommended, and the use of suvorexant with any other drug to treat insomnia is not recommended.

Tapentadol

May enhance the CNS depressant effect of CNS Depressants. Management: Avoid concomitant use of tapentadol and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug.

Zolpidem

CNS Depressants may enhance the CNS depressant effect of Zolpidem. Management: Reduce the Intermezzo brand sublingual zolpidem adult dose to 1.75 mg for men who are also receiving other CNS depressants. No such dose change is recommended for women. Avoid use with other CNS depressants at bedtime; avoid use with alcohol.

Risk Factor X (Avoid combination)

Aclidinium

May enhance the anticholinergic effect of Anticholinergic Agents.

Azelastine (Nasal)

CNS Depressants may enhance the CNS depressant effect of Azelastine (Nasal).

Bromperidol

May enhance the CNS depressant effect of CNS Depressants.

Cimetropium

Anticholinergic Agents may enhance the anticholinergic effect of Cimetropium.

Eluxadoline

Anticholinergic Agents may enhance the constipating effect of Eluxadoline.

Glycopyrrolate (Oral Inhalation)

Anticholinergic Agents may enhance the anticholinergic effect of Glycopyrrolate (Oral Inhalation).

Glycopyrronium (Topical)

May enhance the anticholinergic effect of Anticholinergic Agents.

Ipratropium (Oral Inhalation)

May enhance the anticholinergic effect of Anticholinergic Agents.

Levosulpiride

Anticholinergic Agents may diminish the therapeutic effect of Levosulpiride.

Orphenadrine

CNS Depressants may enhance the CNS depressant effect of Orphenadrine.

Oxatomide

May strengthen an anticholinergic agent's anticholinergic action.

Oxomemazine

CNS depressants may have an enhanced CNS depressant impact.

Paraldehyde

The CNS depressing effects of paraldehyde may be enhanced by CNS depressants.

Pitolisant

Antihistamines may diminish the therapeutic effect of Pitolisant.

Potassium Chloride

Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Chloride. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium chloride.

Potassium Citrate

Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Citrate.

Revefenacin

Anticholinergic Agents may enhance the anticholinergic effect of Revefenacin.

Thalidomide

CNS Depressants may enhance the CNS depressant effect of Thalidomide.

Tiotropium

Anticholinergic Agents may enhance the anticholinergic effect of Tiotropium.

Umeclidinium

May enhance the anticholinergic effect of Anticholinergic Agents.

 

Monitoring parameters:

Creatinine clearance should be calculated before treatment for dosing adjustment.


How to administer Levocetirizine?

It should be given either with or without food in the evening. When measuring the oral solution, use a precise measuring tool. A regular teaspoon is not a precise measurement tool.


Mechanism of action of Levocetirizine (Levocet):

  • An antihistamine called levocetirizine competes with histamine for H-1 receptor sites on effector cells in the digestive system, blood vessels, and respiratory tract.
  • Levocetirizine, the active enantiomer of cetirizine, binds to the H-receptor with a twofold higher affinity than cetirizine.

The onset of action:

  • 1 hour.

Duration:

  • 24 hours.

Absorption:

  • Rapid and extensive

Protein binding:

  • 91% to 92%

Metabolism:

  • Minimal (<14%) via aromatic oxidation, N and O-dealkylation (via CYPA4), and taurine conjugation

Half-life elimination:

  • Children 1 to 2 years: Oral solution: 4.09 ± 0.67 hours;
  • Children 6 to 11 years: Oral tablet: 5.7 ± 0.2 hours;
  • Adults: ~8 to 9 hours

Time to peak, plasma:

  • Children 1 to 2 years: Oral solution: Median: 1 hour (range: 1 to 6 hours);
  • Children 6 to 11 years: Oral tablet: 1.2 ± 0.2 hours;
  • Adults: Oral solution: 0.5 hours, Tablet: 0.9 hours

Excretion:

  • Urine (85.4 %);
  • feces (12.9%)

International Brand Names of Levocetirizine:

  • Xyzal Allergy 24HR Children
  • Xyzal Allergy 24HR
  • Xyzal
  • Alergocit
  • Alermax
  • Aleron
  • Alerzin
  • Allear
  • Allergostop
  • Allerzal
  • Allerzet
  • Allezal F.C.
  • Antiss
  • Aralevo
  • Avocel
  • Calivida
  • Cetimer
  • Cetizal
  • Cetriler
  • Cetrilev
  • Cevozin
  • Cipen
  • Coalbi
  • Curin
  • Degraler
  • Degraler Forte
  • Ellezin
  • Enacet
  • Getcet
  • Glencet
  • Histaplen
  • L-Cet
  • L-Falergi
  • L-Zet
  • Lerex
  • Lertazin
  • Letrizine
  • Levocen
  • Levocet
  • Levocezal
  • Levomine
  • Levorid
  • Levozine
  • Levrix
  • Levtrizin
  • Lezat
  • Lezinsan 5
  • Libbera
  • Lisinex
  • Locemine
  • NeoAlertop
  • Newzal
  • Rinozal
  • Seasonix
  • Sensitin
  • Singkast
  • Tecovel
  • Vocet
  • Xaltec
  • Xazal
  • Xozal
  • Xusal
  • Xuzal
  • Xyzal
  • Xyzall
  • Xyzine
  • Zalkevor
  • Zenaro
  • Zobral
  • Zyller
  • Zyxem

Levocetirizine Brand Names in Pakistan:

Levocetirizine Syrup 2.5 /5ml in Pakistan

Ocitra Searle Pakistan (Pvt.) Ltd.

 

Levocetirizine Syrup 5 Mg/5ml in Pakistan

Letirix Alliance Pharmaceuticals (Pvt) Ltd.

 

Levocetirizine Syrup 2.5 Mg/5ml in Pakistan

Histasun Hisun Pharmaceuticals
Letrix Alliance Pharmaceuticals (Pvt) Ltd.
Levo Melt S.J. & G. Fazul Ellahie (Pvt) Ltd.
Levomelt Kair Pharma (Subsidiart Of S.J & G)
Levozaf Zafa Pharmaceutical Laboratories (Pvt) Ltd.
Lixer Barrett Hodgson Pakistan (Pvt) Ltd.
Neo-Sedil Sami Pharmaceuticals (Pvt) Ltd.
Pip Unison Chemical Works
Primlivo Standard Drug Co.
Setzine Macter International (Pvt) Ltd.
T-Day Novartis Pharma (Pak) Ltd
Welcet Kaizen Pharmaceuticals Pvt Ltd.

 

Levocetirizine Tablets 5 Mg in Pakistan

Alergocit Global Pharmaceuticals
Allerno Well & Well Pharma (Pvt) Ltd
Alvoxine Amarant Pharmaceuticals (Pvt)
Alvozine Amarant Pharmaceuticals (Pvt)
Atiza Asian Agencies
Belair Bayer Health Care
Ben-Sun Benson Pharamceuticals.
Bianchi Noa Hemis Pharmaceuticals
Cerigex-L Fedro Pharmaceutical
Cetlergy Evergreen Pharmaceuticals Pvt Limited
Cetrawin Winilton Pharmaceuticals (Pvt) Ltd
Cezomax Max Pharmaceuticals
Citi-Vo Qintar Pharmacuticals
Citrafast The Schazoo Laboratories Ltd.
Citrfast Schazoo Zaka
Eeze Biogen Pharma
Elfine Epharm Laboratories
Erract Libra Pharmaceuticals (Pvt) Ltd
Etrizine-L Derma Techno Pakistan
Evotrazin Shawan Pharmaceuticals
Frisk Webros Pharmaceuticals
Helvin Zephyr Pharmatec (Pvt) Ltd.
Hetrax Healers Laboratories
Histaset Wilshire Laboratories (Pvt) Ltd.
Hizin Spl Pharmaceuticals (Pvt) Ltd
Ievocen Pulse Pharmaceuticals
Ilr-G Genix Pharma (Pvt) Ltd
Invocet Aries Pharmaceuticals (Pvt) Ltd
Irnazin Indus Pharma (Pvt) Ltd.
Ivocen Wisdom Therapeutics
L-Cetra Crown Pharmaceuticals
L-Zine Fassgen Pharmaceuticals
Le-Vin Rasco Pharma
Lecet Genome Pharmaceuticals (Pvt) Ltd
Lecetzi Jawa Pharmaceuticals(Pvt) Ltd.
Leozin Hilton Pharma (Pvt) Limited
Leridal Axis Pharmaceuticals
Lerozine Wise Pharmaceuticals (Pvt) Ltd
Les Unimark Pharmaceuticals
Letirix Alliance Pharmaceuticals (Pvt) Ltd.
Letrazim Sapient Pharma
Levastine Biogen Pharma
Leve-Cit Fynk Pharmaceuticals
Levera Vertex Pharma
Levil Wns Field Pharmaceuticals
Levocet Trison Research Laboratories (Pvt) Ltd
Levocetrin Biorex Pharmaceuticals
Levocit Brookes Pharmaceutical Laboratories (Pak.) Ltd.
Levocit Linear Pharma
Levocitrin Everest Pharmaceuticals
Levocitrin Everest Pharmaceuticals
Levogix Cherwel Pharmaceuticals (Pvt) Ltd
Levoline Pearl Pharmaceuticals
Levomelt Kair Pharma (Subsidiart Of S.J & G)
Levoriz Pharmatec Pakistan (Pvt) Ltd.
Levortizin Obsons Pharmaceuticals
Levosit Lotus Pharmaceuticals (Pvt) Ltd
Levozex Alson Pharmaceuticals
Levozine Global Pharmaceuticals
Levtrin Wellborne Pharmachem And Biologicals
Licet Standpharm Pakistan (Pvt) Ltd.
Licid Wisdom Therapeutics
Lixer Barrett Hodgson Pakistan (Pvt) Ltd.
Makzine Makson Pharmaceuticals
Markcit Welmark Pharmaceuticals
Marvel Shrooq Pharmaceuticals
Neo-Sedil Sami Pharmaceuticals (Pvt) Ltd.
Neocetrin Paramount Pharmaceuticals
Ocitra Searle Pakistan (Pvt.) Ltd.
Otrazn Elko Organization (Pvt) Ltd.
Renfoz Fozan Pharmaceuticals Industriers (Pvt) Ltd
Rescit Miracle Pharmaceuticals(Pvt) Ltd
Revozin Syntex Pharmaceuticals
Rimp Gray`S Pharmaceuticals
Seasonex Goodman International,
Setzine Macter International (Pvt) Ltd.
Shavozin Shaheen Agencies
Shic-5 Tagma Pharma (Pvt) Ltd.
Sitara Olive Pharmaceuticals
Sliz Ambrosia Pharmaceuticals
T-Day Novartis Pharma (Pak) Ltd
T-Day Novartis Pharma (Pak) Ltd
Tandegyl-Day Novartis Pharma (Pak) Ltd
Tandegyl-Day Novartis Pharma (Pak) Ltd
Velkeno Semos Pharmaceuticals (Pvt) Ltd.
Vocet Crown Pharmaceuticals
Voizin Martin Dow Pharmaceuticals (Pak) Ltd.
Welcet Kaizen Pharmaceuticals Pvt Ltd.
Xylizine Nexpharm
Xyzal Ucb Pharma
Zamocetrin Zam Zam Corporation
Zecit-L Polyfine Chempharma (Pvt) Ltd.
Zenest-L Meditech Pharmaceuticals
Zeocit Polyfine Chempharma (Pvt) Ltd.
Zevizine Medisure Laboratories Pakistan (Pvt.) Ltd.
Zosper Mega Pharmaceuticals (Pvt) Ltd

 

Levocetirizine Tablets 10 Mg in Pakistan

Jardin High - Q International
Nolar Jaens Pharma
Ottocit Ottoman Pharma
Renocit Envoy Pharma

 

Levocetirizine Tablets 5 Mg/5ml in Pakistan

Histasun Hisun Pharmaceuticals