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Last updated January 15, 2020. 5 minute read

Xyzal: what it is and how it works

Histamines are responsible for some of the signature symptoms of an allergic reaction, like a runny nose, hives, sneezing, and more. Antihistamines—like Xyzal—work by blocking the effects of these histamines. Antihistamine medications can be both prescription-strength or available over-the-counter (OTC).

Self Written by Michael Martin
Reviewed by Dr. Mike Bohl, MD, MPH

If you’ve ever suffered from allergy symptoms, chances are, you’ve probably tried your fair share of allergy medications. Whether you’ve reached for pills, liquids, nasal sprays, or shots, you might have experienced the significant effects different types of medications can have on allergy symptoms. But with all the different types of allergy medications out there—antihistamines, corticosteroids, immunotherapy, and more—you might be wondering what kinds of potential advantages and disadvantages one particular type of medication has compared to any other. And if you’ve ever been curious about a type of allergy medication known as Xyzal, you might be wondering if it’s right for you.


  • Xyzal is the brand name for a medication called levocetirizine, a type of antihistamine that may help treat allergy symptoms.
  • Xyzal is used for the treatment of symptoms related to allergic rhinitis (aka hay fever). These include runny nose, sneezing, rash, and itchy eyes.
  • Xyzal is available over the counter but carries the risk of some side effects like headache, cough, drowsiness, and more.

What is Xyzal?

Xyzal is the brand name for a drug called levocetirizine, which is an antihistamine. When your body is sensitive to a specific substance (called an allergen), your immune system releases chemicals called histamines (NIH, 2016). Histamines are responsible for some of the signature symptoms of an allergic reaction, like a runny nose, hives, sneezing, and more. Antihistamines work by blocking the effects of these histamines (NIH, 2018). Antihistamine medications can be both prescription-strength or available over-the-counter (OTC). They come in different forms like pills, chewable tablets, liquids, and capsules. 

The Food and Drug Administration (FDA) has approved Xyzal as a type of OTC antihistamine that’s designed to provide allergy sufferers 24-hour relief from symptoms that are associated with seasonal allergies (also called allergic rhinitis, perennial allergic rhinitis, or hay fever) (NIH, 2020). These symptoms include: 

  • Runny nose
  • Sneezing
  • Red eyes
  • Itchy eyes
  • Hives
  • Skin itching
  • Rash

Different types of allergies can trigger these symptoms in different people. Some of the most common triggers of these allergic symptoms are pollen, dust mites, pet dander, and mold, but people can experience seasonal allergies or year-round allergies to many different substances.

One common use of Xyzal is to treat a condition called “chronic idiopathic urticaria,” which is a type of chronic hives that involves itchy, red bumps on the skin that can come and go for years at a time. Research has shown that a daily dose of Xyzal can help quickly treat the symptoms of chronic idiopathic urticaria, but patients have to stay on the medication to continue seeing results (Nettis, 2006). 

The active ingredient in Xyzal is the antihistamine levocetirizine dihydrochloride. Xyzal’s inactive ingredients include colloidal anhydrous silica, hypromellose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, polyethylene glycol 400, and titanium dioxide. The medication is manufactured by the company, Sanofi.


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How does Xyzal work?

Just like other antihistamines like cetirizine (brand name Zyrtec), diphenhydramine (brand name Benadryl), and loratadine (brand name Claritin), Xyzal helps treat allergy symptoms by blocking the effects of histamines in the body. If a person is allergic to a particular substance, the mast cells in their immune system produce chemicals called histamines (American Academy of Allergy, Asthma & Immunology, 2020). Histamines play a major role in allergic reactions. They affect the body’s glands, vessels, and sensory nerves, and they promote inflammation (Xie, 2005). All of this can result in the symptoms of an allergic reaction. 

Antihistamines work by preventing histamines from binding to the receptors on certain cells. Some types of antihistamines, like Benadryl, are considered sedating, which means they can cause you to feel extremely tired or drowsy (Wong, 2015). Drugs like Xyzal, which are part of a newer form of antihistamines called second-generation antihistamines, are less likely to cause sedation, but they can still cause tiredness, so it’s best to always follow dosage instructions and to talk to your doctor before taking Xyzal or any other medication (Becker, 2018). 

Some sources actually classify Xyzal as a “third-generation antihistamine” (National Center for Biotechnology Information, n.d.). Some experts believe that third-generation antihistamines are preferable to use over older medications to treat allergy symptoms because they are non-sedating. Xyzal is chemically a mirror image of Zyrtec (known as an enantiomer), and some health experts prefer it as a treatment because it is less likely to cause drowsiness (Walsh, 2009). 

Xyzal comes in the form of 5 mg breakable tablets as well as a 2.5 mg/5 mL oral solution. You don’t need a doctor’s prescription to get Xyzal since it’s an OTC medication. You can take Xyzal with or without food. Because Xyzal may cause you to feel tired, it’s best to take it in the evening. You should also avoid driving a motor vehicle or operating machinery until you know how the medication affects you.

What are the potential side effects and risks of Xyzal?

Like all prescription and OTC medications, Xyzal may cause side effects in some people. Some of the most common side effects of Xyzal include (, 2019):

  • Headache
  • Muscle aches
  • Sleepiness
  • Sore throat
  • Cough
  • Stuffy nose or runny nose

Some of the less common side effects of Xyzal include:

  • Diarrhea
  • Tender, swollen glands in the neck
  • Bloody nose
  • Fever

Xyzal carries the risk of other side effects too. These include anxiety, trouble sleeping, and vision problems. If you experience any concerning side effects or are concerned about your risk of side effects, be sure to talk to your doctor before taking Xyzal. Serious side effects of Xyzal include hives, rash, itching, and/or swelling of the arms, feet, ankles, or lower legs (NIH, 2016).

Talk to your doctor before taking Xyzal if you’re pregnant or plan to become pregnant. Don’t take Xyzal if you’re breastfeeding, and be sure to talk to your doctor if you have or have ever had kidney disease, liver disease, or are on dialysis. Also, talk to your doctor about the safe use of alcohol while taking Xyzal since drinking alcohol can increase the amount of drowsiness you experience.