Q: I enjoy your column and thank God it is available. It has helped me a number of times. I am grateful that I am able to write to you.
My 22-year-old daughter has been on Zyrtec daily for almost six years for allergies. She began getting allergy shots and decided to stop the Zyrtec. The first time was for five days. It was winter and she complained about being very itchy, she had heart palpitations, woke up with night terrors, and had bad anxiety. We attributed it to winter, dry skin, snowy days, and being cooped up in the house. She went back on Zyrtec because of feeling like liquid was in her ears and everything was back to normal. About two months later she decided to stop the Zyrtec again. All the same symptoms appeared and the anxiety was so bad she had to leave work. She was sobbing and shaking and this time it was with the feeling of impending doom. We discussed what had changed in her life and tried to make sense of it. The only thing we could figure was her stopping the Zyrtec.
We searched the internet and found many message boards with tale after tale of people, young and old, experiencing these same symptoms in various degrees after stopping Zyrtec. Of course when we went on Zyrtec’s website, there was nothing about withdrawal problems. Have you heard anything about this and what would you suggest for her t5o do to wean herself off this?
Please get the word out that something sold OTC can have wild side effects when stopped. Thank you for your attention to this. I eagerly look forward to your response.
A: Zyrtec is an antihistamine prescribed to lessen the effects of naturally occurring histamine that can produce symptoms of watery eyes, sneezing, itching, vision problems, tremors, insomnia, cardiac arrhythmias, fatigue, and more. Hypersensitivity side effects have been reported by patients who discontinue the product, as have depression, delusional thinking, and aggressive behavior. Serious reactions are rare according to packaging details. Despite this, some individuals appear to have symptoms that are comparable to those your daughter has — rash, dizziness, difficulty breathing, and itching.
Controlled and uncontrolled clinical trials on Zyrtec conducted in both the US and Canada have included more than 6,000 patients aged 12 and older. More than 3,900 individuals on doses of between 5 and 20 mg daily for a period of between one week and six months were involved in the studies. Most negative reactions were mild to moderate. Adverse reactions in patients 12 and older taking a maximum dose of 10 mg report somnolence in 13.7% of patients, fatigue in 5.9%, dry mouth in 5.0%, and headaches and nausea in more than 2%.
You are correct in that there are countless notations from patients reporting on the internet regarding withdrawal of Zyrtec yet nothing appears on the package insert warning patients of potential ill effects. The FDA has guidelines on when to place warnings but apparently those warnings haven’t yet been included on Zyrtec packaging. When a product – OTC or via prescription — appears to affect numerous individuals, I agree that a warning panel should be included, so congratulations for doing your part to spread the word.
On the home front, one recommendation for control is that a gradual decrease in dosing may help. After about two weeks, the itching should be reduced and is reported to gradually disappear. Another possibility is a short course of corticosteroids while weaning off the OTC. Your daughter might ask about a steroid for control. One last thought is that an antihistamine might provide a degree of treatment. She should speak with her prescribing physician in regard to these possibilities for management.
