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Pharmacologic class: Histamine1 (H1)-receptor antagonist
Therapeutic class: Antihistamine
Pregnancy risk category B
Exerts principal antihistaminic effects via selective inhibition of H1 receptors
Oral solution: 2.5 mg/5 ml (0.5 mg/ml)
Tablets: 5 mg
Indications and dosages
➣ Symptoms of allergic rhinitis (seasonal and perennial); uncomplicated skin manifestations of chronic idiopathic urticaria
Adults and children ages 12 and older: 5 mg P.O. daily in evening
Children ages 6 to 11: 2.5 mg P.O. daily in evening; don't exceed recommended dosage.
• Renal impairment.
• Hepatic impairment
• Hypersensitivity to drug, its components, or cetirizine
• End-stage renal disease
• Renal impairment (children ages 6 to 11)
Use cautiously in:
• renal impairment
• pregnant patients
• elderly patients
• breastfeeding patients (use not recommended)
• children younger than age 6 (safety and efficacy not established).
• Give with or without food.
CNS: somnolence, fatigue, asthenia
EENT: epistaxis (children), nasopharyngitis, pharyngitis
GI: dry mouth
Respiratory: cough (children)
Other: pyrexia (children)
Drug-drug. Ritonavir: increased levocetirizine blood level and half-life, decreased clearance
Drug-behaviors. Alcohol use: increased risk of impaired CNS function
• Stay alert for excessive CNS depression.
• Closely monitor renal function tests in patients with renal impairment.
• Tell patient drug can be taken with or without food.
• Instruct patient to avoid alcohol and other depressants, such as sleeping pills, unless prescriber approves.
• Caution patient to avoid hazardous activities until drug's effects on concentration and alertness are known.
• Advise female patient to notify prescriber if she is pregnant or intends to become pregnant.
• Tell breastfeeding patient to discontinue breastfeeding during therapy.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs and behaviors mentioned above.
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Adverse Reactions/Side Effects
Central nervous system
- dry mouth
- urinary retention
Drug-Drug interaction↑ levels of ritonavir.↑ CNS depression may occur with alcohol, opioid analgesics, or sedative hypnotics.
Renal ImpairmentOral (Children 6–11 yr) 2.5 mg once daily in the evening.
Renal Impairment(Adults and Children ≥12 yr) CCr 50–80 mL/min—2.5 mg once daily; CCr 30–50 mL/min—2.5 mg every other day; CCr 10–30 mL/min—2.5 mg twice weekly (every 3–4 days).
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.
- May cause transient ↑ in serum bilirubin and transaminases.
Potential Nursing DiagnosesIneffective airway clearance (Indications)
Risk for injury (Adverse Reactions)
- Oral: Administer once daily in the evening without regard to food. Solution is clear and colorless; administer undiluted.
- Instruct patient to take medication as directed. Do not increase doses; may cause increased drowsiness.
- May cause 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.
- Decrease in allergic symptoms.
- Resolution of uncomplicated skin manifestations of chronic idiopathic urticaria.