Cetirizine Tablets

What is Cetirizine?

Cetirizine 10mg film-coated tablets contain the active substance cetirizine hydrochloride, which belongs to a class of medicines called second-generation antihistamines. Cetirizine is a selective H1-receptor antagonist that provides effective relief from allergy symptoms with a lower risk of sedation compared to first-generation antihistamines.

Mechanism of Action

Cetirizine works through a targeted mechanism:

• Histamine blockade: Competitively antagonizes peripheral H1 receptors
• Anti-inflammatory effects: Reduces migration of inflammatory cells to allergic sites
• Rapid onset: Begins working within 1 hour of administration
• Long duration: Provides 24-hour symptom relief with single daily dosing

Think of histamine as a key that unlocks allergy symptoms - Cetirizine effectively blocks the keyhole, preventing histamine from triggering sneezing, itching, and other allergic reactions. The drug is minimally metabolized, with most of the dose excreted unchanged in urine.

What is Cetirizine Used For?

Cetirizine is indicated for the relief of symptoms associated with:

• Seasonal allergic rhinitis (hay fever): Sneezing, runny or blocked nose, itchy/red/watery eyes
• Perennial allergic rhinitis (year-round allergies): Symptoms caused by dust mites, pet dander, mould
• Chronic idiopathic urticaria: Swelling, redness and itching of the skin (chronic nettle rash/hives)

Approved Patient Groups

Before Using Cetirizine

Essential considerations before initiating treatment:

Medical History Assessment

• Kidney disease or impairment (requires dose adjustment)
• Predisposition to urinary retention (spinal cord lesion, prostatic hyperplasia)
• Epilepsy or risk of convulsions
• Known hypersensitivity to cetirizine, hydroxyzine, or piperazine derivatives
• Planned allergy skin tests (stop Cetirizine 3 days before testing)

Required Considerations

1. Assess renal function if kidney impairment is suspected
2. Confirm patient is not pregnant
3. Evaluate for lactose intolerance (tablets contain lactose)
4. Review for predisposition to urinary retention
5. Consider epilepsy history or seizure risk

Cetirizine Contraindications

Absolute contraindications where Cetirizine must not be used:

Absolute Contraindications

• Severe renal impairment (creatinine clearance below 10 ml/min)
• Hypersensitivity to cetirizine or any excipients
• Hypersensitivity to hydroxyzine (closely related active substance)
• Hypersensitivity to piperazine derivatives (e.g., buclizine, cyclizine, meclozine)
• Children under 6 years old (tablet formulation doesn't allow dose adjustment)

Special Warnings

Special Population Considerations

Elderly Patients (≥65 years)

• No specific dose adjustment generally required
• Increased monitoring for side effects recommended
• Consider potential age-related renal impairment
• Higher risk of urinary retention

Renal Impairment

• Mild impairment: No dose adjustment needed
• Moderate impairment (creatinine clearance 30-49 ml/min): 5mg once daily
• Severe impairment (creatinine clearance 10-29 ml/min): 5mg every other day
• End-stage renal disease (<10 ml/min): Contraindicated

Hepatic Impairment

• No specific dose adjustment required
• Use with caution in severe hepatic impairment
• Monitor for increased side effects

Paediatric Population

• Children 12 years and older: 10mg once daily
• Children 6-12 years: 5mg twice daily (half tablet twice daily)
• Children under 6 years: Not recommended (use paediatric formulations)

Cetirizine and Other Medicines

According to the BNF guidelines, no clinically significant interactions with other drugs are expected due to cetirizine's pharmacokinetic profile. However, consider these points:

Potential Interactions

• CNS depressants: Alcohol, sedatives, tranquillizers - may increase drowsiness
• Theophylline: Slight decrease in cetirizine clearance (not clinically significant)
• Ketoconazole: Increased cetirizine levels (no dosage adjustment needed)

Important Timing Notes

Based on the official NHS guidelines:

• No food interactions - can be taken with or without meals
• Alcohol should be avoided due to potential additive sedative effects
• Always inform your doctor about all medicines you take, including over-the-counter products

Pregnancy & Breastfeeding

Pregnancy

• Avoid use during pregnancy unless clearly needed
• Limited human data available
• Animal studies show no direct harmful effects at therapeutic doses
• Accidental use during pregnancy should not produce harmful effects, but medical advice should be sought
• Use only if clearly needed and after medical consultation

Breastfeeding

• Cetirizine passes into breast milk
• Side effects may be seen in breastfed infants
• Do not take during breastfeeding unless advised by a doctor
• Consider alternative antihistamines approved for breastfeeding
• Discuss with healthcare provider about risks vs benefits

Driving & Machine Operation

• Clinical studies show no evidence of impaired attention, alertness or driving capabilities at recommended doses
• However, individual responses vary - some may experience drowsiness
• Precautions:
  • Observe your response before driving or operating machinery
  • Do not exceed recommended dose
  • Avoid alcohol and other CNS depressants
  • If you feel drowsy, do not drive or engage in hazardous activities
• Sensitive patients may experience additional impairment with alcohol or other depressants

Cetirizine Ingredients

Active Substance

• Cetirizine hydrochloride 10mg per film-coated tablet

Excipients

Allergen Information

• Contains lactose - patients with lactose intolerance should not take
• Free from gluten, soy, nuts (but always check specific product)
• Vegetarian suitable (contains no animal-derived ingredients)

How to Use Cetirizine Tablets

Preparation Steps

1. Wash hands thoroughly before handling tablets
2. Remove tablet from blister pack by pushing through foil
3. For children 6-12 years or dose adjustment: break tablet along score line
4. Tablet can be taken with or without food
5. Swallow whole with a glass of water or other liquid

Administration Technique

• Timing: Take at approximately the same time each day
• With food: Can be taken with or without meals
• Breaking tablets: Only for children 6-12 years or dose adjustment in renal impairment
• Liquid intake: Ensure adequate water to swallow tablet

Cetirizine Dosage Guidelines

Standard Dosage Schedule

Dose Adjustment Criteria

• No titration required - start with therapeutic dose
• Do not exceed recommended doses
• For renal impairment: reduce frequency or dose amount
• Treatment duration: Can be used as needed or long-term under medical supervision
• Duration depends on type, duration and course of symptoms

Administration Instructions

Step-by-step administration guide:

For Adults and Adolescents ≥12 years

1. Take one tablet (10mg) orally once daily
2. Swallow whole with water or other drink
3. Can be taken at any time of day that suits your schedule
4. Maintain consistent timing for optimal symptom control

For Children 6-12 years

1. Break tablet along the score line using clean, dry hands
2. Give half tablet (5mg) twice daily
3. Space doses approximately 12 hours apart
4. Ensure child swallows with adequate water

For Patients with Swallowing Difficulties

1. Break tablet if prescribed half dose
2. Take with adequate liquid
3. Do not crush or chew unless directed by healthcare professional
4. Consider alternative formulations if persistent difficulty

Missed Dose Management

General Principles

• Do NOT double doses to make up for forgotten tablet
• Take as soon as remembered if within a few hours
• If close to next dose time, skip missed dose
• Wait at least 24 hours before taking next tablet

Time-Based Guidance

Overdose Information

Symptoms

• Confusion, dizziness, tiredness
• Headache, restlessness, agitation
• Diarrhoea, dilated pupils, itching
• Sedation, somnolence, stupor
• Tachycardia (rapid heart rate), tremors
• Urinary retention

Management

1. Seek immediate medical attention or call 111
2. Bring medication packaging to hospital
3. Symptomatic treatment:
   • Activated charcoal if within 1 hour of ingestion
   • Cardiac monitoring for tachycardia
   • Supportive care for CNS symptoms
   • Catheterization for urinary retention if needed
4. No specific antidote available
5. Haemodialysis not effective (cetirizine highly protein-bound)

Possible Side Effects

Like all medicines, Cetirizine can cause side effects, although not everyone gets them. According to clinical studies, cetirizine has a favorable safety profile compared to first-generation antihistamines.

Common (may affect up to 1 in 10 patients)

• Fatigue, somnolence (sleepiness)
• Dizziness, headache
• Dry mouth, nausea (feeling sick)
• Diarrhoea (children only)
• Pharyngitis (sore throat), rhinitis (children only)

Uncommon (may affect up to 1 in 100 patients)

• Pruritus (itching), rash
• Abdominal pain
• Agitation
• Asthenia (feeling of weakness), malaise
• Paraesthesia (abnormal skin sensations), tingling in hands/feet

Rare (may affect up to 1 in 1,000 patients)

Very Rare (may affect up to 1 in 10,000 patients)

• Thrombocytopenia (low platelets - bleeding risk)
• Visual disturbances (accommodation disorder, blurred vision, nystagmus)
• Syncope (fainting), dyskinesia, dystonia, tremor, dysgeusia
• Tics (abnormal repetitive movements)
• Fixed drug eruption (red/swollen skin patches)
• Urinary problems (incontinence, dysuria, retention)

Frequency Not Known

• Increased appetite
• Suicidal ideation, nightmares
• Amnesia, memory impairment
• Vertigo (sensation of spinning)
• Joint pain
• Pustular rash
• Hepatitis (liver inflammation)
• Pruritus/urticaria upon discontinuation

How to Store Cetirizine

Storage Conditions

• Store in original packaging to protect from moisture
• No special temperature requirements - store at room temperature
• Keep out of sight and reach of children
• Do not use after expiry date printed on box and blister

Expiry Information

• Check expiry date before use
• Do not use if tablets appear discoloured or damaged
• Do not store above 25°C
• Protect from light and moisture

Disposal

• Do not dispose of medicines via wastewater or household waste
• Return unused or expired tablets to pharmacy for safe disposal
• These measures help protect the environment

Pack Information

Available Pack Sizes

• 7 tablets (1-week supply for adults)
• 10 tablets
• 30 tablets (1-month supply for adults)

Note: Not all pack sizes may be marketed or available through all suppliers.

Tablet Appearance

• White, capsule-shaped film-coated tablets
• Score line on one side for breaking if needed
• Approximately 15mm in length
• Smooth, coated surface

Marketing Authorisation

• Holder/Manufacturer: Dexcel Pharma Ltd, 7 Sopwith Way, Drayton Fields, Daventry, Northamptonshire, NN11 8PB, UK
• Product licence number: PL 14017/0157
• Leaflet last revised: June 2019

Where Can I Buy Cetirizine Online in the UK