Cetirizine HCl (Zyrtec) is an antihistamine used in the management of seasonal allergic rhinitis.
Generic Name
cetirizine hydrochloride
Brand Names
- Reactine (CAN)
- Zyrtec
Drug class
- Antihistamine
- Pregnancy Category B
Therapeutic actions
Potent histamine (H1) receptor antagonist; inhibits histamine release and eosinophil chemotaxis during inflammation, leading to reduced swelling and decreased inflammatory response
Indications
- Management of seasonal and perennial allergic rhinitis
- Treatment of chronic, idiopathic urticaria
- Treatment of year-round allergic rhinitis and chronic idiopathic urticaria in infants > 6 mo
Contraindications and cautions
- Contraindicated with allergy to any antihistamines, hydroxyzine.
- Use cautiously with narrow-angle glaucoma, stenosing peptic ulcer, symptomatic prostatic hypertrophy, asthmatic attack, bladder neck obstruction, pyloroduodenal obstruction (avoid use or use with caution as condition may be exacerbated by drug effects); lactation.
Available forms
Tablets—5, 10 mg; chewable tablets—5, 10 mg; syrup—5 mg/5 mL
Dosages
ADULTS
5–10 mg daily PO; maximum dose 20 mg/day.
PEDIATRIC PATIENTS
6 mo–5 yr: 2.5 mg (one-half teaspoon) PO once daily. In children 1 yr and older, may increase to maximum 5 mg daily given as one-half teaspoon q 12 hr; 2–5 yr—one 5 mg chewable tablet per day.
6–11 yr: 5 or 10 mg daily PO.
> 12 yr: Use adult dosage.
PATIENTS WITH HEPATIC OR RENAL IMPAIRMENT
5 mg PO daily.
Pharmacokinetics
| Route | Onset | Peak | Duration |
| Oral | Rapid | 1 hr | 24 hr |
Metabolism: Hepatic; T1/2: 7–10 hr
Distribution: Crosses placenta; enters breast milk
Excretion: Urine and feces
Adverse effects
- CNS: Somnolence, sedation
- CV: Palpitation, edema
- GI: Nausea, diarrhea, abdominal pain, constipation
- Respiratory: Bronchospasm, pharyngitis
- Other: Fever, photosensitivity, rash, myalgia, arthralgia, angioedema
Nursing considerations
Name confusion has occurred between Zyrtec (cetirizine) and Zyprexa (olanzapine);
Assessment
- History: Allergy to any antihistamines, hydroxyzine; narrow-angle glaucoma, stenosing peptic ulcer, symptomatic prostatic hypertrophy, asthmatic attack, bladder neck obstruction, pyloroduodenal obstruction; lactation
- Physical: Skin color, lesions, texture; orientation, reflexes, affect; vision examination; R, adventitious sounds; prostate palpation; renal function tests
Interventions
- Give without regard to meals.
- Provide syrup form or chewable tablets for pediatric use if needed.
- Arrange for use of humidifier if thickening of secretions, nasal dryness become bothersome; encourage adequate intake of fluids.
- Provide skin care for urticaria.
Teaching points
- Take this drug without regard to meals.
- You may experience these side effects: Dizziness, sedation, drowsiness (use caution if driving or performing tasks that require alertness); thickening of bronchial secretions, dryness of nasal mucosa (humidifier may help).
- Report difficulty breathing, hallucinations, tremors, loss of coordination, irregular heartbeat.