cetirizine (Rx, OTC)

Brand and Other Names:Zyrtec, Zyrtec Allergy, more...Children's Zyrtec Allergy, Children's Zyrtec Hives Relief, PediaCare Children's 24 Hour Allergy, Aller-Tec, Wal-Zyr
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 5mg
  • 10mg

tablet, oral-disintegrating

  • 10mg

tablet, chewable

  • 5mg
  • 10mg

syrup

  • 5mg/5mL

solution

  • 5mg/5mL
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Allergies/Hay Fever/Urticaria

Perennial and seasonal allergic and vasomotor rhinitis; relief of symptoms from colds, urticaria, angioedema, anaphylactic reactions, pruritus, allergic conjunctivitis

5-10 mg PO qDay, depending on severity of symptoms; not to exceed 10 mg qDay

Dosing Modifications

Renal impairment

  • GFR >50 mL/min: Dose adjustment not necessary
  • GFR ≤ 50 mL/min: 5 mg PO qDay
  • Peritoneal dialysis: 5 mg PO qDay
  • Intermittent hemodialysis: 5 mg PO qDay; may also administer 3 times weekly

Hepatic impairment

  • Dose adjustment not provided by manufacturer's label

Dosage Forms & Strengths

tablet

  • 5mg
  • 10mg

tablet, oral-disintegrating

  • 10mg

tablet, chewable

  • 5mg
  • 10mg

syrup

  • 5mg/5mL

solution

  • 5mg/5mL
more...

Allergies/Hay Fever/Urticaria

Perennial and seasonal allergic and vasomotor rhinitis

<2 years: Safety and efficacy not established

2-6 years: 2.5 mg (0.5 teaspoon) oral solution PO qDay; can increase to 5 mg PO qDay or 2.5 mg PO twice daily; not to exceed 5 mg qDay

>6 years: 5-10 mg PO qDay, depending on severity of symptoms; not to exceed 10 mg qDay

Dosing Modifications

Renal impairment

  • GFR ≥30 mL/min/1.73 m²: Dose adjustment not necessary
  • GFR 10-29 mL/min/1.73 m²: Decrease dose by 50%
  • GFR < 10 mL/min/1.73 m²: Not recommended
  • Intermittent hemodialysis or peritoneal dialysis: Decrease dose by 50%

Hepatic impairment

  • Dose adjustment not provided by manufacturer's label

5 mg PO qDay; may increase to 10 mg/day mazimum, depending on severity of symptoms; not to exceed 5 mg qDay in patients >77 years

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Interactions

Interaction Checker

and cetirizine

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Somnolence (2-14%)

            Headache (11-14%)

            1-10%

            Fatigue (5.9%)

            Dry mouth (5%)

            Dizziness (2%)

            Diarrhea (2-3%)

            Malaise (4%)

            Bronchospasm (2-3%)

            Vomiting (2-3%)

            Epistaxis (2-4%)

            <1%

            Stomach pain

            Drowsiness

            Angioedema

            Fussiness

            Hallucinations

            Hypotension

            Tremor

            Tongue discoloration

            Postmarketing Reports

            Cardiac disorders: Severe hypotension

            Gastrointestinal disorders: Cholestasis

            Nervous system disorders: Extrapyramidal symptoms, myoclonus, orofacial dyskinesia, tic

            Pregnancy, puerperium and perinatal conditions: Stillbirth

            Renal and urinary disorders: Glomerulonephritis

            Skin and subcutaneous tissue disorders: acute generalized exanthematous pustulosis (AGEP); rebound pruritus-pruritus within a few days after discontinuation of cetirizine, usually after long-term use (eg, months to years)

            Postmarketing reports of active metabolite (levocetirizine)

            • Cardiac disorders: Palpitations, tachycardia
            • Ear and labyrinth disorders: Vertigo
            • Eye disorders: Blurred vision, visual disturbances
            • Gastrointestinal disorders: Nausea, vomiting
            • General disorders and administration site conditions: Edema
            • Hepatobiliary disorders: Hepatitis
            • Immune system disorders: Anaphylaxis and hypersensitivity Metabolism and nutrition disorders: Increased appetite
            • Musculoskeletal, connective tissues, and bone disorders: Arthralgia, myalgia
            • Nervous system disorders: Dizziness, dysgeusia, febrile seizure, movement disorders (including dystonia and oculogyric crisis), paraesthesia, seizure (reported in subjects with and without a known seizure disorder), tremor
            • Psychiatric disorders: Aggression and agitation, depression, hallucinations, insomnia, nightmare, suicidal ideation
            • Renal and urinary disorders: Dysuria, urinary retention
            • Respiratory, thoracic, and mediastinal disorders: Dyspnea
            • Skin and subcutaneous tissue disorders: Angioedema, fixed drug eruption, pruritus, rash and urticaria
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            Warnings

            Contraindications

            Documented hypersensitivity to cetirizine, hydroxyzine

            Cautions

            Avoid alcohol, sedatives, and tranquilizers, due to increased risk of drowsiness

            May cause CNS depression; avoid activities requiring mental alertness until accustomed to medication

            Use caution in hepatic and renal impairment

            The elderly may be more sensitive to adverse effects

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            Pregnancy & Lactation

            Pregnancy category: B; C for Zyrtec-D 12 Hour

            Lactation: Excreted in breast milk; use not recommended

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Histamine H1-receptor antagonist; competes with histamine on effector cells in the gastrointestinal tract, blood vessels and respiratory tract

            Absorption

            Peak plasma concentration: 114 ng/mL

            Peak serum time: 1 hr

            Duration: >24 hr (suppression of skin wheal and flare reactions)

            Distribution

            Protein bound: 93%

            Vd: 0.56 L/kg

            Metabolism

            Metabolism: Liver; low first pass

            Limited extent by oxidative O-dealkylation to inactive metabolite

            Elimination

            Half-life: 7.9hr

            Excretion: Urine (70%); feces (10%)

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            Administration

            Oral Administration

            May take with or without food

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            Images

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            Formulary

            FormularyPatient Discounts

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            • Compare formulary status to other drugs in the same class.
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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.