We first heard about the cetirizine – Zyrtec antihistamine withdrawal phenomenon 15 ago from a reader of our syndicated newspaper column:
“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.”
Notifying the FDA about Zyrtec Antihistamine Withdrawal:
After receiving over 700 comments from readers of our column, we reached out to the Food and Drug Administration. We wanted to know 1) if the FDA knew about this problem, 2) if the agency would alert health professionals and consumers about withdrawal itching, and 3) if the FDA and the drug company would provide some guidance on how to stop taking drugs like cetirizine or its chemical cousin levocetirizine (Xyzal).
The FDA eventually responded that it had reviewed the issue and listed the following adverse reaction in the cetirizine prescribing information:
“Rebound pruritus- pruritus within a few days after discontinuation of cetirizine, usually after long-term use (e.g. months to years) of cetirizine”.
“Pruritis” is doctor-speak for itching. Why can’t the FDA just use normal language? Itching is a perfectly good word.
Search as we might, we have not been able to find this information listed on the over-the-counter labeling for cetirizine (Zyrtec) or levocetirizine (Xyzal). We repeatedly asked the FDA why consumers shouldn’t be informed of this Zyrtec antihistamine withdrawal phenomenon. For years we did not receive a clear answer. What’s more, we doubted that the FDA had any solid scientific evidence to support its contention that this “usually occurs after long-term use.”
There were no guidelines on how to prevent Zyrtec antihistamine withdrawal. As a result, neither patients nor health professionals had access to information that would alert them to this problem.
Fast Forward to 2020:
That’s when a reader shared the same concern that a reader in 2010 had brought to our attention.
Q. I have been complaining to doctors for years that I am physically addicted to Zyrtec. I can’t go more than three days off the drug before the itching becomes completely unbearable.
I am now on my fifth day off of it because I am getting allergy tests later this week. My co-workers said they’ve never seen me this unhinged. I feel like I’m flea-infested!
I’ve had to break down twice now and take a Benadryl just so I can function at work. That definitely helps, but the itch comes back as soon as the drug wears off. What else can I do?
A. We have been concerned about this withdrawal reaction for years. Although the FDA acknowledges that stopping cetirizine suddenly can cause itching, it provides no guidance for gradual withdrawal (Therapeutic Advances in Drug Safety, July 5, 2019). People who have reported their experience on our website have found that the itching fades within several weeks, if you can hold out that long.
Here are some additional articles about this problem:
Running Out of Zyrtec on a Remote Island Causes a Crisis
A reader who lives on a Pacific island discovered to his dismay that running out of Zyrtec triggered horrible itching and hives
The Itch That Won’t Quit | Itching After Stopping Xyzal (Levocetirazine)
The FDA Finally Warns about Xyzal and Zyrtec Antihistamine Withdrawal Itching:
It took a very long time, but on May 23, 2025 the FDA has finally issued a Drug Safety Communication:
“The FDA is warning that patients stopping the oral allergy medicines cetirizine (Zyrtec) or levocetirizine (Xyzal) after long-term use may experience rare but severe itching. These medicines are available in prescription and over-the-counter (OTC) forms. The itching, also called pruritus, has been reported in patients who used these medicines daily, typically for at least a few months and often for years. Patients did not experience itching before starting the medicines. Reported cases were rare but sometimes serious, with patients experiencing widespread, severe itching that required medical intervention. As a result, we are revising the prescription cetirizine and levocetirizine prescribing information to include a new warning about this risk. We will subsequently request that manufacturers add a warning about pruritus to the Drug Facts Label of the OTC versions.”
We find it fascinating that the FDA continues to emphasize that the withdrawal itching is “rare.” How does the agency know that? Have there been any studies to discover what the incidence of Xyzal or Zyrtec antihistamine withdrawal really is? Does the itching occur 1 in 3, 1 in 10 or 1 in 1000?
Without an actual study, we have no way of knowing. Just a guess, mind you, but we suspect it may not be as rare as the FDA implies. We have received a lot of complaints over the last 15 years.
Here are just a few:
“I took Zyrtec for years, and I thought it had stopped working so I quit cold turkey. I had itching for almost two months!
“My doctor suggested I try Xyzal, since it had a similar chemical makeup. No other allergy medicines have ever proven to work for me. That was not helpful. I took Xyzal for a year and it did not help with my allergy symptoms as much as Zyrtec.
“I quit cold turkey. Now the itching is back. There should definitely be warning labels on these drugs for long-term users. Enduring this constant itching for another two months is not going to be fun.”
The FDA asks: “What Should Health Professionals Do?“
“Health care professionals should discuss the risk of pruritus after stopping cetirizine or levocetirizine with patients when prescribing or recommending these medicines, especially if planned for chronic use, and with those who indicate they are using OTC versions. Encourage patients to contact you if they experience severe itching after stopping cetirizine or levocetirizine. Effective treatments for pruritus have not been evaluated. However, symptoms resolved in most patients who restarted the medicine and in some who tapered off the medicine after restarting it.”
Do you find it intriguing that the FDA kind of implies that “…symptoms resolved in most patients who restarted the medicine and in some who tapered off the medicine after restarting it.”
We take that to mean that patients experiencing Xyzal and Zyrtec antihistamine withdrawal itching can ease the overwhelming symptoms by restarting the medicine. Hmmmmm. Does that mean patients are stuck taking such drugs for years or decades?
There is also the implication that “tapering” can help “resolve” the problem. So, what is the tapering plan? The FDA is careful not to make any specific recommendations, which leaves health care professionals and patients in limbo. Does tapering mean a week, a month or 3 months? And how gradually should people taper off such antihistamines?
The FDA also implies that withdrawal itching occurs:
“…in patients who used these medicines daily, typically for at least a few months and often for years.”
But if one were to dig a bit deeper into the section about “What did FDA find?” you will discover:
“Most patients who experienced pruritus after medicine discontinuation reported using these medicines for more than 3 months; however, some experienced this reaction after less than 1 month of use.”
Final Words:
We are grateful that the Food and Drug Administration has finally taken our concerns seriously. It took many years, but at long last our readers have been vindicated. The new warnings that will eventually show up on the label of Zyrtec, Xyzal, and house brands of cetirizine and levocetirizine will be thanks to the readers of The People’s Pharmacy.
What We Don’t Know About Xyzal and Zyrtec Antihistamine Withdrawal Itching:
- How common is this reaction?
- How long does it take to manifest? In other words, if people only take such antihistamines for a few weeks, can they avoid withdrawal itching when they stop?
- How long does the itching typically last after discontinuing such medications?
- Do any other antihistamines cause this problem?
- What’s the best way to taper off such drugs without suffering intense itching?
What’s Your Experience?
Share your own experience with Xyzal or Zyrtec antihistamine withdrawal in the comment section below. If you have not had any problems stopping cetirizine (Zyrtec) or levocetirizine (Xyzal) please share your story too.
If you think this vindication of our readers’ stories is worth sharing, please let your friends and family know about this small “victory.” If you appreciate the efforts of The People’s Pharmacy to be a watchdog over the FDA and the pharmaceutical industry, please consider a donation to keep our work moving forward at this link.
Citations
- Ekhart, C., et al, "Unbearable Pruritus After Withdrawal of (Levo)cetirizine," Drug Safety - Case Reports, Dec. 3, 2016, doi: 10.1007/s40800-016-0041-9
