Are you one of the millions who rely on Cetirizine for allergy relief? Whether it’s seasonal sniffles, persistent itching, or chronic hives, Cetirizine (often sold under brand names like Zyrtec or Allercet) is a go-to medication. But a common question arises: Is Cetirizine safe to consume? This in-depth guide will delve into the safety aspects of Cetirizine, equipping you with the knowledge to use it responsibly and effectively.
What is Cetirizine and How Does it Work?
Cetirizine is a second-generation antihistamine. Unlike older, first-generation antihistamines (like diphenhydramine), it’s designed to cause less drowsiness. It works by blocking histamine, a natural substance your body produces during an allergic reaction. By blocking histamine, Cetirizine helps alleviate symptoms such as:
- Sneezing
- Runny nose
- Itchy or watery eyes
- Itchy throat
- Hives (urticaria)
It’s important to note that Cetirizine is not for treating severe allergic reactions like anaphylaxis. For such emergencies, an epinephrine auto-injector is necessary.
Common Side Effects of Cetirizine
While generally well-tolerated, Cetirizine can cause some side effects. The most common include:
- Drowsiness or sleepiness: Although it’s a “non-drowsy” antihistamine compared to older generations, some individuals may still experience this. It’s often dose-dependent, with higher doses being more likely to cause sleepiness.
- Headache: Mild headaches can occur.
- Dry mouth: This is a fairly common anticholinergic side effect.
- Fatigue: A general feeling of tiredness.
- Nausea or abdominal pain: Gastrointestinal discomfort is possible.
- Sore throat
- Dizziness
For children, diarrhoea, sneezing, or a blocked and runny nose may be more common side effects than in adults.
Coping with Common Side Effects:
- Drowsiness: Consider taking Cetirizine in the evening, or discuss alternative non-drowsy antihistamines with your doctor or pharmacist. Avoid driving or operating machinery until you know how Cetirizine affects you.
- Headaches: Ensure adequate rest and fluid intake. Over-the-counter pain relievers may help.
- Dry mouth: Chewing sugar-free gum or sucking on sugar-free sweets can provide relief.
- Nausea: Try taking the medication with food.
Serious, But Rare, Side Effects
Serious side effects with Cetirizine are rare but can occur. Seek immediate medical attention if you experience:
- Signs of a severe allergic reaction (anaphylaxis): Swelling of the face, lips, tongue, or throat; difficulty breathing; rapid breathing; feeling of choking; tightness in the throat; blue/grey/pale skin; sudden confusion, drowsiness, or dizziness; fainting.
- Unexplained bruising or bleeding that takes longer to stop.
If any side effect becomes severe or persistent, or if you have any concerns, always consult your doctor or pharmacist.
Long-Term Use of Cetirizine: What You Need to Know
For many, allergies are a chronic condition, leading to consistent use of antihistamines like Cetirizine. While generally considered safe for long-term use, recent information from the FDA highlights a rare but significant concern:
- Severe Itching (Pruritus) Upon Discontinuation: The FDA has issued a warning that patients stopping Cetirizine or levocetirizine after long-term, daily use (typically for at least a few months, often years) may experience severe itching (pruritus). This itching was not present before starting the medication and usually develops within a few days of stopping it.
Important Considerations for Long-Term Users:
- If you are planning long-term use (especially more than a few months), discuss the benefits and risks with your healthcare professional.
- If you experience severe itching after discontinuing Cetirizine, contact your doctor. Do not restart the medication without medical advice.
Who Should Avoid Cetirizine or Use With Caution?
While Cetirizine is widely available over-the-counter, certain individuals should exercise caution or avoid it entirely:
- Allergic Reactions: If you have ever had an allergic reaction to Cetirizine or any of its ingredients.
- Peanut or Soya Allergy: Some brands of cetirizine capsules may contain soya.
- Kidney or Liver Disease: Individuals with impaired kidney or liver function may need a reduced dosage, as the body may have difficulty clearing the medication, leading to increased side effects. Consult your doctor for appropriate dosage adjustments.
- Elderly Patients: Older adults (over 65) may be more sensitive to the sedative effects and may benefit from a lower starting dose (e.g., 5 mg once a day).
- Children: Cetirizine is approved for use in children, with specific dosages based on age. Always follow the instructions on the product label or consult a pediatrician. It’s generally not recommended for children under 6 months.
Cetirizine and Specific Populations
Pregnancy
Current information suggests that Cetirizine appears safe for use during pregnancy. Studies have not indicated that it causes harm to the mother or baby. However, it’s always advisable to discuss any medication use during pregnancy with your doctor or midwife to weigh the benefits against any potential, albeit rare, risks.
Breastfeeding
Cetirizine is generally not recommended while breastfeeding. It can pass into breast milk and may cause sleepiness in a breastfed infant. Discuss alternative, more suitable medications with your doctor or pharmacist if you are breastfeeding.
Driving and Operating Machinery
Even though Cetirizine is considered “non-drowsy,” it can still cause somnolence in some individuals. Exercise caution and avoid driving or operating heavy machinery until you understand how the medication affects your alertness. Do not exceed the recommended dose.
Drug Interactions with Cetirizine
Cetirizine has a relatively low risk of drug interactions compared to some older antihistamines. However, it’s crucial to be aware of potential interactions:
- Alcohol: Combining Cetirizine with alcohol can increase the risk of drowsiness, dizziness, and impaired coordination. It’s best to avoid alcohol while taking Cetirizine.
- CNS Depressants: Taking Cetirizine with other medications that cause drowsiness or central nervous system (CNS) depression can heighten these effects. This includes:
- Other antihistamines (especially first-generation ones like diphenhydramine)
- Benzodiazepines (e.g., alprazolam, lorazepam)
- Sleeping pills (e.g., zolpidem, eszopiclone)
- Certain antidepressants (e.g., mirtazapine)
- Certain antipsychotic drugs (e.g., aripiprazole)
- Certain anti-seizure drugs (e.g., gabapentin, pregabalin)
- Muscle relaxants (e.g., baclofen)
- Opioid pain relievers (e.g., oxycodone, hydrocodone)
- NSAIDs (Non-Steroidal Anti-Inflammatory Drugs): Some studies suggest potential pharmacokinetic interactions, which could affect how your body processes Cetirizine.
- Pilsicainide: A significant interaction leading to elevated plasma concentrations and a risk of severe arrhythmias has been reported, particularly in patients with renal insufficiency.
- Gabapentin: Cetirizine may reduce the plasma concentrations and therapeutic effects of Gabapentin.
Always inform your doctor or pharmacist about all medications, supplements, and herbal remedies you are taking before starting Cetirizine to avoid potential interactions.
Dosage and Administration
Cetirizine is available in various forms, including tablets, chewable tablets, oral disintegrating tablets, oral capsules, and oral solutions/syrups.
Typical Adult Dosage:
- 5 to 10 mg orally once a day.
- Maximum dose: 10 mg/day.
Typical Pediatric Dosage (refer to product packaging or pediatrician for specific guidelines):
- 6 months to 2 years: Initial dose of 2.5 mg once a day, potentially increasing to 2.5 mg twice a day. Maximum 5 mg/day.
- 2 to 5 years: Initial dose of 2.5 mg once a day, potentially increasing to 2.5 mg twice a day or 5 mg once a day. Maximum 5 mg/day.
- 6 years and older: 5 to 10 mg orally once a day. Maximum 10 mg/day.
Cetirizine can be taken with or without food. Swallow tablets with a glass of water.
The Bottom Line: Is Cetirizine Safe to Consume?
Overall, Cetirizine is considered a safe and effective medication for relieving allergy symptoms when used as directed. Its safety profile is generally favorable, especially compared to older antihistamines, due to its reduced sedative and anticholinergic effects.
However, like all medications, it’s not without potential side effects or considerations. The recent FDA warning regarding severe itching upon long-term discontinuation is a crucial piece of information for consistent users.
Key takeaways for safe Cetirizine consumption:
- Follow Dosage Instructions: Adhere strictly to the recommended dosage on the label or as advised by your healthcare provider.
- Be Aware of Side Effects: Understand common and rare side effects and know when to seek medical attention.
- Inform Your Doctor: Always disclose your complete medical history, including any pre-existing conditions (especially kidney or liver disease) and all other medications you are taking, to your doctor or pharmacist.
- Discuss Long-Term Use: If you use Cetirizine daily for extended periods, talk to your healthcare professional about the risks and benefits, particularly concerning discontinuation.
- Avoid Alcohol: Steer clear of alcohol to minimize enhanced sedative effects.
By being informed and consulting with healthcare professionals, you can confidently use Cetirizine to manage your allergies safely and effectively.
References and Further Reading
- FDA Drug Safety Communication – Severe Itching (Pruritus) after Stopping Cetirizine or Levocetirizine:
- U.S. Food and Drug Administration (FDA). (2025, May 16). FDA requires warning about rare but severe itching after stopping long-term use of oral allergy medicines cetirizine or levocetirizine (Zyrtec, Xyzal, and other trade names). Retrieved from https://www.fda.gov/drugs/drug-safety-and-availability/fda-requires-warning-about-rare-severe-itching-after-stopping-long-term-use-oral-allergy-medicines
- NHS – Cetirizine (Side Effects, Pregnancy & Breastfeeding):
- National Health Service (NHS). (n.d.). Cetirizine: Side effects of cetirizine. Retrieved from https://www.nhs.uk/medicines/cetirizine/side-effects-of-cetirizine/
- National Health Service (NHS). (n.d.). Pregnancy, breastfeeding and fertility while taking cetirizine. Retrieved from https://www.nhs.uk/medicines/cetirizine/pregnancy-breastfeeding-and-fertility-while-taking-cetirizine/
- MedlinePlus – Cetirizine Drug Information:
- MedlinePlus. (2023, October 15). Cetirizine Oral. Retrieved from https://medlineplus.gov/druginfo/meds/a623043.html
- Drugs.com – Cetirizine Pregnancy and Breastfeeding Warnings:
- Drugs.com. (n.d.). Cetirizine Use During Pregnancy. Retrieved from https://www.drugs.com/pregnancy/cetirizine.html
- NCBI Bookshelf – Cetirizine – Drugs and Lactation Database (LactMed®):
- National Center for Biotechnology Information (NCBI). (n.d.). Cetirizine. In: Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Library of Medicine (US). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK501509/
- Medical News Today – Cetirizine interactions:
- Medical News Today. (2025, May 6). Cetirizine OTC oral forms interactions: Alcohol, medications, and other factors. Retrieved from https://www.medicalnewstoday.com/articles/drugs-cetirizine-otc-oral-forms-interactions
- Consensus Academic Search Engine – Drug Interactions Of Cetirizine:
- Consensus. (n.d.). Drug Interactions Of Cetirizine. Retrieved from https://consensus.app/questions/drug-interactions-of-cetirizine/
