Pruritus after discontinuation of cetirizine

Abstract

Background: Intense pruritus or itching emerging after discontinuation of cetirizine has been the subject of postmarketing reports submitted to the U.S. Food and Drug Administration (FDA), published in the medical literature, and discussed on the internet. To better understand and further investigate this adverse event, we analyzed cases of pruritus occurring after discontinuation of cetirizine in the FDA Adverse Event Reporting System (FAERS) database and medical literature. Methods: We conducted a retrospective study to identify and describe cases of pruritus occurring after discontinuation of cetirizine in the FAERS database and medical literature through April 24, 2017. Data collected from the reports included demographic information, reason for use, serious outcome, report source, duration of cetirizine use, time to onset of pruritus after cetirizine discontinuation, presence of associated urticaria, treatment for pruritus, concomitant comorbidities and medications associated with pruritus, rechallenge information, and patient outcome information. Results: We identified 146 cases of pruritus after discontinuation of cetirizine. Reporting frequency increased starting in 2008. The median patient age was 38 years ( n = 141), ranging from 6 to 71 years, and cases were predominantly reported in females ( n = 110). Most cases ( n = 115) were submitted directly to the FDA from consumers or healthcare providers. The median duration of use of cetirizine prior to discontinuation was 24 months ( n = 130), ranging from 0.3 to 172.2 months. The median time to onset of pruritus from discontinuation was 2 days ( n = 91), ranging from 0.5 to 5 days. Of the 55 cases that reported discontinuation of cetirizine again after restarting, 54 reported pruritus recurrence. Conclusions: Our case series provided evidence of an association between the discontinuation of cetirizine and the development of pruritus. The mechanism by which cetirizine causes pruritus upon discontinuation is unknown. Patients and prescribers should have knowledge of this adverse event, given the widespread use and availability of cetirizine, and potential impact on patient quality of life.

CpG Adjuvant in Allergen-Specific Immunotherapy: Finding the Sweet Spot for the Induction of Immune Tolerance

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A Review on the Natural Treatments of Allergic Rhinitis

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“…Furthermore, consistently utilizing one antihistamine can lead to the development of tolerance to the treatment and even withdrawal upon stopping. 7 As such, this paper will focus on three alternatives to current over-the-counter (OTC) pharmacotherapy, butterbur, astragalus membranaceus, and tinospora cordifolia, to determine the potential of herbal treatments of allergic rhinitis, especially since they are often less expensive and incur fewer side effects. A review of various studies and trials will be conducted to determine the efficacy of the herbs and to analyze whether or not it is advantageous to OTC medications.…”

Influences of Bifid Triple Viable Capsules Plus Cetirizine on Gut Microbiota and Immune Function in Children with Eczema

“… 13 However, after drug withdrawal, the allergy is easy to recur, which will induce itching again. 14 Another drug, bifid triple viable capsules, is composed of Bifidobacterium, Lactobacillus and Enterococcus , which has been shown to be effective against diarrhea caused by GMB disturbances or enteritis and has been approved by the State Food and Drug Administration of China as a nonprescription drug. 15 Pharmacological studies have shown that bifid triple viable, given orally, can alleviate intestinal inflammations via regulating beneficial and harmful flora like Lactobacillus and Escherichia coli .…”