Adult: 10 mg 24 hourly over 1-2 minutes. Child: 6 months to 5 years 2.5 mg 24 hourly; 6-11 years 5-10 mg 24 hourly, depending on the severity of symptoms; ≥12 years Same as adult dose.
Ophthalmic Ocular itching associated with allergic conjunctivitis
Adult: Instil 1 drop into the affected eye(s) bid (approx 8 hours apart). Child: ≥2 years Same as adult dose.
Oral Allergic conditions
Adult: For symptomatic relief of seasonal and perennial allergic rhinitis; chronic idiopathic urticaria: 10 mg once daily. Child: 6-12 years 5 mg bid; >12 years Same as adult dose. Treatment and dosing recommendations may vary among individual products and between countries (refer to specific product guidelines).
Renal Impairment
Oral:
Treatment and dosing recommendations may vary among individual products and between countries (refer to specific product guidelines).
CrCl (mL/min)
Dosage
<10
Contraindicated.
<30
5 mg once every 2 days.
30-49
5 mg once daily.
50-79
Same as adult dose.
Administration
May be taken with or without food.
Contraindications
Severe renal impairment.
Special Precautions
Patients with epilepsy and patients at risk of convulsions; risk factors for urinary retention (e.g. spinal cord lesion, prostatic hyperplasia). Hepatic and mild to moderate renal impairment. Children, elderly. Pregnancy and lactation.
Adverse Reactions
Eye disorders: Decreased visual acuity, ocular hyperaemia (ophth soln). Gastrointestinal disorders: Abdominal pain, dry mouth, nausea, diarrhoea, vomiting. General disorders and administration site conditions: Fatigue, local pain at instillation site (ophth). Nervous system disorders: Dizziness, headache, somnolence. Respiratory, thoracic and mediastinal disorders: Pharyngitis, rhinitis, epistaxis, bronchospasm.
Patient Counseling Information
This drug may cause CNS depression (e.g. somnolence), if affected, do not drive or operate machinery. Remove contact lenses prior to admin of cetirizine ophthalmic solution, wait 10 minutes before reinserting.
Monitoring Parameters
Monitor relief of symptoms, sedation, mental alertness, and anticholinergic effects.
Overdosage
Symptoms: Confusion, diarrhoea, dizziness, fatigue, headache, malaise, mydriasis, pruritus, restlessness, sedation, somnolence, stupor, tachycardia, tremor, and urinary retention. Management: Symptomatic and supportive treatment. Gastric lavage may be performed following early ingestion.
Drug Interactions
Additive CNS depression when administered concomitantly with other CNS depressants.
Food Interaction
Decreased rate of absorption with food. Enhanced CNS depressant effect with alcohol.
Lab Interference
May cause false-positive serum TCA screen. May suppress the wheal and flare reactions to skin test antigens.
Action
Description: Mechanism of Action: Cetirizine, a piperazine derivative and metabolite of hydroxyzine, is an antihistamine which competitively and selectively inhibits H1 receptors in the gastrointestinal tract, blood vessels, and respiratory tract. Onset: Suppression of skin wheal and flare: 20-60 minutes. Duration: Suppression of skin wheal and flare: ≥24 hours. Pharmacokinetics: Absorption: Rapidly absorbed from the gastrointestinal tract. Decreased rate of absorption with food. Time to peak plasma concentration: Approx 1 hour. Distribution: Enters breast milk. Volume of distribution: 0.56 L/kg. Plasma protein binding: 93%. Metabolism: Metabolised limitedly in the liver. Excretion: Mainly via urine (50% as unchanged drug); faeces (10%). Elimination half-life: 8 hours.
Chemical Structure
Cetirizine Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 2678, Cetirizine. https://pubchem.ncbi.nlm.nih.gov/compound/Cetirizine. Accessed June 29, 2022.
S01GX12 - cetirizine ; Belongs to the class of other ophthalmologic antiallergics. R06AE07 - cetirizine ; Belongs to the class of piperazine derivatives used as systemic antihistamines.
References
Anon. Cetirizine (EENT). AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 10/02/2022.Anon. Cetirizine (Ophthalmic). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 10/02/2022.Anon. Cetirizine (Systemic). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 10/02/2022.Anon. Cetirizine. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 10/02/2022.Benadryl Allergy Liquid Release 10 mg Capsules (McNeil Products Limited). MHRA. https://products.mhra.gov.uk. Accessed 10/02/2022.Buckingham R (ed). Cetirizine Hydrochloride. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 10/02/2022.Cetirizine Hydrochloride Chewable Tablet (Sandoz Private Ltd.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 10/02/2022.Cetirizine Hydrochloride Oral Solution (Aidarex Pharmaceuticals, LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 10/02/2022.Cetirizine Hydrochloride Tablet (Mylan Pharmaceuticals Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 10/02/2022.Children’s Zyrtec Syrup (Johnson & Johnson Consumer Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 10/02/2022.GlaxoSmithKline Consumer Healthcare. Cetirizine Hydrochloride (BP) 10 mg Film Coated Tablets/Cetirizine Hydrochloride (BP) 1 mg/1 mL Oral Solution data sheet 29 May 2020. Medsafe. http://www.medsafe.govt.nz. Accessed 10/02/2022.Joint Formulary Committee. Cetirizine Hydrochloride. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 10/02/2022.Piriteze Allergy 1 mg/mL Syrup (GlaxoSmithKline Consumer Healthcare [UK] Trading Limited). MHRA. https://products.mhra.gov.uk. Accessed 10/02/2022.Quzyttir Injection (TerSera Therapeutics LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 10/02/2022.Zerviate Ophthalmic Solution (Eyevance Pharmaceuticals LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 10/02/2022.Zirtek Allergy Relief 10 mg Film-coated Tablets (UCB Pharma Ltd). MHRA. https://products.mhra.gov.uk. Accessed 10/02/2022.Zirtek Allergy Relief for Children 1 mg/mL Oral Solution (UCB Pharmaceuticals Limited). MHRA. https://products.mhra.gov.uk. Accessed 10/02/2022.Zyrtec Capsule (Johnson & Johnson Consumer Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 10/02/2022.
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