Cetirizine.

Generic and proprietary names
- Cetirizine.

- Benadryl.

- Zirtek.

Action
- Blocks histamine binding, preventing allergy symptoms.

Classification
- Functional: antihistamines (second generation, peripherally selective).

- Chemical: Piperazine H1 histamine antagonist.

Indications
- Symptom relief from nasal allergies such as hay fever.

- Symptom relief from insect bites and skin rashes.

Contraindications
- Hypersensitivity.

- Lactation.

- Not recommended for children under two years of age.

Cautions
- Hepatic disease.

- Renal impairment.

- Epilepsy.

Common side-effects
- The incidence of sedation and antimuscarinic side-effects is low, especially compared with older, sedating antihistamines, because cetirizine only penetrates the blood-brain barrier to a slight extent.

- Children and older people may be more sensitive to side-effects.

- Dry mouth.

- Headache.

- Psychomotor impairment.

- Blurred vision.

- Sore throat.

- Gastrointestinal disturbances.

Rare side-effects
- Palpitations.

- Arrhythmias.

- Hypotension.

- Hypersensitivity.

- Extrapyramidal effects.

- Sleep disturbances.

- Depression.

Interactions
- Antimuscarinic and sedative effects are increased with monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants.

Administration
- Tablets.

- Oral solution.

Nursing considerations
- Assess symptoms and record baseline before and during treatment.

- Assess respiratory status, such as wheeze or tightness of the chest.

- Cetirizine is good at reducing rhinorrhoea and sneezing, but less effective at reducing nasal congestion.

- Other products such as eyedrops and inhalers may be required to control severe hay fever.

- Evaluate therapeutic response.

- If allergy-testing is planned, medication should be stopped 48 hours before testing.

Patient teaching
- Ensure patients are aware that this medication may make them drowsy. If affected they should not drive or operate machinery.

- Alcohol can increase any drowsiness.

- Patients who have missed a dose should take it as soon as they remember. If it is almost time for the next dose, patients should skip the missed dose. Double doses should not be taken.

- Health education advice should be given regarding limiting exposure to allergens.

Nurses should refer to manufacturer's summary of product characteristics and to appropriate local guidelines

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