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CETIRIZINE HCl (Zyrtec)

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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.
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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

RouteOnsetPeakDuration
OralRapid1 hr24 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
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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.

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