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Cetirizine / pseudoephedrine Side Effects

In Summary

More frequently reported side effects include: insomnia. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to cetirizine / pseudoephedrine: oral tablet extended release

Along with its needed effects, cetirizine/pseudoephedrine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Get emergency help immediately if any of the following symptoms of overdose occur while taking cetirizine / pseudoephedrine:

Symptoms of Overdose

  • Changes in mood, irrational behavior, depersonalization hallucinations
  • convulsions (seizures)
  • extreme sleepiness or unusual drowsiness
  • fast, slow, pounding, or irregular heartbeat or pulse
  • feeling anxious
  • giddiness
  • headache
  • irritability
  • muscle weakness or tenderness
  • nausea
  • restlessness
  • shallow, irregular, fast, or slow breathing
  • sleeplessness or trouble in sleeping
  • abdominal and/or chest pain
  • thirst

Check with your doctor as soon as possible if any of the following side effects occur while taking cetirizine / pseudoephedrine:


  • Breathing, troubled
  • back, leg, or stomach pain
  • blurred vision
  • bloody, cloudy, or dark urine, sudden decrease in amount of urine
  • black, tarry stools, diarrhea, light-colored stools
  • confusion
  • dizziness, feeling faint, or lightheaded
  • fever or chills
  • increased blood pressure
  • rapid weight gain
  • skin rash or hives
  • swelling of face, mouth, throat, fingers, glands, feet, and/or lower legs
  • stillbirth
  • twitching, twisting, or uncontrolled repetitive movements of the face
  • sudden sweating
  • vomiting blood, bleeding gums, nosebleeds, unusual bleeding or bruising
  • pale or yellow eyes or skin
  • unusual tiredness or weakness

Some side effects of cetirizine / pseudoephedrine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More Common

  • Sleepiness or unusual drowsiness, extreme tiredness

Less Common

  • Dry mouth
  • weakness


For Healthcare Professionals

Applies to cetirizine / pseudoephedrine: oral tablet extended release


Dermatologic side effects have included maculopapular and urticarial eruptions.[Ref]


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

Gastrointestinal adverse effects of pseudoephedrine have included anorexia and gastric irritation (5%). Dry mouth, nose, or throat have occurred in up to 15% of patients.[Ref]


Hepatic side effects have included rare liver function test abnormalities which resolved spontaneously following discontinuation of cetirizine therapy.[Ref]

Nervous system

Cetirizine appears to be more sedating than terfenadine, astemizole, and loratadine.[Ref]

Nervous system side effects of cetirizine administration 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.

Nervous system side effects of pseudoephedrine have included insomnia in up to 30% of patients. Tremor, anxiety, nervousness, and headache have also been reported.[Ref]


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


Hypersensitivity reactions have included fixed drug eruptions with pseudoephedrine use.[Ref]


Cardiovascular side effects have included tachycardia. Some patients have developed hypertension and/or arrhythmias.[Ref]


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


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

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.