Cetirizine

Medically Reviewed by HaVy Ngo, Pharm.D.

Last Reviewed: Jun 14, 2022

Warnings

What are the risks of taking cetirizine hydrochloride?

Cetirizine (Zyrtec) can cause serious health problems in certain groups of people. You should talk to your healthcare provider if you have any concerns or about other treatment options.
Severe allergic reaction:

Risk factor: History of being allergic to hydroxyzine
People who have a history of being allergic to hydroxyzine can develop a serious allergic reaction to cetirizine. An anaphylactic reaction is a strong allergic reaction with symptoms such as rash, hives, difficulty breathing, swelling of the throat and tongue - you need to get emergency medical attention if you experience any of these symptoms

A build-up of phenylalanine in the body:

Risk factor: History of phenylketonuria (PKU)
The chewable cetirizine tablets contain phenylalanine. Phenylalanine is not a concern for most people, but if you have PKU, phenylalanine can cause a serious medical problem. The regular tablets, oral-disintegrating tablets, and the oral liquid form of cetirizine are safer options if you have PKU.

Reduced mental alertness:

Risk factor: Concurrent use of alcohol or other CNS (central nervous system) depressants
Cetirizine can cause somnolence and tiredness; thus, this medication can impair your ability to think, focus, and react. Refrain from driving or operating hazardous machinery until you know how your body will react to this medication. CNS depressants can make you less alert. Examples of these drugs are anti-anxiety medication, sleeping pills, and opioid pain medications. Talk to your doctor if you are taking any of these medications before you start taking cetirizine.

Geriatric use:

Risk factor: People over 65 years of age; history of liver or renal impairment
People who are 65 or older and those with kidney or liver disease are at higher risk of experiencing adverse effects from taking cetirizine; their bodies don’t clear cetirizine out as sufficiently compared to younger individuals without kidney or liver problems. Symptoms of increased antihistamines are vision changes, dry mouth, decreased urine output, and constipation. Talk to your doctor before you start taking cetirizine. Your doctor may make a dose adjustment if you are 65 years or older or have any kidney disease or liver insufficiency. Healthcare providers only recommend using cetirizine in people over 65 years old with kidney disease when the benefits outweigh the risks.

Cautions for pregnant women and breastfeeding mothers:

Cetirizine is pregnancy category B. There is not enough data on the use of cetirizine in pregnant women. Even though cetirizine is considered reasonably safe to be used during pregnancy, you should talk to your doctor before you start taking cetirizine if you are pregnant or planning to get pregnant.
Cetirizine has been found to be excreted into human breast milk. The use of cetirizine in nursing mothers is not recommended.

What should I tell my doctor before starting cetirizine?

Tell all your doctors your full medical history. You should inform your doctor about all of your medical conditions, allergies, pregnancy, and breastfeeding status. Also, let your doctor know if you have any kidney or liver disease.

If you are allergic to cetirizine, Zyrtec, or hydroxyzine, you should not take cetirizine. Tell your doctor if you are pregnant, planning to get pregnant, or if you are breastfeeding.

Cetirizine is considered to be relatively safe to be used during pregnancy. However, do not start taking cetirizine before discussing it with your doctor.

Cetirizine is not to be used with children under six months old. Always talk to your child’s doctor before you start giving cetirizine regardless of their age.

What proper medical care should I take while on cetirizine?

If you use cetirizine liquid medicine, you should measure the dose carefully using an oral syringe or medicine cup.
Do not take cetirizine with other medicines that make you sleepy.
Consult with your child’s pediatrician before using cetirizine to treat hives or allergies.
Cetirizine is not indicated to treat allergic reactions. If your doctor prescribes you epinephrine (EpiPen) to treat an anaphylactic reaction, you should always carry it with you.

What drugs can interact with cetirizine hydrochloride?

Cetirizine can cause drowsiness; Taking cetirizine with other medications that make you drowsy worsens this effect. Examples of those medications are anti-anxiety medications, anti-seizure medications, opioid pain relievers, muscle relaxers, and sleeping pills. Inform your doctor and pharmacist of all your medicines to avoid drug interaction.

This is not a complete list; there may be other drugs that can interact with cetirizine. Other drugs, including prescriptions, over-the-counter medicines, herbal products, and vitamins, may interact with cetirizine. Not all possible drug interactions are listed in this guide. It is highly recommended to keep a list of all the drug products you are using (prescriptions, over-the-counter products, herbal supplements, natural products, and vitamins) and share it with your doctor and pharmacist.

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