You should not use Zyrtec-D if you have narrow-angle glaucoma, severe high blood pressure (hypertension), severe coronary artery disease, if you are unable to urinate, or if you are allergic to hydroxyzine (Atarax, Vistaril). Do not use this medicine if you have taken an MAO inhibitor in the past 14 days.
Zyrtec is safe for most people, but there are some individuals who should stay away. Children under 2, anyone with a history of an allergic reaction to Zyrtec or hydroxyzine/piperazine derivatives, and those with severe renal impairment shouldn't take Zyrtec, says Dr. Patel.
Which allergy medications are best for people with high blood pressure? Second-generation antihistamines that are not combined with decongestants are the best choice for people with hypertension. These include oral medications like: Cetirizine (Zyrtec)
First generation antihistamines, while very effective at controlling symptoms, are often associated with symptoms in older adults such as anxiety, confusion, sedation, blurred vision, reduced mental alertness, urinary retention and constipation.
ZYRTEC® Allergy Relief Tablets
Adults under 65 and children 6 years and older One 10 mg tablet once daily; do not take more than one 10 mg tablet in 24 hours. A 5 mg product may be appropriate for less severe symptoms. Adults 65 years and over Ask a doctor. Consumers with liver or kidney disease Ask a doctor.
So what can older adults safely take for allergy relief? Wozniak: Newer antihistamines such as Claritin® (loratadine) and Allegra® (fexofenadine) tend to be safer and better tolerated.
For allergy sufferers with heart disease, medicines such as Allegra, Zyrtec or Claritin should be safe. However, medicines containing decongestants — including Allegra-D, Zyrtec-D and Claritin-D — could increase your blood pressure and heart rate or interfere with your heart medication.
Antihistamines are generally viewed as safe, even for people with heart disease or high blood pressure. However, the FDA does state that antihistamines could elevate heart rate and blood pressure temporarily.
Severe Side Effects
If you experience any of the following after taking Zyrtec, call your doctor immediately: Rapid or irregular heartbeats. Hyperactivity.
Sandoz issued a voluntary recall of 1,023,430 units of Zyrtec (10 mg) capsules as a result of failed impurities and a specification being reported for impurity at the 21-month stability time point, according to an FDA Enforcement Report.
Claritin and Zyrtec are effective and safe for most people with minor allergies.
Mechanism of Injury. The cause of acute liver injury from cetirizine is not known. It is metabolized by the liver and a toxic metabolite may account for idiosyncratic injury.
The drowsiness and fatigue which may occur in a small percentage of patients may be more of a problem for the elderly because of the increased risk of bone fracture if they fall. Other medical problems common in elderly patients may contribute to sedation.
Cetirizine is unlikely to do you any harm if you take it for a long time. However it's best to take cetirizine only for as long as you need to. If you take it regularly over a long period there's a very small chance of severe itching if you stop treatment suddenly.
Antihistamines
Antihistamines are known to cause extreme drowsiness; however, in certain people, they can cause insomnia, excitability, anxiety, restlessness, and a rapid heart rate.
A decongestant eases congestion by constricting the blood vessels in your nasal passages. This dries up nasal mucus. But these medications can also abnormally stimulate the heart and blood vessels throughout the body. “This can cause an increase in blood pressure and heart rate, or skipped beats.
Rarely, they can cause acute self-limited liver injury. One study has reported a more serious long-term effect, a 3.5-fold increase in the risk of gliomas, a common type of brain tumor in patients with long-term antihistamine use for allergic conditions.
Many people using this medication do not have serious side effects. Tell your doctor right away if you have any serious side effects, including: difficulty urinating, fast/irregular/pounding heartbeat, shaking (tremor), mental/mood changes (such as anxiety, confusion, nervousness, restlessness), weakness.
In the drug realm, antihistamines such as diphenhydramine (Benadryl), chlorpheniramine (Chlor-Trimeton), cetirizine (Zyrtec), and loratadine (Claritin) can help with a stuffy nose are safe for the heart.
Newer antihistamines like fexofenadine, ceterizine and loratadine are all fairly safe for the heart, with fexofenadine seeming to be the absolute safest if you are at risk of arrythmia.
Cetirizine (applies to Zyrtec) renal/liver disease
Cetirizine is eliminated primarily by the kidney but also undergoes metabolism in the liver to some extent. Patients with renal and/or liver disease may be at greater risk for adverse effects from cetirizine due to decreased drug clearance.
Benadryl and older antihistamines
But first-generation antihistamines should be avoided in older adults in many cases. Because as we age, it's harder for our bodies to properly get rid of them. And higher doses may be needed for them to work. That can greatly raise your risk of side effects, including confusion.
I just noticed on the label that it says "not for over 65." Why is that? Now what do I use? Answer: They don't mean to imply that Zyrtec is not for folks over the age of 65. What they actually recommend is that if you're over 65, or if you have liver or kidney problems, you should ask your doctor if it's OK to use it.