Objective: This review is written to summarize the present state of knowledge on the use of cetirizine in dermatologic disorders, its efficiency, and concerns regarding the safety of the drug.
Data sources and study selection: A Medline search from 1980 until August 1997 was conducted. In addition, older literature especially concerning hydroxyzine was evaluated as well. The review considers all double-blind trials and in addition focuses on all information regarding the pharmacology and possible side effects of the drug.
Results: Peak plasma levels are reached within 1 hour after intake. Drug elimination occurs largely unchanged by renal excretion and drug interactions are not known. Cetirizine has no cardiac toxicity. No evidence for teratogenicity has been found. Possible adverse events include somnolence but are dose-dependent and mostly mild. At the dose of 10 mg no impairment of driving performance or response time was observed. In dermatology, cetirizine has proven to be effective in the treatment of various forms of urticaria and it reduces the pruritus of atopic eczema. For these conditions, frequently doses higher than 10 mg (up to 40 mg) are recommended to achieve the best benefit. In other pruritic dermatoses, cetirizine has been reported to be helpful but, with the exception of mosquito bites where 10 mg daily had a significant effect, controlled studies are missing.
Conclusions: Cetirizine is a safe second generation antihistamine. It is effective especially in the treatment of urticaria and reduces significantly the pruritus of atopic dermatitis. An individual dosage should be chosen based on the severity of symptoms.