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Zyrtec Allergy
cetirizine
Uses .
- [ cetirizine ]
- antihistamine for relieving allergic rhinitis, sneezing, itchy/watery eyes, itchy nose/throat; treating chronic idiopathic urticaria
Dosing .
allergy sx
- [ 6-64 yo ]
- Dose: 5-10 mg PO qd prn; Max: 10 mg/24h; Info: consider alternatives for 5 mg dose
- [ 65 yo and older (off-label) ]
- Dose: 5 mg PO qd prn; Max: 5 mg/24h; Info: consider alternatives for 5 mg dose
chronic idiopathic urticaria (off-label)
- [ 6 yo and older ]
- Dose: 5-10 mg PO qd; Info: consider alternatives for 5 mg dose; some pts may benefit from higher doses, weigh risk/benefit
renal dosing
- [ allergy sx, 6-11 yo ]
- CrCl 11-50: 2.5-5 mg qd prn; CrCl <11: avoid use; Info: consider alternatives for 2.5-5 mg dose
- HD/PD: not defined
- [ allergy sx, 12-17 yo ]
- CrCl 11-30: 5 mg qd prn; CrCl <11: avoid use; Info: consider alternatives for 5 mg dose
- HD: 5 mg qd prn; supplement after dialysis not defined; PD: 5 mg qd prn; supplement not defined; Info: consider alternatives for 5 mg dose
- [ allergy sx, adults ]
- CrCl <30: 5 mg qd prn; Info: consider alternatives for 5 mg dose
- HD: 5 mg qd prn; no supplement after dialysis; Alt: 5 mg 3x/wk prn; no supplement after dialysis; PD: 5 mg qd prn; no supplement; Info: consider alternatives for 5 mg dose
- [ chronic idiopathic urticaria, 6-11 yo ]
- CrCl 11-50: 2.5-5 mg qd; CrCl <11: avoid use; Info: consider alternatives for 2.5-5 mg dose
- HD/PD: not defined
- [ chronic idiopathic urticaria, 12-17 yo ]
- CrCl 11-30: 5 mg qd; CrCl <11: avoid use; Info: consider alternatives for 5 mg dose
- HD: 5 mg qd; supplement after dialysis not defined; PD: 5 mg qd; supplement not defined; Info: consider alternatives for 5 mg dose
- [ chronic idiopathic urticaria, adults ]
- CrCl <30: 5 mg qd; Info: consider alternatives for 5 mg dose
- HD: 5 mg qd; no supplement after dialysis; Alt: 5 mg 3x/wk; no supplement after dialysis; PD: 5 mg qd; no supplement; Info: consider alternatives for 5 mg dose
hepatic dosing
- [ allergy sx, 6-11 yo ]
- hepatic impairment: 2.5 mg qd prn; Info: consider alternatives for 2.5 mg dose
- [ allergy sx, 12 yo and older ]
- hepatic impairment: 5 mg qd prn; Info: consider alternatives for 5 mg dose
- [ chronic idiopathic urticaria, 6-11 yo ]
- hepatic impairment: 2.5 mg qd; Info: consider alternatives for 2.5 mg dose
- [ chronic idiopathic urticaria, 12 yo and older ]
- hepatic impairment: 5 mg qd; Info: consider alternatives for 5 mg dose
Formulations .
oral tablet/capsule
- [active ingredients per tab/cap]
- cetirizine 10 mg
chewable tablet
- [active ingredients per tab]
- cetirizine 10 mg
- [flavors/selected other ingredients]
- unflavored formulation contains sucralose, no alcohol, no dye, no phenylalanine, no saccharin, no sugar
orally disintegrating tablet
- [active ingredients per tab]
- cetirizine 10 mg
- [flavors/selected other ingredients]
- citrus flavor contains sucralose, no alcohol, no dye, no phenylalanine, no saccharin, no sugar
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- hypersensitivity to hydroxyzine
- pts <2 yo
- hepatic impairment (pts <6 yo)
- renal impairment (pts <6 yo)
- CrCl <11 (peds pts not on hemodialysis)
- caution: CNS depressant use, concurrent
- caution: alcohol use, concurrent
- caution: pts <6 yo
- caution: pts 65 yo and older
- caution: hepatic impairment
- caution: renal impairment
- caution: CrCl <50
Drug Interactions .
Overview
cetirizine
antihistamine, 2nd generation
Interaction Characteristics:
- CNS depression
- decreases central histamine effects
Contraindicated
- isocarboxazid
Avoid/Use Alternative
- butalbital
- codeine
- doxylamine
- ethanol
- hydrocodone
- kava
- metaxalone
- metoclopramide
- midazolam
- oxybate
- phenelzine
- promethazine
- ropeginterferon alfa-2b
- thalidomide
- tranylcypromine
- trimethobenzamide
Monitor/Modify Tx
- aldesleukin
- alfentanil
- alprazolam
- baclofen intrathecal
- butorphanol
- carbamazepine
- chlorpromazine
- clobazam
- clonazepam
- daridorexant
- desflurane
- dexmedetomidine injection
- diazepam
- dihydrocodeine
- droperidol
- esketamine
- estazolam
- etomidate
- fentanyl
- flurazepam
- gabapentin
- hydromorphone
- hydroxyzine
- isoflurane
- ketamine
- levorphanol
- lorazepam
- methadone
- methohexital
- mirtazapine
- morphine
- nalbuphine
- nelarabine
- oliceridine
- opicapone
- oxazepam
- oxybutynin
- oxymorphone
- pentazocine
- perphenazine
- phenobarbital
- primidone
- propofol
- remifentanil
- remimazolam
- sufentanil
- suvorexant
- tapentadol
- temazepam
- thioridazine
- tramadol
- triazolam
- ziconotide
- zolpidem
Caution Advised
- 5-HTP
- allopurinol
- almotriptan
- amantadine
- amitriptyline
- amoxapine
- apomorphine
- apraclonidine ophthalmic
- aripiprazole bimonthly injection
- aripiprazole lauroxil
- aripiprazole monthly injection
- aripiprazole oral
- asenapine
- baclofen
- brexpiprazole
- brimonidine ophthalmic
- brimonidine topical
- brivaracetam
- bromocriptine
- brompheniramine
- buspirone
- cannabidiol
- cannabis
- carbinoxamine
- cariprazine
- carisoprodol
- cenobamate
- chamomile, German
- chlophedianol
- chlorpheniramine
- chlorzoxazone
- citalopram
- clemastine
- clomipramine
- clozapine
- cyclobenzaprine
- cyproheptadine
- dantrolene
- darifenacin
- desipramine
- desvenlafaxine
- deutetrabenazine
- dexbrompheniramine
- dexchlorpheniramine
- dichlorphenamide
- difelikefalin
- difenoxin
- dimenhydrinate
- diphenhydramine
- diphenoxylate
- domperidone
- doxepin
- doxepin topical
- dronabinol
- duloxetine
- efavirenz
- eletriptan
- entacapone
- entrectinib
- escitalopram
- eslicarbazepine acetate
- ethanol (in some formulations)
- ethosuximide
- felbamate
- fenfluramine
- fesoterodine
- flibanserin
- fluoxetine
- fluvoxamine
- foslevodopa
- fosphenytoin
- frovatriptan
- ganaxolone
- glofitamab
- glycopyrrolate
- guanfacine
- haloperidol
- hyoscyamine
- iloperidone
- imipramine
- lacosamide
- lamotrigine
- lasmiditan
- levetiracetam
- levocetirizine
- levodopa
- levomilnacipran
- linvoseltamab
- lofexidine
- loxapine
- lumateperone
- lurasidone
- meclizine
- melatonin
- meprobamate
- methocarbamol
- methsuximide
- methyldopa
- metyrapone
- metyrosine
- milnacipran
- mitotane
- molindone
- mosunetuzumab
- mycophenolate mofetil
- naltrexone
- naratriptan
- nefazodone
- nortriptyline
- orphenadrine
- oxcarbazepine
- paliperidone
- paroxetine
- passion flower
- perampanel
- pheniramine
- phenytoin
- pimozide
- pramipexole
- procarbazine
- prochlorperazine
- protriptyline
- pyrilamine
- quetiapine
- rasagiline
- repotrectinib
- risperidone
- rizatriptan
- ropinirole
- rotigotine transdermal
- rufinamide
- safinamide
- scopolamine
- selegiline
- selegiline transdermal
- selinexor
- sertraline
- solifenacin
- stiripentol
- sumatriptan
- tasimelteon
- tetrabenazine
- thiotepa
- tiagabine
- tizanidine
- tolcapone
- tolterodine
- topiramate
- trazodone
- trihexyphenidyl
- trimipramine
- triprolidine
- trospium
- valbenazine
- valerian
- valproic acid
- venlafaxine
- vigabatrin
- vilazodone
- viloxazine
- ziprasidone
- zolmitriptan
- zonisamide
Adverse Reactions .
Serious Reactions
- bronchospasm
- anaphylactoid rxn
- anaphylaxis
- hypersensitivity rxn
- pruritus after D/C, severe (long-term use)
- hepatotoxicity
- cholestasis
- seizures
- hemolytic anemia
- thrombocytopenia
- syncope
- hypotension, severe
Common Reactions
- drowsiness
- fatigue
- abdominal pain
- headache
- dry mucous membranes
- diarrhea
- pharyngitis
- dizziness
- nausea
- vomiting
Pregnancy/Lactation .
Pregnancy
Clinical Summary
may use during pregnancy; risk of fetal harm not expected based on limited human data
Lactation
Clinical Summary
may use short-term while breastfeeding, otherwise weigh risk/benefit; no known risk of infant harm based on limited human data, though possible risk of infant CNS depression based on limited human data w/ other antihistamines; no human data available, though theoretical risk of decr. milk production based on decr. prolactin levels
Pharmacology .
Metabolism: liver minimally; CYP450: minimal; 3A4 substrate
Excretion: urine 70% (50% unchanged), feces 10%; Half-life: 8.3h, 24.9h (moderate to severe renal impairment)
Subclass: Antihistamines, 2nd generation ; Pruritus/Urticaria, Systemic Nonsteroidal Agents
Mechanism of Action: selectively antagonizes peripheral histamine H1 receptors
Alternatives .
Search for Alternative Products by:
- Other OTCs w/ Same Active Ingredient(s)
- Children's Zyrtec Allergy: chewable tablet; orally disintegrating tablet; oral solution
- Related Subclasses
- Anticholinergics, Intranasal
- Antihistamine/Corticosteroid Combos, Intranasal
- Antihistamine/Decongestant Combos
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- Antihistamines, Ophthalmic
- Corticosteroids, Intranasal
- Corticosteroids, Topical 7: Lowest Potency
- Mast Cell Stabilizers, Intranasal
- Mast Cell Stabilizers, Ophthalmic
- Zinc, Homeopathic
- Atopic Dermatitis, Systemic Nonsteroidal Agents
- Pruritus/Urticaria, Topical Nonsteroidal Agents
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