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Cetirizine (Zyrtec) Withdrawal & Unbearable Itching

Antihistamines calm allergic symptoms like itching and hives. How could cetirizine (Zyrtec) withdrawal lead to unbearable itching?
Cetirizine (Zyrtec) Withdrawal & Unbearable Itching
Young woman allergy scratching her abdomen stomach with fingers isolated on a white background

Cetirizine (Zyrtec) and its close chemical cousin levocetirizine (Xyzal) are popular antihistamines for allergies. They both used to be available only by prescription. Zyrtec became available over the counter in 2008 and Xyzal went OTC in 2017. Some people report that if they stop such antihistamines suddenly, they can experience levocetirizine (Xyzal) and cetirizine (Zyrtec) withdrawal itching. 

What Is It Like to Go Through Cetirizine (Zyrtec) Withdrawal?

Q. Years ago, an allergist recommended that I take Zyrtec daily for allergies. After several months I stopped and immediately began to suffer from severe itching on the palms of my hands and soles of my feet. It kept me up at night and impeded my workday.

I tried to wean off it to see if that made a difference but still experienced itching and burning whenever I quit. When I scoured the Internet to find out if this was a thing, there wasn’t much information.

Fortunately, I met a dermatologist who listened to me and did not act like I was crazy. She helped me wean off the antihistamine and prescribed a med that helped with the itching. I’m frustrated that people are not told about this side effect.

A. Your story is not unusual. We have heard from hundreds of others who also experienced itching upon cetirizine (Zyrtec) withdrawal. We brought this to the attention of the FDA and the agency eventually acknowledged this reaction (Therapeutic Advances in Drug Safety, July 5, 2019). Although the FDA offers no advice, very gradual withdrawal may help. 

Another Reader Describes Cetirizine (Zyrtec) Withdrawal:

“So glad to come across all these posts online and realize what is happening. I have been on Zyrtec (cetirizine) for 10+ years. Originally I started taking this antihistamine because I was experiencing hives (uticaria) but did not have any other allergies. After having hives a few times, the doctor told me to start taking this drug every day to prevent getting them.

“Well, after years of taking these pills, I finally started questioning why I needed to take them every day. I went off of them for a few days to get allergy tested and when I went to the allergist he gave me a hard time and told me that people takes these pills their entire life. It’s working so why am I trying to get off of them, etc. They first refused to test me for allergies but then finally did but only tested me for about 10 different allergens to which I was negative.

“Those 5 days trying to get off the Zyrtec were the WORST of my life, I literally laid on the couch and scratched and got hives all over. And, I thought, wow I really can’t live without this drug that’s how bad my body is.

“Well obviously it’s not, it’s the drug or the withdrawal from the drug. Before I started taking this drug I didn’t get random itching all over my body. So slowly but surely I’ve come to this point. I’m on day 5 of the Zyrtec withdrawal. For me, this time is a little different. I’m eating very healthy food, at least much as I possibly can. I’ve realized that the initial hives could have possible been some sort of allergy to the food I was eating or drinking and now that has been covered up for 10+ years by this drug so just imagine how much damage has been done to my body.

“The first two days were fine, day 3 has been pretty bad. Today I have had some slight improvement. When I wake up I’m fine but then slowly but surely the itching will start and it is HORRIBLE. It seems to travel and I can itch in multiple places at once. The absolute worst is in places that you would never want to itch.

Advice on Coping:

“Here is how I’m coping:

– I’m drinking as much water as possible, when I drink lots of water it actually seems to help

– I’m 100% gluten free, dairy free, sugar free. I have an inkling that this is helping me so much more than the first time I did this. I’ve had some grains (rice and quinoa) but plan starting tomorrow to be grain and soy free and potentially nut free while I’m going through this.

– I started taking Vitamin C yesterday and it does seem to help

– Hot showers for me work much better than cold

– I’ve started dry skin brushing (in the morning and before I go to bed) and then applying coconut oil that I’ve whipped into a natural moisturizer so as not to put any chemicals on my already having a hard time skin

– I’m trying to juice in the mornings (all greens for breakfast) and then eat fruit until dinner. However, from what I can tell I have the least reaction when I eat cooked vegetables.

– When all else fails, I find that keeping all my skin covered (long pants and sweatshirts) and focusing on breathing normally even when I’m in excruciating itch mode can bring me back to some state of normal.

“I hope some day that there is something done about this drug. At a minimum there should be some sort of disclaimer about the withdrawal effects. I wish when I was put on this drug that there was more information out there like these posts so that I would have never taken it in the first place.”

The People’s Pharmacy & Antihistamine Withdrawal:

We never knew about the cetirizine withdrawal itch until visitors to this website began sharing their experiences. Here is one of the first messages:

Q. I have had terrible trouble trying to stop taking Zyrtec (the generic is cetirizine). After using this antihistamine for about three years while having allergy shots, I first attempted to stop taking it in preparation for allergy testing. Within three days, my entire body itched. It was so horrible that I was crying and preparing to go to the hospital for relief.

Confused by the relentless itching, I forgot and took a Zyrtec by accident. Lo and behold, before I could get dressed and get in the car, my symptoms were GONE. Now, seven years later, I have tried unsuccessfully at least 10 times to quit this drug, and the reaction is more severe each time.

Today while I was researching this problem online, I found a community of thousands of people who have had the same problems I have. There should be better warnings about this withdrawal problem.

On May 5, 2010, we answered:

Cetirizine is an antihistamine that is often used to treat itching due to allergies, but the withdrawal phenomenon you and other patients have experienced is not included in the medical literature. That has changed, but we suspect few health professionals are aware of cetirizine (Zyrtec) withdrawal.

Please discuss this problem with a dermatologist. She might have a solution to weaning off this antihistamine, perhaps with a short course of corticosteroids.

Stopping Cetirizine or Levocetirizine?

People have tried a number of ways to overcome the chronic and nearly intolerable itching that may begin shortly after discontinuing cetirizine. Some people report that a gradual reduction in dose helps a bit and that after about two weeks, the itching slowly recedes and eventually disappears.

It took us years of pestering the FDA to get the agency to look into cetirizine (Zyrtec) withdrawal. The agency eventually did do some research and included a report in the medical literature. We doubt that many health professionals are aware of the problem, though. 

There is no warning and no recommendation about how to get off this allergy medicine on the OTC label. Most people assume that a nonprescription allergy medicine must be safe. That leaves them on their own when it comes to stopping.

The problem of cetirizine (Zyrtec) withdrawal points up a huge flaw in the FDA’s regulatory system. The agency seems oblivious to what has been called “discontinuation syndrome” or withdrawal from a number of medications. It took years for the FDA to figure out that anti-anxiety agents like diazepam (Valium) or alprazolam (Xanax) could trigger withdrawal symptoms when stopped suddenly. Ditto for antidepressants like sertraline (Zoloft) or venlafaxine (Effexor).

Even now that the FDA requires some mention of this problem in the official prescribing information with anti-anxiety agents and antidepressants, there are no guidelines or recommendations about how to gradually discontinue such medications.

That leaves physicians, pharmacists and patients at a loss to come up with a solution to this huge problem. People make up their own regimens, but it is very much hit or miss.

Here are some additional stories and successes. Please share your own story in the comment section.

Cetirizine (ZYRTEC) Withdrawal:

This reader (Jawbone) had a terrible time with cetirizine (Zyrtec) withdrawal:

“Just found this thread on Zyrtec and am so glad to find I am not alone. I have taken Zyrtec and its generics for years now, but back when it was prescription only, if I’d forget to refill on time I would get itching within a few days. First, I would randomly get itches on my scalp, then my arms would begin itching, and it would go on from there. I vaguely recall even getting hivish little bumps.

“It is good to know it’s the pill and not in my mind. It actually was ON my head… as a type of withdrawal symptom. When I was hospitalized recently, I had to tell the doctors I had to continue the Zyrtec generic or my burns would be getting itchy and maybe break into hives.”

Another reader (Anonymous) went through misery for two weeks:

“I took Zyrtec for many years (both brand name and generic) for allergies. A couple months ago I decided to go off of it ‘cold turkey’ and I was miserable for a full two weeks. The itching was uncontrollable… and scratching made everything worse. I did find a little relief by putting ice packs on my body when I itched, taking quercetin several times a day, going for acupuncture 2x week, yoga/meditation several times a week, and by slathering Sarna cream all over my body.

“It was total torture going off this drug! For the spring allergies when pollen levels are off the charts I do use a nasal spray and sometimes have to take an Advil & Sudafed for headaches.”

Dermot shared this initial strategy for dealing with cetirizine withdrawal:

“I’m in the same boat too. Been taking it for about 14 years, since I was 16. For the last month or so I’ve been weaning down. 1/2 a tablet every day for a few weeks, then 1/2 tablet every second day.

“I’m now on 1/4 tablet every second day. Itching starts about 24 hours after the last tablet, but I can push through to the 48 hours before taking another 1/4. Will try the vitamin C and other remedies mentioned here. I too told my doctor and he said he never heard of it. Maybe I should tell him to google it… :-)”

Dermot wrote several weeks later to offer a modified approach:

“Ok, I posted about almost month ago, still tapering off. Its definitely the way to go (rather than cold turkey). I reached a point where I was taking 1/4 tablet every 2 days, but the last 12 hours of each 2-day period were a nightmare.

“Instead, I take it every 24 hours, but just reduce the amount. So instead of 1/4 tab every 48 hours, take 1/8 of a tab every 24 hours. Last week I reduced it to a few tiny crumbs of a zyrtec tablet every morning, about 1/16th of a tablet (Thats 1 tablet every two weeks!).

“I’ve crushed a tablet up between two spoons, and tried to divide up the resulting powder into 16. Pretty hard to do. now I just lick my finger and dab it in the powder and take a few particles of the tablet every morning. I’m still reducing it every few days. I’m probably at about 1/20 of a tablet now.

“I know it seems a bit extreme, but if I stopped cold turkey, even from 1/8 of a tablet to nothing, I started itching all over so much it was unbearable.

“Just keep taking less and less until you’re taking a couple of tiny crumbs, then one crumb, then 1/2 a crumb (!!), then nothing. I hope to be off it completely within the next 4 – 6 weeks.”

More Cetirizine (Zyrtec) Withdrawal Strategies:

Should you wish to learn more about how others have phased off the antihistamine cetirizine and levocetirizine (Xyzal), check out these links:

Zyrtec Withdrawal Stories

The Itch That Won’t Quit | Itching After Stopping Xyzal (Levocetirazine)
The FDA responded to our questions about itching after stoping Xyzal or Zyrtec. See what you think about the answer. Should people be warned about this?

Share your own cetirizine (Zyrtec) withdrawal experience below.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
Citations
  • Chung AH et al, " Pruritus after discontinuation of cetirizine." Therapeutic Advances in Drug Safety, July 5, 2019. DOI: 10.1177/2042098619859996
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