Zyrtec Side Effects

Generic Name: cetirizine

Note: This page contains side effects data for the generic drug cetirizine. It is possible that some of the dosage forms included below may not apply to the brand name Zyrtec.

It is possible that some side effects of Zyrtec may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

For the Consumer

Applies to cetirizine: oral solution, oral tablets and chewable tablets

Side effects include:

Adults and children ≥12 years of age: Somnolence, fatigue, dry mouth. Insomnia reported with cetirizine (the active ingredient contained in Zyrtec) hydrochloride-pseudoephedrine hydrochloride fixed combination.

Children 2–11 years of age: Headache, pharyngitis, abdominal pain.

Children 6 months to 2 years of age: Irritability, fussiness, insomnia, fatigue, malaise.

For Healthcare Professionals

Applies to cetirizine: oral capsule, oral syrup, oral tablet, oral tablet chewable, oral tablet dispersible

Nervous system

Nervous system side effects have included headache (16%), fatigue (5.6%), and somnolence (5% to 20%). Somnolence tends to be dose-related and generally occurs more frequently with doses higher than 10 mg per day. Other nervous system side effects include dizziness (1.8%), insomnia (1.5%), and nervousness (1.1%). Post marketing reports have included aggression reaction and convulsions.[Ref]

Cetirizine appears to be more sedating than loratadine.[Ref]

Gastrointestinal

Gastrointestinal side effects have included dry mouth (5.7%) and nausea or vomiting (2.2%). Pharyngitis, dyspepsia, and increased appetite have occasionally been reported.[Ref]

Hepatic

Hepatic side effects have included rare liver function test abnormalities which resolved spontaneously following discontinuation of cetirizine (the active ingredient contained in Zyrtec) therapy. At least one case of recurrent acute hepatitis has also been associated with cetirizine use.[Ref]

Respiratory

Respiratory side effects have included relatively rare reports of wheezing, coughing, bronchitis, sinusitis, and asthma.[Ref]

Dermatologic

Dermatologic side effects have included reports of maculopapular and urticarial eruptions. Fixed drug eruptions have also been associated with cetirizine (the active ingredient contained in Zyrtec) [Ref]

General

General side effects have included epistaxis (1.1%) and accidental injury (1.1%).[Ref]

Hypersensitivity

Hypersensitivity side effects have included a case report of an anaphylactic reaction.[Ref]

Psychiatric

Delusional thinking and depression has been reported in an 18-year-old woman started on cetirizine (the active ingredient contained in Zyrtec) the symptoms resolved once cetirizine was discontinued.[Ref]

Postmarketing psychiatric side effects have included reports of aggressive reaction, hallucinations, suicidal ideation and suicide.[Ref]

References

1. Barnes CL, McKenzie CA, Webster KD, Poinsett-Holmes K "Cetirizine: a new, nonsedating antihistamine." Ann Pharmacother 27 (1993): 464-70

2. Lockey RF, Widlitz MD, Mitchell DQ, Lumry W, Dockhorn R, Woehler T, Grossman J "Comparative study of cetirizine and terfenadine versus placebo in the symptomatic management of seasonal allergic rhinitis." Ann Allergy Asthma Immunol 76 (1996): 448-54

3. Salmun LM, Gates D, Scharf M, Greiding L, Ramon F, Heithoff K "Loratadine versus cetirizine: Assessment of somnolence and motivation during the workday." Clin Ther 22 (2000): 573-82

4. Spencer CM, Faulds D, Peters DH "Cetirizine. A reappraisal of its pharmacological properties and therapeutic use in selected allergic disorders." Drugs 46 (1993): 1055-80

5. Campoli-Richards DM, Buckley MM, Fitton A "Cetirizine. A review of its pharmacological properties and clinical potential in allergic rhinitis, pollen-induced asthma, and chronic urticaria." Drugs 40 (1990): 762-81

6. Takahashi H, Ishida-Yamamoto A, Iizuka H "Effects of bepotastine, cetirizine, fexofenadine, and olopatadine on histamine-induced wheal-and flare-response, sedation, and psychomotor performance." Clin Exp Dermatol 29 (2004): 526-32

7. Adelsberg BR "Sedation and performance issues in the treatment of allergic conditions." Arch Intern Med 157 (1997): 494-500

8. "Product Information. Zyrtec (cetirizine)." Pfizer US Pharmaceuticals, New York, NY.

9. Desager JP, Horsmans Y "Pharmacokinetic pharmacodynamic relationships of h-1-antihistamines." Clin Pharmacokinet 28 (1995): 419-32

10. Sannita WG, Crimi E, Riela S, Rosadini G, Brusasco V "Cutaneous antihistaminic action of cetirizine and dose-related EEG concomitants of sedation in man." Eur J Pharmacol 300 (1996): 33-41

11. Shamsi Z, Kimber S, Hindmarch I "An investigation into the effects of cetirizine on cognitive function and psychomotor performance in healthy volunteers." Eur J Clin Pharmacol 56 (2001): 865-71

12. Breneman DL "Cetirizine versus hydroxyzine and placebo in chronic idiopathic urticaria." Ann Pharmacother 30 (1996): 1075-9

13. Hannuksela M, Kalimo K, Lammintausta K, Mattila T, Turjanmaa K, Varjonen E, Coulie PJ "Dose ranging study: cetirizine in the treatment of atopic dermatitis in adults." Ann Allergy 70 (1993): 127-33

14. Reunala T, Brummer-Korvenkontio H, Karppinen A, Coulie P, Palosuo T "Treatment of mosquito bites with cetirizine." Clin Exp Allergy 23 (1993): 72-5

15. Breneman D, Bronsky EA, Bruce S, Kalivas JT, Klein GL, Roth HL, Tharp MD, Treger C, Soter N "Cetirizine and astemizole therapy for chronic idiopathic urticaria: a double-blind, placebo-controlled, comparative trial." J Am Acad Dermatol 33 (1995): 192-8

16. Grant JA, Nicodemus CF, Findlay SR, Glovsky MM, Grossman J, Kaiser H, Meltzer EO, Mitchell DQ, Pearlman D, Selner J, Settipa "Cetirizine in patients with seasonal rhinitis and concomitant asthma: prospective, randomized, placebo-controlled trial." J Allergy Clin Immunol 95 (1995): 923-32

17. Rihoux JP, Mariz S "Cetirizine. An updated review of its pharmacological properties and therapeutic efficacy." Clin Rev Allergy 11 (1993): 65-88

18. Simons FER, Fraser TG, Reggin JD, Simons KJ "Comparison of the central nervous system effects produced by six h-1-receptor antagonists." Clin Exp Allergy 26 (1996): 1092-7

19. Spector SL, Nicodemus CF, Corren J, Schanker HM, Rachelefsky GS, Katz RM, Siegel SC "Comparison of the bronchodilatory effects of cetirizine, albuterol, and both together versus placebo in patients with mild-to-moderate asthma." J Allergy Clin Immunol 96 (1995): 174-81

20. Pompili M, Basso M, Grieco A, Vecchio FM, Gasbarrini G, Rapaccini GL "Recurrent acute hepatitis associated with use of cetirizine." Ann Pharmacother 38 (2004): 1844-7

21. Calista D, Schianchi S, Morri M "Urticaria induced by cetirizine." Br J Dermatol 144 (2001): 196

22. Stingeni L, Caraffini S, Agostinelli D, Ricci F, Lisi P "Maculopapular and urticarial eruption from cetirizine." Contact Dermatitis 37 (1997): 249-50

23. Mahajan VK, Sharma NL, Sharma VC "Fixed drug eruption: a novel side-effect of levocetirizine." Int J Dermatol 44 (2005): 796-8

24. Kranke B, Kern T "Multilocalized fixed drug eruption to the antihistamine cetirizine." J Allerg Clin Immunol 106 (2001): 988

25. Karamfilov T, Wilmer A, Hipler UC, Wollina U "Cetirizine-induced urticarial reaction." Br J Dermatol 140 (1999): 979-80

26. Afonso N, Shetgaonkar P, Dang A, Rataboli PV "Cetirizine-induced anaphylaxis: a rare adverse drug reaction." Br J Clin Pharmacol 67 (2009): 577-8

27. Garden BC, Francois D "Cetirizine-associated delusions and depression in an 18-year-old woman." Clin Neuropharmacol 36 (2013): 96-7

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