Home Drug Guide Cetirizine Hydrochloride

Drug Guide

Generic Name

Cetirizine Hydrochloride

Brand Names Zyrtec Allergy, Zyrtec Hives, Zyrtec, Children's Zyrtec Allergy, Children's Zyrtec Hives Relief, Children's Zyrtec Hives, Cetirizine Hydrochloride Allergy, Cetirizine Hydrochloride Hives Relief, Cetirizine Hydrochloride Hives, Children's Cetirizine Hydrochloride Allergy, Children's Cetirizine Hydrochloride Hives Relief, Zerviate, Quzyttir

Classification

Therapeutic: Antihistamine, Allergy Agent

Pharmacological: Piperazine Derivative H1 Receptor Antagonist

FDA Approved Indications

  • Allergic rhinitis (seasonal and perennial)
  • Chronic urticaria (hives)

Mechanism of Action

Cetirizine selectively antagonizes peripheral H1 receptors, thereby reducing the allergic response caused by histamine.

Dosage and Administration

Adult: 10 mg once daily, can be adjusted based on response and tolerability.

Pediatric: 2-6 years: 5 mg once daily; over 6 years: 10 mg once daily.

Geriatric: Start with lower dose in elderly; monitor for sedation and anticholinergic effects.

Renal Impairment: Dose adjustment needed; typically 5 mg or less in severe impairment.

Hepatic Impairment: Use with caution; no specific dose adjustment recommended, but monitor for adverse effects.

Pharmacokinetics

Absorption: Rapidly absorbed with peak plasma concentrations at ~1 hour.

Distribution: Widely distributed; crosses the blood-brain barrier minimally.

Metabolism: Minimal hepatic metabolism; primarily excreted unchanged.

Excretion: Urinary excretion of unchanged drug; also through feces.

Half Life: Approx. 8 hours (adults); longer in renal impairment.

Contraindications

  • Hypersensitivity to cetirizine or hydroxyzine.
  • Children under 2 years of age for some formulations.

Precautions

  • Use with caution in renal or hepatic impairment.
  • Monitor for sedation and anticholinergic effects.
  • Use caution in elderly due to increased sensitivity.

Adverse Reactions - Common

  • Drowsiness (Common)
  • Headache (Common)
  • Dry mouth (Less common)
  • Fatigue (Less common)

Adverse Reactions - Serious

  • Pruritus, rash, or other hypersensitivity reactions (Rare)
  • Cardiovascular reactions (e.g., tachycardia) (Rare)

Drug-Drug Interactions

  • Other central nervous system depressants (increased sedation)
  • Theophylline (may alter clearance)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for effectiveness and adverse effects, especially sedation.

Diagnoses:

  • Risk for sedation related to CNS effects.
  • Risk for allergic reaction if hypersensitive.

Implementation: Administer with or without food. Advise patient to avoid alcohol and CNS depressants.

Evaluation: Assess relief of allergy symptoms and adverse effects.

Patient/Family Teaching

  • Take medication as prescribed.
  • Avoid alcohol and sedatives while taking cetirizine.
  • Report any signs of allergic reactions or unusual side effects.

Special Considerations

Black Box Warnings:

  • No black box warnings for cetirizine.

Genetic Factors: Consider genetic variability in metabolism, though unlikely to impact typical dosing.

Lab Test Interference: No known significant interference with laboratory tests.

Overdose Management

Signs/Symptoms: Severe drowsiness, hallucinations, agitation, or seizures in overdose.

Treatment: Supportive care, activated charcoal if ingestion is recent, gastric lavage, and monitoring. No specific antidote.

Storage and Handling

Storage: At room temperature, away from moisture and light.

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.