cetirizine hydrochloride

(se teer' i zeen)

Reactine (CAN), Zyrtec

Pregnancy Category B

Drug class
Antihistamine

Therapeutic actions
Potent histamine (H1) receptor antagonist; inhibits histamine release and eosinophil
chemotaxis during inflammation, leading to reduced swelling and decreased
inflammatory response

Indications
• Management of seasonal and perennial allergic rhinitis
• Treatment of chronic, idiopathic urticaria
• Treatment of year-round allergic rhinitis and chronic idiopathis urticaria in infants
> 6 mo

Contraindications and cautions

• Contraindicated with allergy to any antihistamines, hydroxyzine; narrow-angle
glaucoma, stenosing peptic ulcer, symptomatic prostatic hypertrophy, asthmatic
attack, bladder neck obstruction, pyloroduodenal obstruction (avoid use or use
with caution as condition may be exacerbated by drug effects); lactation

Available forms
Tablets—5, 10 mg; syrup—5 mg/5 mL

Dosages
ADULTS
5–10 mg daily PO; maximum dose 20 mg/day.
PEDIATRIC PATIENTS
6 mo–5 yr: 2.5 mg (one-half teaspoon) PO once daily. In children 1 yr and older, may
increase to maximum 5 mg daily given as one-half teaspoon q 12 hr.
6–11 yr: 5 or 10 mg daily PO.
> 12 yr: Use adult dosage.
PATIENTS WITH HEPATIC OR RENAL IMPAIRMENT
5 mg PO daily.

Pharmacokinetics
Route Onset Peak Duration
Oral Rapid 1 hr 24 hr

Metabolism: Hepatic; T1/2: 7–10 hr

Distribution: Crosses placenta; enters breast milk
Excretion: Urine and feces
Adverse effects
• CNS: Somnolence, sedation
• CV: Palpitation, edema
• GI: Nausea, diarrhea, abdominal pain, constipation
• Respiratory: Bronchospasm, pharyngitis
• Other: Fever, photosensitivity, rash, myalgia, arthralgia, angioedema

Nursing considerations
CLINICAL ALERT!
Name confusion has occurred between Zyrtec (cetirizine) and Zyprexa
(olanzapine); use caution.

Assessment
• History: Allergy to any antihistamines, hydroxyzine; narrow-angle glaucoma,
stenosing peptic ulcer, symptomatic prostatic hypertrophy, asthmatic attack,
bladder neck obstruction, pyloroduodenal obstruction; lactation
• Physical: Skin color, lesions, texture; orientation, reflexes, affect; vision exam; R,
adventitious sounds; prostate palpation; renal function tests

Interventions
• Give without regard to meals.
• Provide syrup form for pediatric use if needed.
• Arrange for use of humidifier if thickening of secretions, nasal dryness become
bothersome; encourage adequate intake of fluids.
• Provide skin care for urticaria.

Teaching points
• Take this drug without regard to meals.
• These side effects may occur: Dizziness, sedation, drowsiness (use caution if
driving or performing tasks that require alertness); thickening of bronchial
secretions, dryness of nasal mucosa (humidifier may help).
• Report difficulty breathing, hallucinations, tremors, loss of coordination, irregular
heartbeat.

Adverse effects in Italic are most common; those in Bold are life-threatening.