Cetirizine (Zyrtec) Withdrawal & Unbearable Itching

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.