darbvin asked
I have been taking Zyrtec (otc) for seasonal allergies every morning for the past week or two since pollen hit our area hard. It helps me a great deal during the day but doesn't last the full 24 hours, so I have not been sleeping very well - a lot of sneezing, coughing and congestion in the last several hours of the cycle. Is there something safe/recommended that lasts 8-10 hours to take at bedtime to push through till morning? Or maybe 6 hour Benadryl is my best bet?
Answer
Zyrtec (cetirizine) has a half-life of 8 hours on average and the effect may start to wear off before the full 24 hours. Changing the way you take the medication may be one option. Another option would be to add another medication to supplement the effect of Zyrtec.
Zyrtec Dosing Options For 24 Hour Coverage
First, Zyrtec dosing may be split into twice daily dosing to have a more consistent effect. Since the maximum dose is 10 mg daily, taking 5 mg in the morning and 5 mg prior to bedtime may help. Another option would be to switch to taking the full 10 mg prior to bedtime. This should help with the symptoms at night as well as in the morning. The early morning is typically when the pollen counts are highest so taking at night may be the most effective.
Adding Other Medication To Zyrtec For Better All Day Coverage
Another option would be to switch or add Flonase (fluticasone) nasal spray. Flonase was approved by the FDA in 1990, but has only been available over-the-counter since 2014. Flonase is a type of steroid that blocks inflammation, itching, and congestion. According to the Flonase website, it has some advantages over Claritin (similar to Zyrtec) including working better for nasal congestion. Flonase can be used once daily with 1 or 2 sprays into each nostril or may be used as needed instead of every day.
Zyrtec Information
Zyrtec is a second-generation antihistamine and is thought to cause drowsiness in some patients and relatively more drowsiness than other second-generation antihistamines including Claritin (loratadine) and Allegra (fexofenadine). First-generation antihistamines including Benadryl (diphenhydramine) cross the blood-brain barrier and cause significantly more drowsiness than the second-generation antihistamines.
Antihistamine Information
Antihistamines bind to histamine receptors that are found in the nose, lungs, eyes, and skin without activating the histamine response. By binding and changing the shape of the histamine receptor, antihistamines inhibit histamine from binding and creating its response. Histamine creates an immune response to essentially attempt to remove the offensive allergen. Histamine can be triggered by a variety of things including pollen, dust, and pet dander. Some people are more sensitive to this response and may not even know what triggers their allergies. Antihistamines are useful in preventing the immune cascade so common in people suffering from allergies.
