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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?
Young woman is scratching herself on arm

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:

Several years ago we became aware of a withdrawal reaction (pruritis) when these antihistamines (cetirizine [Zyrtec] and levocetirizine [Xyzal] 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 the FDA

“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…”

We were left with further questions and responded to the FDA 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

Intense Itching From Stopping Zyrtec (Cetirizine) Suddenly

Unbearable itching after Stopping Antihistamines Like Xyzal Or Zyrtec

Cetirizine (Zyrtec) Withdrawal & Unbearable 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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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.” .
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I have been taking Xyzal for 8 years, before that I tried ALL of the other allergy medicines and none worked as well as Xyzal. I have terrible year round allergies and am almost symptom free with a combination of Xyzal, Singulair, and Nasacort. I finally decided I was tired of taking 3 medications every day so I scheduled allergy testing. They told me not to take my Xyzal until the testing date (one week). The first two days were fine and then came the itch. Completely unbearable. I was in tears the first two nights. I begged my husband to let me take an antihistamine and he reminded me how badly I wanted to start allergy shots again. I am still not taking it and my testing is tomorrow. It has been hell. My allergy doctor said that I could reschedule, take the Xyzal and then go on Prednisone as I try to stop again and that should help, but I’m sticking with it. Even with this awful withdrawal symptom I do plan to go back on the Xyzal after allergy testing until the shots take effect and then I plan to not stop the Xyzal again until I start on Prednisone as I withdrawal

About the second day after stopping Xyzal *(after taking it for only a couple of months, if that) the itching started. My nose itches like crazy; my shoulders are covered in pin-prick bruises from scratching so much. The situation is slowly improving so I’m just going to power through (and toss the Xyzal !!!!)

If I had been aware of this possibility before I started taking Xyzal I wouldn’t have tried it. It works, sure, but I wish they’d put withdrawal symptoms on the label like they do for the decongestant nasal sprays.

I started taking Xyzal and then switched to the generic. I’ve been on it for around ten years. I’ve tried getting off this drug for the past four years, but the intense and unbearable itching after I stop taking it makes it impossible. I just tried again and failed. Two days of misery. Ten minutes ago, I took the pill. I don’t know how to get off this medication.

This happened to me a few weeks ago. All of the sudden my upper back, chest and neck started to have an unbearable itch. I was covered in a rash. I had no idea what I was having a reaction to. I took Benadryl, and I was fine. Then the same thing happened the next two days. All of the sudden I realized the only thing that was different about the past 3 days was that I ran out of Xyzal 4 days ago. I quickly went to go get more. Guess what … No more itching! I thought there was no way this was remotely possible. Tonight I thought it was still a weird coincidence, so here I lay in bed reading everything I can find on this topic. I’m shocked as to the amount of people that have also experienced this. What now?!

I thought I was crazy!!! I have had severe itching for days. It seems that when I scratch it only seems to make it worse. It is a burning, stinging itch. This itching literally had me depressed. I took Benadryl but didn’t have much relief. I itched EVERYWHERE!! Then it hit me: I haven’t taken Xyzal in a few days. I went to the store on my lunch break, got Xyzal, and within 45mins my itching was completely gone. My light bulb came on, and I started researching and found this site. Interesting comments. Now I need to figure out how to stop taking it daily. I CAN NOT DEAL WITH THE WITHDRAWAL ITCHING. Welcome any advice from anyone who’s made it through this,please.

Please everyone: get checked for Histamine intolerance.

I’m going through this right now. The palms of my hands itch, the bottoms of my feet itch. I thought I was going crazy, trying to think what I had eaten that was causing this. I finally realized that I had stopped taking Zyrtec. I looked it up and found I’m not alone. It’s been a couple of weeks and I still have the intense itching. Benedryl seems to help a little but causes me to feel tired and I worry that I’m just prolonging the itching. It is truly awful. I wanna take a Zyrtec to make it stop but I know that’s not the answer

I hope that EVERYONE (and their loved ones!) who experienced any of these horrible side effects will contact the FDA to complain about this lack of honest labeling, and lack of information being provided to doctors. Anyone who experiences this may want to print out or e-mail this article and show it/send it any medical professionals with whom you come in contact…if the FDA won’t tell them, you’d be doing them and their other patients a favor by sharing this debilitating information! People’s Pharmacy may want to print the FDA’s complaint line number and e-mail address in instances such as these, to help facilitate responses.

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!

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.

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