Cetirizine

Cetirizine
Clinical data
Pronunciation/sɛˈtɪrɪziːn/
Trade namesAllacan, Piriteze, Zyrtec, others
AHFS/Drugs.comMonograph
MedlinePlusa698026
License data
Pregnancy
category
  • AU: B2
Routes of
administration		By mouth
ATC code
Legal status
Legal status
Pharmacokinetic data
BioavailabilityWell-absorbed (>70%)[1]
Protein binding88–96%[1]
MetabolismMinimal (non-cytochrome P450-mediated)[3][2]
Onset of action20–42 minutes[2]
Elimination half-lifeMean: 8.3 hours[3][2]
Range: 6.5–10 hours[4]
Duration of action≥24 hours[4]
ExcretionUrine: 70–85%[3]
Feces: 10–13%[3]
Identifiers
  • (±)-[2-[4-[(4-Chlorophenyl)phenylmethyl]-1-piperazinyl]ethoxy]acetic acid
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.223.545 Edit this at Wikidata
Chemical and physical data
FormulaC21H25ClN2O3
Molar mass388.89 g·mol−1
3D model (JSmol)
  • Clc1ccc(cc1)C(c2ccccc2)N3CCN(CC3)CCOCC(=O)O
  • InChI=1S/C21H25ClN2O3/c22-19-8-6-18(7-9-19)21(17-4-2-1-3-5-17)24-12-10-23(11-13-24)14-15-27-16-20(25)26/h1-9,21H,10-16H2,(H,25,26) checkY
  • Key:ZKLPARSLTMPFCP-UHFFFAOYSA-N checkY
  (verify)

Cetirizine is a second-generation antihistamine used to treat allergic rhinitis (hay fever), dermatitis, and urticaria (hives).[5] It is taken by mouth.[6] Effects generally begin within thirty minutes and last for about a day.[6] The degree of benefit is similar to other antihistamines such as diphenhydramine, which is a first-generation antihistamine.[6]

Common side effects include sleepiness, dry mouth, headache, and abdominal pain.[6] The degree of sleepiness that occurs is generally less than with first-generation antihistamines because second-generation antihistamines are more selective for the H1 receptor.[7][5] Compared to other second-generation anti-histamines, cetirizine can cause drowsiness.[7] Among second-generation antihistamines, cetirizine is more likely than fexofenadine and loratadine to cause drowsiness.[8]

Use in pregnancy appears safe, but use during breastfeeding is not recommended.[9] The medication works by blocking histamine H1 receptors, mostly outside the brain.[6]

Cetirizine can be used for paediatric patients. The main side effect to be cautious about is somnolence.[10]

It was patented in 1983[11][12] and came into medical use in 1987.[13] It is on the World Health Organization's List of Essential Medicines.[14] It is available as a generic medication.[5] In 2022, it was the 43rd most commonly prescribed medication in the United States, with more than 13 million prescriptions.[15][16]

  1. ^ a b Chen C (2008). "Physicochemical, pharmacological and pharmacokinetic properties of the zwitterionic antihistamines cetirizine and levocetirizine". Current Medicinal Chemistry. 15 (21): 2173–2191. doi:10.2174/092986708785747625. PMID 18781943.
  2. ^ a b c Cite error: The named reference pmid10384858 was invoked but never defined (see the help page).
  3. ^ a b c d Cite error: The named reference pmid14680442 was invoked but never defined (see the help page).
  4. ^ a b Simons FE (December 2002). "Comparative pharmacology of H1 antihistamines: clinical relevance". The American Journal of Medicine. 113 (Suppl 9A): 38S–46S. doi:10.1016/s0002-9343(02)01436-5. PMID 12517581.
  5. ^ a b c British national formulary : BNF 76 (76 ed.). Pharmaceutical Press. 2018. p. 279. ISBN 9780857113382.
  6. ^ a b c d e "Cetirizine Hydrochloride Monograph for Professionals". Drugs.com. American Society of Health-System Pharmacists. Archived from the original on 28 August 2021. Retrieved 3 March 2019.
  7. ^ a b Slater JW, Zechnich AD, Haxby DG (January 1999). "Second-generation antihistamines: a comparative review". Drugs. 57 (1): 31–47. doi:10.2165/00003495-199957010-00004. PMID 9951950. S2CID 46984477.
  8. ^ Cite error: The named reference PMID9951950 was invoked but never defined (see the help page).
  9. ^ "Cetirizine Pregnancy and Breastfeeding Warnings". Drugs.com. Archived from the original on 6 March 2019. Retrieved 3 March 2019.
  10. ^ Zhou P, Jia Q, Wang Z, Zhao R, Zhou W (25 August 2022). "Cetirizine for the treatment of allergic diseases in children: A systematic review and meta-analysis". Frontiers in Pediatrics. 10: 940213. doi:10.3389/fped.2022.940213. PMC 9452751. PMID 36090559.
  11. ^ Cite error: The named reference :0 was invoked but never defined (see the help page).
  12. ^ US4525358A, Baltes, Eugene; Lannoy, Jean de & Rodriguez, Ludovic, "2-[4-(Diphenylmethyl)-1-piperazinyl]-acetic acids and their amides", issued 1985-06-25 
  13. ^ Fischer J, Ganellin CR (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 549. ISBN 9783527607495. Archived from the original on 8 October 2022. Retrieved 19 September 2020.
  14. ^ World Health Organization (2023). The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023). Geneva: World Health Organization. hdl:10665/371090. WHO/MHP/HPS/EML/2023.02.
  15. ^ "The Top 300 of 2022". ClinCalc. Archived from the original on 30 August 2024. Retrieved 30 August 2024.
  16. ^ "Cetirizine Drug Usage Statistics, United States, 2013 - 2022". ClinCalc. Retrieved 30 August 2024.