Drugs Q & A

Is Zyrtec Safe During Pregnancy?

Pregnancy may be complicated by new-onset or pre-existing allergic diseases, including rhinitis, urticaria, angioedema, or atopic dermatitis (AD). Many pregnant women know the feeling of a stuffy nose, itchy eyes, and post-nasal drip that seem to come out of nowhere during pregnancy. While it’s not a life-threatening medical condition, pregnancy rhinitis can be very troublesome.

During your pregnancy, you might find you are more sensitive to hay fever and other allergies. While they won’t harm you or your baby, they can have an impact on your general wellbeing – giving you a stuffy nose and causing sneezing or lack of sleep.  Symptoms of pregnancy rhinitis are similar to those of allergic rhinitis (‘hay fever’) and include a runny, itchy, or congested nose, sneezing, and watery eyes.

There are several medications that can help manage this condition. Some medicines are considered safe during pregnancy, but the effects of other medicines on your unborn baby are unknown. Certain medicines can be most harmful to a developing baby when taken during the first three months of pregnancy, often before a woman even knows she is pregnant.

It can be hard to know if a medicine is safe for your baby. Most medicines are not studied in pregnant women. That’s because researchers worry about how the medicines might affect the baby. But some medicines have been taken for so long by so many women that doctors have a good idea of how safe they are.

What is Zyrtec?

Zyrtec is a brand of cetirizine, a second-generation antihistamine that reduces the natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and a runny nose.

Zyrtec is used to treat cold or allergy symptoms such as sneezing, itching, watery eyes, or runny nose.

Zyrtec is also used to treat an allergic reaction, itching, and swelling caused by chronic urticaria (hives) and minimizes or eliminates the symptoms of perennial allergic rhinitis, seasonal allergic rhinitis, chronic idiopathic urticaria, allergic asthma, physical urticaria, and atopic dermatitis.

How should Zyrtec be used?

Zyrtec comes as a tablet, a chewable tablet, an extended-release tablet, and a syrup (liquid) to take by mouth. It is usually taken once a day with or without food. Take Zyrtec at around the same time every day. Follow the directions on your package label carefully, and ask your doctor or pharmacist to explain any part you do not understand.

Typical dosing for Zyrtec is as follows:

Adults and children 6 years and older: 5 mg to 10 mg by mouth once daily, depending on how severe your allergy symptoms are. You can take at most 10 mg in 24 hours.

Adults 65 years and older: 5 mg by mouth once daily. You can take at most 5 mg in 24 hours unless a healthcare provider has recommended otherwise.

Children 2 to 5 years of age: 2.5 mg by mouth once daily. If needed, you can take at most 5 mg in 24 hours, given as 2.5 mg by mouth every 12 hours.

Children under 2 years of age: Ask your provider to see if this medication is appropriate.

Take Zyrtec exactly as directed. Do not take more or less of it or take it more often than directed on the package label or as recommended by your doctor.

Do not use Zyrtec to treat hives that are bruised or blistered, that are an unusual color, or that do not itch. Call your doctor if you have these types of hives.

Stop taking Zyrtec and call your doctor if your hives do not improve during the first 3 days of your treatment or if your hives last longer than 6 weeks. If you do not know the cause of your hives, call your doctor.

If you are taking Zyrtec to treat hives, and you develop any of the following symptoms, get emergency medical help right away: difficulty swallowing, speaking, or breathing; swelling in and around the mouth or swelling of the tongue; wheezing; drooling; dizziness; or loss of consciousness. These may be symptoms of a life-threatening allergic reaction called anaphylaxis. If your doctor suspects that you may experience anaphylaxis with your hives, he may prescribe an epinephrine injector (EpiPen). Do not use cetirizine in place of the epinephrine injector.

Is Zyrtec safe during pregnancy?

Yes, Zyrtec is considered relatively safe for pregnant women to take during pregnancy as there is no good evidence that it causes harm to the baby. Studies on a small number of pregnancies did not find a higher chance for birth defects, preterm delivery (having the baby before 37 weeks), or low birth weight.

Although current evidence indicates that antihistamines like Zyrtec are well-tolerated during pregnancy, data regarding fetal safety are inconclusive. This drug should not be used during pregnancy unless the benefit outweighs the risk to the fetus.

Talk to your doctor or healthcare provider before you take Zyrtec if you are pregnant or planning to become pregnant, or if you’re breastfeeding.

Side Effects of Zyrtec

Common side effects of Zyrtec include:

•          constipation, or

•          cough,

•          dizziness,

•          drowsiness,

•          dry mouth,

•          fatigue,

•          headache.

•          nausea,

•          sore throat,

•          tired feeling,

In children, side effects of Zyrtec include:

•          stomach pain and

•          vomiting.

The side effect of sleepiness may occur when taking Zyrtec, so do not drive a car or operate potentially dangerous machinery.

Interactions with Zyrtec

Zyrtec does interact with other substances.

For example, avoid consuming alcoholic drinks while you take Zyrtec. Doing so may be dangerous. Mixing Zyrtec with alcohol can cause drowsiness or make you less alert.

If you take any type of tranquilizer, sedative, or sleep aid, make sure to mention this to your doctor before you use Zyrtec.

Mixing Zyrtec with drugs that depress your central nervous system can increase sleepiness. It can also further affect your mental and nervous system functions.

There is a possibility of a drug interaction between Zyrtec and theophylline. Theophylline (Theo-24) is a drug that some people with asthma and other lung problems take.

In some instances when the two drugs were taken, it took longer for Zyrtec to leave the body. However, the interaction may be dose-related. It has only been reported with daily theophylline doses of 400 mg or more.

Talk to your doctor if you take theophylline and are considering Zyrtec.


Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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