Does Stopping Zyrtec Cause Rebound Itching?

In our latest question and answer, the pharmacist discusses whether or not stopping Zyrtec can cause rebound symptoms like itching.

Does Stopping Zyrtec Cause Rebound Itching?
Dec 23, 2019

mee asked

Hi. I've been taking Zyrtec 10mg once a day for urticaria. Now that the itching is gone, is it safe to stop taking it? Thanks.

At a glance

  • Stopping Zyrtec (or another antihistamine for that matter) is generally not associated with any rebound or withdrawal effects.
  • There have been rare reports of pruritus (itching) occurring in some individuals, but a definitive relationship has not been established.

Answer

Zyrtec Gels Bottle

Hi there and thanks for reaching out to us!

Yes, it is safe to stop taking Zyrtec (cetirizine) after you have been taking it for an extended period of time. The vast majority of available data shows that antihistamines (like Zyrtec) are not known to cause any rebound or withdrawal symptoms like many other medications can (e.g. opioids, benzodiazepines).

In fact, the prescribing information for the drug states this specifically:

There is no information to indicate that abuse or dependency occurs with ZYRTEC.

Personally, I had not heard of anyone experiencing withdrawal symptoms with an antihistamine.

However, I always do at least some research with every question that comes in to PharmacistAnswers, just to be sure the information I give is current and germane to the topic.

I did come across some recent studies discussing a small number of individuals who have reported experiencing one particular withdrawal symptoms from Zyrtec, itching.

One of the most referenced studies on the matter can be found on PubMed and it reports on 146 cases, starting from 2008. The itching the individuals reported in the study (after stopping Zyrtec) ranged from mild, to serious (to the point of altering daily activity). Per the study:

Itch was described as intense and unbearable; in some cases, the patient reported the itch started in the hands, feet, and scalp before spreading to the rest of the body.

It further stated:

Some patients described the itch as so intense that it impacted their ability to work, sleep, or perform their normal daily activities; however, some cases that reported the serious outcome of ‘other’ did not contain sufficient case details to determine which aspect of the report was considered serious by the reporter.

Other, smaller studies, have also reported on cases of rebound or withdrawal itching when stopping an antihistamine (such as this one involving Xyzal, or levocetirizine).

Even though these studies exist, larger, more comprehensive ones are needed to draw a definitive conclusion regarding whether or not there is a relationship between the intense itching patients experienced and stopping Zyrtec (or other antihistamines). We also don't know if there could be any specific medical condition or situation that may make someone more susceptible to these side effects (if there is a relationship).

It does appear that if withdrawal itching is a potential withdrawal symptom of Zyrtec, it is quite uncommon.

Nevertheless, it is important not to just dismiss what someone is experiencing because it isn't a known problem or has a small incidence rate. It is always recommended to report side effects to the FDA through their Adverse Event Reporting System (FAERS) and report any side effects you are experiencing to your doctor.

So, to answer your question as briefly as possible, it is very unlikely that you will experience any issues stopping Zyrtec after having taken it to treat hives. It is good to be aware of problems some others have experienced in your situation though.

As a final note here, there are plenty of websites that have posted testimonials from individuals who have had problems, so I suggest reading those if you are concerned or want to hear from others (one such site is People's Pharmacy).

References
  1. Zyrtec Prescribing Information. JACI
  2. Pruritus after discontinuation of cetirizine. PubMed
  3. Unbearable Pruritus After Withdrawal of (Levo)cetirizine. PubMed

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