Zyrtec Side Effects: Generic name cetirizine. Zyrtec is available in 10 mg oral tablets and capsules as well as 5 gm/5 ml liquid. Zyrtec is a second generation antihistamine, marketed primarily as a non-sedating antihistamine. This is really a misnomer, as all antihistamines have some degree of sedation as a common side effect, and Zyrtec is no exception. Actually sedation as a Zyrtec side effect is probably somewhat more common than with the competing drugs including Allegra and Claritin.

Common Zyrtec Side Effects: Like all antihistamines Zyrtec side effects include the whole spectrum of anti-cholinergic effects. These include dry mouth, drowsiness and fatigue, dizziness, and fatigue. Other common Zyrtec side effects include headache, abdominal pain, dizziness, sore throat, nausea, vomiting, and diarrhea. Overall though, Zyrtec, like the competing drugs Claritin and Allegra, is very well tolerated without side effects of concern in a large percentage of patients.

Serious Side Effects: Fortunately, serious Zyrtec side effects are very uncommon. They include liver issues like cholestasis and hepatitis, allergic reactions including anaphylaxis and bronchospasm, hematologic side effects including hemolytic anemia and thrombocytopenia (low platelet count), low blood pressure and fainting, and seizures.

Drug Interactions: Zyrtec when combined with other antihistamines may have an additive effect of sedation. This may especially be an issue with dexmedetomidine. Other antihistamines of concern for additive sedation include Benadryl, Chlorpheneramine, and really any of the antihistamines or antihistamine/decongestant combination drug products. Many of the antidepressants, especially amitriptyline, imipramine, and the rest of the tricyclics can also have additive sedation side effects. Opiates like codeine, hydrocodone, oxydocone, morphine, and others also can have additive sedation side effects. All of the barbiturates, benzodiazapines, centrally acting Alpha-2 agonists, and really any drugs with anti-cholinergic side effect can exacerbate the sedation Zyrtec side effects. Alcohol is also sedation and can add to the sedation issues. See the manufacturer’s prescriber information for a complete list of Zyrtec drug interactions.

Pregnancy and Lactation: Zyrtec is pregnancy category B, considered safe with no animal studies showing risk or adverse effects but no controlled human studies available. Lactation safety is unknown with Zyrtec.

Special considerations: Zyrtec is generally considered quite safe, but as with all medications that can have sedation as a possible side effect, driving or operating potentially dangerous equipment while taking Zyrtec is a concern. Anyone who feels that they have sedation as a Zyrtec side effect should not drive while on this medication. In this situation one of the alternative drugs in the second generation antihistamine class may be a less sedation option. These include Allegra and Zyrtec. Xyzal, an isomer of Zyrtec is sometimes less sedating than Zyrtec and may also be an option.

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