Is Zyrtec (Cetirizine) Safe If You Have BPH Or An Enlarged Prostate?

In our latest question and answer, the pharmacist discusses whether or not Zyrtec (cetirizine) is safe in those with an enlarged prostate.

Jul 26, 2018

cody asked

Hi there, Cetirizine Hydrochloride 10mg Tablets works very well for me. I just want to know for how long can it be taken by a 74 years old man suffering from BPH? Thanks.


Antihistamines, like Zyrtec (cetirizine), are recommended to be used cautiously in those with an enlarged prostate or have been diagnosed with BPH (benign prostatic hyperplasia).

Antihistamines have anticholinergic effects, meaning they block the neurotransmitter acetylcholine. Drugs with anticholinergic effects can cause the following:

  • A "drying" effect, which can cause:
    • Constipation
    • Dry eyes
    • Dry mouth
    • Urinary retention
    • Decreased mucus production
  • Dizziness
  • Increased heart rate
  • Hyperthermia
  • Drop in blood pressure

While many anticholinergic side effects are relatively uncommon at usual doses of antihistamines, if you have a conflicting condition like an enlarged prostate, they could worsen urinary retention and low urine flow.

Zyrtec (cetirizine) is a "second-generation" antihistamine and has far less anticholinergic effects than "first-generation" antihistamines like Benadryl (diphenhydramine) and Chlor-Trimeton (chlorpheniramine). While Benadryl is typically recommended to be avoided in those with BPH, Zyrtec doesn't hold the same recommendation. 

Zyrtec is generally considered to be safe in those with BPH and even though it does have some anticholinergic effects, they are relatively mild. If you do notice symptoms worsening with Zyrtec (e.g. decreased urine flow rate), other second-generation antihistamines, such as Claritin and Allegra, are thought to have even less anticholinergic effects than Zyrtec.

It is important to discuss any medication you take with your doctor so you can be appropriately monitored.

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