From the Guidelines
Cetirizine is a suitable option for treating allergy symptoms, but it may cause mild drowsiness in some patients, and its efficacy is comparable to other second-generation antihistamines 1.
Key Points
- Cetirizine is a second-generation antihistamine that works by blocking histamine receptors to prevent allergy symptoms.
- The standard adult dose is 10 mg once daily, and it can be taken with or without food.
- Cetirizine may cause mild drowsiness in some patients, especially at higher doses, but it is generally considered to be a non-sedating antihistamine 1.
- The efficacy of cetirizine is comparable to other second-generation antihistamines, and no single agent has been conclusively shown to have superior overall response rates 1.
Considerations
- Patients should be cautioned about the potential risk of sedative properties when taking cetirizine, especially at higher doses.
- Cetirizine may be associated with performance impairment, especially at doses higher than 10 mg 1.
- The use of cetirizine in combination with other medications, such as intranasal corticosteroids, may provide additional symptom relief for patients with allergic rhinitis 1.
Recommendations
- Cetirizine can be recommended as a first-line treatment for allergy symptoms, but patients should be monitored for potential side effects and adjusted as needed 1.
- Patients who do not respond to cetirizine may be considered for alternative treatments, such as other second-generation antihistamines or combination therapy with intranasal corticosteroids 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Overview of Cetirizine
- Cetirizine is a selective, second-generation histamine H1 receptor antagonist with a rapid onset and long duration of activity 2.
- It has a low potential for interaction with drugs metabolized by the hepatic cytochrome P450 system 2.
- Cetirizine is effective in treating symptoms of seasonal allergic rhinitis (SAR), perennial allergic rhinitis (PAR), and chronic idiopathic urticaria (CIU) in adult, adolescent, and pediatric patients 2, 3, 4.
Efficacy and Safety
- Cetirizine was generally more effective than other H1 receptor antagonists at inhibiting histamine-induced wheal and flare responses 2.
- It was as effective as conventional dosages of ebastine, fexofenadine, loratadine, or mizolastine in adults with SAR, PAR, or CIU 2.
- Cetirizine was well tolerated in adults, adolescents, and pediatric patients with allergic disorders, with a low incidence of somnolence and no adverse effects on cognitive function 2, 3, 5.
- The most commonly reported adverse reactions to cetirizine were headache, pharyngitis, and abdominal pain, which did not occur with an incidence statistically different from that of placebo 3.
Clinical Applications
- Cetirizine has anti-inflammatory properties that may play a role in asthma management 5.
- It does not interact with concomitantly administered medications and has no cardiac adverse effects 5, 6.
- Cetirizine may be useful in the treatment and prevention of mild asthma, and it decreases the duration and amount of topical anti-inflammatory preparations needed for the treatment of atopic dermatitis 5, 6.
- Dose titration of cetirizine may allow for greater efficacy and quality of life, especially for patients with refractory symptoms of allergic rhinitis 6.