Chances are good that you have seen a Xyzal commercial on TV. You see an animated owl with a distinctive accent. He wears a monocle…presumably to give this wise owl some extra authority. He lets you know that Xyzal “lasts up to six times longer than Benadryl, works faster than Claritin and offers the same relief as Zyrtec at only half the size.” What is not mentioned in the commercial is that some people may experience unbearable itching after stopping Xyzal. Read the FDA’s response to our concerns about this unexpected complication below!

A Reader Reports Bad Itching After Stopping Xyzal:

Q. Every time I stop taking the antihistamine Xyzal, I’m fine until a few days later when the itching starts. It soon becomes unbearable.

I have struggled with this for over two years. My doctors think I’m nuts. They tell me the withdrawal itching is all in my head.

Now I’m terrified to quit the drug. Every time that I stop Xyzal and the hives start, I pop another pill. Will I ever be able to stop?

A. You are not the only one to report withdrawal itching with levocetirizine (Xyzal) or its chemical cousin, cetirizine (Zyrtec). An article in Drug Safety Case Reports (Dec. 2016) presents 12 cases and suggests gradual tapering of the dose.  Visitors to our website (www.PeoplesPharmacy.com) have described a variety of strategies to phase off these antihistamines. Search “itching.”

We have been writing about the Zyrtec Itch for years. Here is one article you may find of interest:

The Zyrtec Itch is Unbearable | Where’s the FDA?

The FDA’s Response to Our Questions About Itching After Stopping Xyzal or Zyrtec:

We contacted the Food and Drug Administration about our concerns on May 15, 2018:

Dr. Woodcock,

We are still here and we are still receiving intriguing reports of therapeutic failures and adverse reactions with bupropion XL products. It would appear that the vigilance surrounding approval of this antidepressant has waned since our efforts several years ago. It would be great if someone looked into this.

I am writing to you on a completely different matter, however. As you probably know, cetirizine (Zyrtec) and levocetirizine (Xyzal) are very popular OTC antihistamines. Several years ago we became aware of a withdrawal reaction (pruritis) when these antihistamines are stopped suddenly. Since then, our website has become a place where people who experience this reaction can report their experiences. Over the last eight years we have accumulated over 700 comments about this problem. We suspect that is substantially more than the FDA’s MedWatch program.

There are no warnings or guidance with regard to this phenomenon. Given the widespread availability of such products it would seem prudent for the FDA to investigate this withdrawal reaction and offer health professionals and consumers some information about 1) the possibility and 2) how to discontinue the drugs safely.

Here are just a few links:

Unbearable Itching

Cetirizine Withdrawal

Zyrtec Withdrawal Unbearable Itching

Respectfully,

Joe (& Terry) Graedon

The FDA’s Response to Our Concerns Re: Itching After Stoping Xyzal or Zyrtec:

On June 3, 2018 we received this message from Dr. Gerald Dal Pan, MD, MHS, Director of the Office of Surveillance and Epidemiology:

“Dear Mr. Graedon,

“Thank you for your email of May 15, 2018 to Dr. Janet Woodcock regarding cetirizine (Zyrtec) and levocetirizine (Xyzal) and withdrawal reactions (pruritus) [itching]. Dr. Woodcock has asked me to respond. We appreciate your interest and perspective regarding this issue. The FDA strives to keep drug prescribing information (labeling) up to date with important safety information so that health care professionals and patients can make informed treatment decisions.

“As stated on the FDA website “Potential Signals of Serious Risks/New Safety Information Identified from the FDA Adverse Events Reporting System FAERS,” the potential safety issue of rebound pruritus with cetirizine, levocetirizine, and hydroxyzine was posted July – September 2017, prompting evaluation to determine the need for regulatory action.

“As a result of this review, the prescription levocetirizine Prescribing Information was revised to include the following information about pruritus after discontinuation of cetirizine in the Adverse Reactions-Postmarketing Experience section (6.2):

“Rebound pruritus- pruritus within a few days after discontinuation of cetirizine, usually after long-term use (e.g. months to years) of cetirizine.

“FDA plans on publishing the results of the review in a peer-reviewed journal to further disseminate the information.

“In addition, FDA continues to monitor and assess serious adverse events for all approved products reported by healthcare providers, patients, and others.

“Best regards,

“Gerald Dal Pan”

We were left with further questions and responded to Dr. Dal Pan with this note on June 3, 2018.

“Dear Dr. Dal Pan,

“Thank you very much for responding to our concerns about withdrawal itching (pruritus) after discontinuing cetirizine and/or levocetirizine. I was not aware that the prescribing information (labeling) had changed. I would be most grateful if you could provide access to the labeling information for cetirizine, levocetirizine and hydroxyzine (Atarax).

“Our usual resource for labeling information is DAILYMED. Once a product like Zyrtec or Xyzal becomes available OTC, the information on the DAILYMED web site becomes the OTC labeling. As a result, there is no mention of rebound pruritus. When I checked the hydroxyzine (Atarax) drug label information, I also found no mention of rebound pruritus.

“We recognize that rebound pruritus may not be perceived as a serious risk, but we can assure you that for hundreds of patients who have left comments on our website it is quite disconcerting/debilitating. We would be happy to supply your office with examples of the physical and emotional distress this reaction triggers.

“We would strongly urge your office to consider making this information available on OTC packaging. Now that cetirizine and levocetirizine are available without a prescription, millions of people will have access to these allergy medications without the benefit of a rebound pruritus warning. For example, if a health professional or a patient were to go to MedlinePlus for accurate and objective information about cetirizine at this website there is no reference to rebound pruritus.

“Finally, the warning that rebound pruritus occurs “usually after long-term use (e.g. months to years)” may not reflect real-world experiences. Is there any science/clinical trial data to support this statement? We simply would like to know how you determined this.

“Thank you again for responding to our request and for facilitating the labeling change. We would be especially gratified to see this included in the OTC labeling information.

Joe (and Teresa) Graedon”

We have heard nothing further from Dr. Dal Pan.

Strategies to Deal with Itching After Stopping Xyzal:

As far as we can tell, the Food and Drug Administration has not required the makers of OTC Xyzal or Zyrtec to notify people about the potential problem of itching after stopping Xyzal or Zyrtec. Many OTC products do not contain the same warnings and cautions that are available on the prescription labeling. We have not found any instructions for gradual weaning off these products.

Many of the visitors to our website have come up with their own strategies for dealing with the itching after stopping Xyzal or Zyrtec. You can read about them at these link:

Stopping Xyzal Triggers Horrible Itching

Stopping Xyzal Triggers Horrible Itching

Intense Itching From Stopping Zyrtec (Cetirizine) Suddenly

Unbearable itching after Stopping Antihistamines Like Xyzal Or Zyrtec

Unbearable itching after Stopping Antihistamines Like Xyzal Or Zyrtec

Cetirizine (Zyrtec) Withdrawal & Unbearable Itching

Stopping Antihistamine Leads to Unbelievable Itching

Stopping Allergy Medicine Abruptly Leads to Itching and Burning

Share Your Story:

We would like to hear from you. Have you ever experienced itching after stopping cetirizine (Zyrtec) or levocetirizine (Xyzal)? If not, we would very much like to hear about your experience too. Did these antihistamines work well to relieve your symptoms? Please let our visitors know how you have fared on these popular drugs in the comment section below.

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  1. Elizabeth
    CA
    Reply

    I took prescribed Xyzal before it was over-the-counter for a couple of years, and it stopped working for my allergies so I quit taking it. I was told my itching afterwards was due to my allergies. Luckily, I did not have it as badly as some people but it was still awful. I started taking Benadryl at bedtime and it seemed to help. After a year the itching finally went away.
    The FDA seems more interested in helping the drug companies they are supposed to be protecting us from!

  2. David
    WA
    Reply

    I also had extreme itching, mostly on my legs, but also on my lower abdomen and lower back. The itching on my legs was so extreme that I couldn’t stop scratching, resulting in sores, dangerous for a diabetic. My itching had nothing to do with Xyzal. My doctor told me it was caused by neuropathy on my legs, caused by my diabetes. This last year I was also diagnosed with Celiac disease. When I started eating a gluten-free diet, all of the itching went away. The doctor then connected the dots and told me that extreme itching is one of the first symptoms of Celiac disease.

  3. Barbara N.
    Georgia
    Reply

    – I have taken Zyrtec for years, for allergies. Last 2-3 years it stopped working. Thought I’d developed a tolerance to it.
    – I switched to Zyzal, and it has worked somewhat better, but not well enough.
    – I then switched to Allegra, and it works fairly well.
    – I continue to have itching, head to toe, especially on my forearms. So far, Allegra works best, but have had to take both XYZAL and Allegra.
    – Then, my doctor added a prescription medicine: Doxepin 10 mg twice daily in the evening and at bedtime as needed for itching. It is a low dose for that medicine and works well, but a side effect is constipation.
    – Not good for my IBS with constipation.
    – So it’s a big balancing act.
    – TRYING TO RESUME MY ALLERGY SHOTS, but had to take a 3-4 weeks break from them when the last allergy shot made my asthma exacerbate severely!
    – Any suggestions are welcome!

  4. RG
    Nokomis,FL
    Reply

    RG Nokomis, Fl

    I took Allegra for 3-4years straight after I finished my allergy shots. I recently stopped taking Allegra because it stopped working. I am experiencing itching skin and eyes. But, I did have one very POSITVIE response to stopping the Allegra. I had been experiencing visual auras which had been increasing in frequency. They went from 3 times a year to 3-4 times a week. When I stopped the Allegra they went away. I haven’t had one since and it has been 2 months. Has any else experienced visual auras with headaches when taking antihistamines? Like Allegra.

  5. Melanie
    Virginia
    Reply

    I was prescribed Allegra eyedrops for dry, red and itchy eyes by my eye doctor, but after initially helping, in week 2 it was worse
    so he switched me to Zyrtec eyedrops. Again for 8-10 days it seemed to help but if I didn’t use it 2-3 x a day, my eyes got very itchy. After more than a week of that, I mentioned my struggle to my sister in Ohio. She sent a link to a People’s Pharmacy web article about the problem of rebound with a number of antihistamines. I’m a nurse, so I also checked the Medline website and found rebound issues reported there as well. At which point it dawned on me: I’d been taking Chlortrematon for years for for seasonal allergies, but got to the point if I stopped at the end of allergy season, my symptoms came back so so ov ov year round so 2 years. A friend suggested Claritin, so I switched during the spring allergy season It worked better, but when I stopped, the same thing happened: my allergy symptoms returned, only worse, with itchy skin, scalp and dry itchy red eyes. That’s when I went to my eye doctor for my annual eye checkup and we discussed my obvious red, itchy eyes too. He recommended the antihistamine eye drops instead. It helped initially but but when I stopped, it got worse… just like stopping Claritin made my seeming “seasonal” allergy worse plus itchy skin and scalp to boot. I stopped all antihisimines cold turkey. I took vitamin C + pantothenic acid (a B vitamin) 2x day, drank 6-8 glasses of water, stopped all sweets during that time (sugar makes any inflammatory process worse), and ate lots more leafy green and other veggies, plus a handful of fresh parsley daily. It took 6 weeks or so, but I got through it. I sense learned about 3 friends who had even more intense itching when they tried to stop taking Claritin. It is awful how issues like this get minimized. But drug manufacturers are powerful entities influencing health policy and our health care system far too much. We need unbiased medical research, period…including for drugs that help people. A drug’s benefits and side-effects must be weighed for each person’s situation; but to do that, doctors need to know about all side effects.

  6. McKPa
    FL
    Reply

    I have been bothered by itchy hives for many years. Allergists diagnosis: “CHRONIC URTICARIA”. I was told to take all of above mentioned including Zyrtec and also noticed the same increases in hives after stopping. I haven’t found a replacement for the antihistamines but I have discovered a remedy for the relentless and painful itch. I dab on “SeaBreeze” on a cotton pad and within 5 minutes or so the itch is diminished and goes away quickly after. The actual hive (welt) is decreased in redness and size also as quickly. The only problem is finding a store that still stocks “SeaBreeze” I used to buy it at Publix and Walgreen’s but they no longer stock it. I will go online now and hope Amazon will stock.

  7. Aslaug
    Spain
    Reply

    I was prescribed Xyzal for hives. It worked very well for the problem, but gave me more jointpain (have arthritis), feeling of weakness all day and hypoglycemia. I felt awefull!! So I got the idea to try with vitamin C: I took 1/2 Tablet of Xyzal a day and a 1 g Tablet of time released vitamin C in the m orning and another in the evening. After about 3 weeks the hives were gone. Today I still take 1 Tablet a day because I think it is good for my health

  8. Anne
    Fort Worth, TX
    Reply

    I took Zyrtec for a couple of years and experienced intense itching while still on the drug. After reading about rebound itching I decided to switch to Claritin, and the itch stopped. No rebound itch either.

  9. Sam
    Portland, Oregon
    Reply

    When I saw this topic, I had to write. Several years ago I developed atopic dermatitis. The dermatologist prescribed Zyrtec. I didn’t like the sleepy way it made me feel, but the skin rash was bad, so I took it twice a day. It actually seemed to make the rash worse in hindsight. But in the way that our minds can work, I told myself it was lucky that I had started taking Zyrtec! I took it for 3 weeks with the rash gradually worsening, so it didn’t help there.

    One morning I was ready to take my first dose right after I finished reading the mail, and there was an article in the People’s Pharmacy about Zyrtec withdrawal and itching after stopping it after long-term use. Wow, I was so happy I had dodged that bullet! I stopped taking it in that moment.

    For 3 days I was fine, and then the unbearable itching set in on the 4th day. The itching lasted for 3 weeks. But luckily I was able to last it out because I had read testimonials on your site from people who had come through this. So to add my voice: 3 weeks’ average use caused a 3-week, extremely miserable withdrawal that I was guided to believe by the dermatologist was probably just the original problem.

    She knew nothing about itching as a possible side effect. No, it wasn’t the original problem. It was the Zyrtec. Never again.

  10. Tricia
    Anacortes, WA
    Reply

    I have been taking Zyrtec for 10-15 years and have tried many times to stop it with the same itching and hives after about that 3 days as everyone else. I am now committed to stopping it and am going to try tapering, and then will do a short course of Prednisone. Fingers crossed.

  11. LouAnn W.
    Inman SC
    Reply

    I’m 62 years old.
    Stopped taking Zyrtec and the itching was absolutely unbelievable! It was a nightmare for weeks. I had to tough it out. Will NEVER take it or any other antihistamine again.

  12. alaskanamber
    USA
    Reply

    I’ve experienced this intense itching when trying to stop Zyrtec and Xyzal. I’ve tried to stop multiple times, but just over the 24 hour mark of taking my last allergy pill, the itching starts.

    It’s so bad that I’ve caused huge bruised on my body, along with blood blisters, from itching and scratching so badly. It’s even caused me to cry due to how bad the itching is.

    Earlier this month, I had allergy testing scheduled, which I’ve tried to have done before, but couldn’t stand the withdrawal itching, so I tapered off the dosage slowly, but that didn’t help at all. I almost didn’t make it this time, but I was determined to be allergy tested.

    I’ve told multiple doctors about this and they act like I’m crazy or that the itching is a result of something else. I don’t know what to do, but I’m now taking Allegra on the advice of my allergy doctor. I’ve put in product problem complaints with the FDA on this. I just hope that something is done and a product warning is added to the medication information.

  13. terri
    Indiana
    Reply

    My Doctor had me taking 1 Zyrtec a day for more than 10 years! (Originally Rx’d for hives). When I would forget to take one I would break out in hives and itch like crazy, so for the past 3 years I took a half a Zyrtec a day.

    Around Christmas 2018 I finally decided to quit Zyrtec altogether and for two months I took a fourth of a pill, then I stopped taking them. I started itching and my sinuses went bonkers! I could barely open my eyes for four days because the sinus pain and pressure was so awful!

    It’s been two months and I don’t have the sinus problem but I still get itchy in the evenings (when it would’ve been time to take my pill). I refuse to go back on them to relieve the withdrawal symptoms. I hope it ends soon. When I start to feel itchy I put lotion on my skin – an ice pack helps too. Reading a book or playing the piano also helps distract my mind from the itchiness. Some nights I can barely sleep because I itch so bad.

  14. Debi
    North Carolina
    Reply

    I experienced such extensive itching on my arms after stopping levocetirizine that I dug scars into my arms for three years. All the doctors I went to thought I was crazy and told me there was no way I was still having symptoms from stopping that drug. They tried me on all sorts of anti-itch medicines and nothing worked. The only time I didn’t itch was when I was asleep and even then I was still scratching. It was pure hell. Don’t let anyone tell you that it won’t last for a long time because it will and it does and you’re not crazy.

  15. Lori
    Oviedo, Florida
    Reply

    I am one of the many people who stopped taking Zyrtec and suffered from intense itchiness. I felt the itchiness from my scalp down to my toes. The intense itchiness lasted for 3 weeks. The only thing that gave me any relief was taking oatmeal baths. I haven’t taken Zyrtec since my previous encounter and I will do whatever is possible to avoid taking it in the future.

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