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Cetirizine is a widely used antihistamine for managing allergy symptoms. While generally considered safe, certain risks are associated with its use, particularly in specific populations and under certain conditions.

A notable concern is the occurrence of severe itching, known as pruritus, after discontinuing long-term use of cetirizine. This rare reaction has been reported in individuals who used the medication daily for several months or years and then stopped. The itching typically begins within a few days after cessation and can be severe enough to require medical attention. In response, the FDA has updated prescribing information to include a warning about this risk. Patients planning to use cetirizine for extended periods should discuss potential benefits and risks with their healthcare provider.

Additionally, cetirizine may cause drowsiness, which can impair alertness and coordination. This effect is more pronounced when combined with alcohol or other central nervous system depressants. Individuals should avoid driving or operating heavy machinery until they understand how cetirizine affects them.

Certain groups should exercise caution when using cetirizine. Older adults and those with kidney or liver impairments may experience heightened effects due to slower drug clearance. Healthcare providers may adjust dosages or recommend alternative treatments for these individuals.

While cetirizine is generally safe during pregnancy, its use during breastfeeding is not recommended, as the drug can pass into breast milk. Pregnant or nursing mothers should consult their healthcare provider before using cetirizine.

In rare instances, cetirizine has been associated with liver injury. Although such cases are uncommon and typically resolve upon discontinuation of the drug, individuals should be aware of this potential risk.

Before starting cetirizine, it's essential to discuss your medical history and any other medications you're taking with your healthcare provider to ensure it's an appropriate choice for you.

When taking cetirizine for allergy relief, it's important to be aware of potential interactions with other substances that can enhance side effects or reduce the medication's effectiveness. Cetirizine may cause drowsiness, and combining it with certain medications or alcohol can intensify this effect.

Alcohol: Consuming alcohol while on cetirizine can increase drowsiness and decrease alertness. It's advisable to avoid alcohol during treatment to prevent these effects.

Other Medications: Combining cetirizine with other substances that cause drowsiness can enhance this side effect. These include:

• Benzodiazepines: Medications like Alprazolam (Xanax) and Lorazepam (Ativan) used for anxiety or sleep disorders.

• Opioids: Pain relievers such as Oxycodone (OxyContin) and hydrocodone (Vicodin).

• Sleep Aids: Drugs like Zolpidem (Ambien) and Eszopiclone (Lunesta).

• Muscle Relaxants: Medications including Cyclobenzaprine and Baclofen.

• Other Antihistamines: Such as diphenhydramine (Benadryl) and chlorpheniramine (Chlor-Trimeton).

Using cetirizine alongside these substances can lead to increased drowsiness, dizziness, and impaired coordination. It's important to consult with a healthcare provider before combining cetirizine with any of these medications.

Theophylline: This medication, used for asthma and other lung conditions, can interfere with the metabolism of cetirizine, potentially increasing its levels in the blood and the risk of side effects. If you're taking theophylline, inform your healthcare provider before starting cetirizine.

Herbal Supplements: Certain herbs, like valerian, which are used to promote sleep, can enhance the sedative effects of cetirizine. It's advisable to consult with a healthcare provider before combining cetirizine with any herbal supplements.

To minimize the risk of interactions, always inform your healthcare provider about all medications, supplements, and substances you are currently using before starting cetirizine.