In March of 2025 FDA issued a warning about a rare but severe itching reaction (pruritus) that can occur after stopping long-term use of anti-allergy medications cetirizine (Zyrtec) or levocetirizine (Xyzal). While this reaction is uncommon, it has significantly impacted some individuals, causing widespread and severe itching that can interfere with daily life.
Recommendations for Patients:
- Be aware of the risk: If you’ve been using cetirizine or levocetirizine daily for months or years, know that stopping suddenly may trigger severe itching. This reaction was typically seen within days of stopping the medication.
- Consider a gradual tapering approach: While tapering hasn’t been formally studied, some patients have reported that gradually reducing their dosage helped minimize withdrawal-related itching.
- Monitor your symptoms: If you’re planning to discontinue long-term use of either of these medications, pay attention to any new symptoms and be aware of the likelihood that your allergy symptoms can recur with greater severity once the medication is stopped.
- Consult a healthcare professional: If you experience intense itching after stopping these medications, speak with your doctor. Restarting the medicine has been shown to relieve symptoms for many individuals. You can then plan to slowly taper off the medication.
- Explore alternative allergy treatments: If you rely on cetirizine or levocetirizine for allergy relief, I highly suggest exploring integrative therapies to reduce symptoms. Various lifestyle modifications, dietary changes, and natural antihistamine options such as vitamin c and quercetin are options.
- As always, look for root causes when chronic severe allergies are an issue. Know that mold exposure is one of the common (reversible) factors that can cause or exacerbate seasonal allergies.
This FDA warning is a reminder that even everyday allergy medications can have unexpected effects, especially when used long-term. Instead of relying solely on antihistamines, consider a more integrative approach—supporting your body’s natural defenses, reducing inflammation, and exploring Integrative and Functional alternatives like nutrition, lifestyle and environmental adjustments.
If you have additional questions about root cause approaches for solving chronic allergies, don’t hesitate to reach out for an appointment.
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