cetirizine HCl Nursing Considerations & Management

Cetirizine HCl (Zyrtec) is an antihistamine used in the management of seasonal allergic rhinitis.

Generic Names & Brand Names

cetirizine hydrochloride

(se teer i zeen)

Reactine (CAN), Zyrtec

Pregnancy Category B

Drug class


Therapeutic actions

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

  • 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.
  • Use cautiously with 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; chewable tablets—5, 10 mg; syrup—5 mg/5 mL

  • 5–10 mg daily PO; maximum dose 20 mg/day.
  • 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; 2–5 yr—one 5 mg chewable tablet per day.
  • 6–11 yr: 5 or 10 mg daily PO.
  • > 12 yr: Use adult dosage.
  • 5 mg PO daily.
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.
  • 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 examination; R, adventitious sounds; prostate palpation; renal function tests
  • Give without regard to meals.
  • Provide syrup form or chewable tablets 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.
  • You may experience these side effects: 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.