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All-Day Allergy, Aller-Relief, Allergy Relief, Benadryl Allergy Oral Solution (UK), Benadryl One a Day (UK), Piriteze (UK), Pollenshield Hayfever (UK), Reactine, Zirtec (UK), Zyrtec
Pharmacologic class: Histamine1-receptor antagonist (peripherally selective)
Therapeutic class: Allergy, cold, and cough agent; antihistamine
Pregnancy risk category B
Antagonizes histamine's effects at histamine1-receptor sites, preventing allergic response. Also has mild bronchodilatory effects and blocks histamine-induced bronchoconstriction in asthma.
Syrup: 5 mg/5 ml
Tablets: 5 mg, 10 mg
⊘Indications and dosages
➣ Allergic symptoms caused by histamine release
Adults and children older than age 6: 5 to 10 mg P.O. daily
Children ages 2 to 5: 2.5 to 5 mg P.O. daily
• Renal impairment
• Hepatic impairment
• Hypersensitivity to drug or hydroxyzine
• Acute asthma attacks
• Angle-closure glaucoma
• Pyloroduodenal obstruction
Use cautiously in:
• renal impairment, significant hepatic dysfunction
• elderly patients
• pregnant patients
• children younger than age 2 (safety not established).
• Give with or without food.
• Administer at same time each day.
CNS: dizziness, drowsiness, fatigue
CV: palpitations, edema
GI: nausea, vomiting, abdominal distress, dry mouth
Musculoskeletal: myalgia, joint pain
Skin: photosensitivity, rash, angioedema
Drug-drug.CNS depressants: additive CNS effects
Theophylline: decreased cetirizine clearance
Drug-diagnostic tests.Allergy skin tests: false-negative results
Drug-behaviors.Alcohol use: additive CNS effects
Sun exposure: photosensitivity
• Monitor creatinine levels in patients with renal dysfunction.
• Assess hepatic enzyme levels in patients with hepatic disease.
• Tell patient to take with full glass of water.
• Inform patient that drug may impair alertness and that alcohol may exaggerate this effect.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and behaviors mentioned above.
Aller Relief(trade name),
ClassificationTherapeutic: allergy cold cough remedies
- Seasonal and perennial allergic rhinitis,
- Chronic urticaria.
Time/action profile (antihistaminic effects)
|PO||30 min||4–8 hr||24 hr|
Adverse Reactions/Side Effects
Central nervous system
- drowsiness (significant with doses >10 mg/day)
Ear, Eye, Nose, Throat
- dry mouth
Drug-Drug interactionAdditive CNS depression may occur with alcohol, opioid analgesics, or sedative/hypnotics.Theophylline may ↓ clearance and ↑ toxicity.
Hepatic/Renal ImpairmentOral (Adults and Children ≥12 yr) CCr ≤31 mL/min, hepatic impairment or hemodialysis—5 mg once daily.
Hepatic/Renal ImpairmentOral (Children 6–11 yr) start therapy at <2.5 mg/day.
Hepatic/Renal ImpairmentOral (Children <6 yr) use not recommended.
Availability (generic available)
- Assess allergy symptoms (rhinitis, conjunctivitis, hives) before and periodically during therapy.
- Assess lung sounds and character of bronchial secretions. Maintain fluid intake of 1500–2000 mL/day to decrease viscosity of secretions.
- Lab Test Considerations: May cause false-negative result in allergy skin testing.
Potential Nursing DiagnosesIneffective airway clearance (Indications)
Risk for injury (Adverse Reactions)
- Do not confuse cetirizine with sertraline. Do not confuse Zyrtec (cetirizine) with Lipitor (atorvastatin), Zantac (ranitidine), Zocor (simvastatin), Zyprexa (olanzapine), Zyrtec-D (cetirizine/pseudoephedrine), Zyrtec Itchy Eye Drops (ketotifen fumarate).
- Oral: Administer once daily without regard to food.
- Instruct patient to take medication as directed.
- May cause dizziness and drowsiness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
- Advise patient to avoid taking alcohol or other CNS depressants concurrently with this drug.
- Advise patient that good oral hygiene, frequent rinsing of mouth with water, and sugarless gum or candy may minimize dry mouth. Patient should notify dentist if dry mouth persists >2 wk.
- Instruct patient to contact health care professional if dizziness occurs or if symptoms persist.
- Decrease in allergic symptoms.