Citruzine tablet
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Citruzine cetirizine tablet uses dosage side effects
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Here is a complete overview of Citruzine (Cetirizine) Tablet:
Citruzine Tablet (Cetirizine HCl)
Citruzine is a brand name for cetirizine hydrochloride, a second-generation H1 antihistamine of the piperazine class. It is the active metabolite of hydroxyzine.
Drug Class & Mechanism
- Class: Second-generation (non-sedating) H1 receptor antagonist / inverse agonist
- Mechanism: Competitively blocks peripheral H1 histamine receptors, preventing histamine from binding to smooth muscle, immune cells, and vascular endothelium. It also has mast cell-stabilizing and anti-inflammatory properties.
- Unlike first-generation antihistamines, cetirizine has negligible penetration into the brain (minimal CNS effects) and minimal anticholinergic activity.
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- Goodman & Gilman's Pharmacological Basis of Therapeutics, Ch. 43
Available Forms
- Tablet: 5 mg, 10 mg
- Oral solution / syrup
- Chewable tablet
- Combination tablet with pseudoephedrine (for nasal congestion)
Indications (Uses)
| Condition | Details |
|---|---|
| Seasonal allergic rhinitis (hay fever) | Sneezing, runny/itchy nose, watery eyes |
| Perennial allergic rhinitis | Year-round allergy symptoms (dust mites, pet dander) |
| Chronic idiopathic urticaria (hives) | Itching, wheals, swelling |
| Allergic conjunctivitis | Itchy, watery eyes |
| Atopic dermatitis | Pruritus relief |
| Acute allergic reactions | As adjunct (with diphenhydramine) |
| Angioedema | Swelling due to histamine release |
Cetirizine provides prolonged wheal-and-flare suppression: 6 days of daily use results in 7 days of suppression after stopping.
- Fitzpatrick's Dermatology, "Second-Generation H1 Antihistamines"
Dosage
| Patient Group | Dose |
|---|---|
| Adults & children ≥12 yr | 10 mg once daily |
| Children 6-11 yr | 5-10 mg once daily |
| Children 2-5 yr | 2.5-5 mg once daily |
| Children < 2 yr | Not recommended (FDA warning re: increased fatality risk) |
| Hepatic impairment (≥12 yr) | Reduce to 5 mg once daily |
| Renal impairment | Dose adjustment required (see prescribing information) |
- Can be taken with or without food.
- Maximum dose: 10 mg per 24 hours.
- The Harriet Lane Handbook (23rd ed.), p. 1073
Side Effects
Common (mild):
- Drowsiness / sedation (more than other second-generation agents, but less than first-generation)
- Headache
- Dry mouth
- Fatigue / tiredness
- Nausea, abdominal pain
- Diarrhea (especially in children)
- Sore throat, pharyngitis
Serious (rare):
- Aggressive reactions / convulsions
- Fast or pounding heartbeat
- Severe allergic reaction (rash, swelling, difficulty breathing)
- Urinary retention
- Confusion, tremors
Citruzine has NOT been implicated in causing cardiac arrhythmias when used with drugs metabolized by hepatic enzymes (e.g., ketoconazole, erythromycin) - unlike some first-generation antihistamines.
- Harriet Lane Handbook (23rd ed.)
Drug Interactions
| Interacting Agent | Effect |
|---|---|
| Alcohol | Increased drowsiness |
| Sedatives / benzodiazepines | Enhanced sedation |
| Other antihistamines | Additive side effects |
| CNS depressants | Increased CNS depression |
Special Populations
- Pregnancy: Category B (relatively safe; risk not ruled out - use with caution)
- Breastfeeding: Use with caution; excreted in breast milk
- Elderly: Use lower dose; increased risk of sedation and urinary retention
- Renal impairment: Dose reduction required (cetirizine is renally excreted)
- Hepatic impairment: Reduce to 5 mg/day for adults
Key Advantages Over First-Generation Antihistamines
- Once-daily dosing (longer half-life)
- Less sedation (though slightly more sedating than loratadine/fexofenadine)
- No significant anticholinergic effects (less dry mouth, urinary retention, tachycardia)
- No cardiac arrhythmia risk
- Additional anti-inflammatory and mast cell-stabilizing effects
The active enantiomer, levocetirizine (Xyzal), has slightly greater potency and can be used at half the dose (5 mg) with potentially less sedation.
- Goodman & Gilman's, Ch. 43
Contraindications
- Known hypersensitivity to cetirizine, hydroxyzine, or any component of the formulation
- End-stage renal disease (CrCl < 10 mL/min)
- Cetirizine capsules containing soya oil: avoid in peanut/soya allergy
Bottom line: Citruzine (cetirizine) is a safe, effective, once-daily antihistamine widely used for allergic rhinitis and urticaria. It works fast, lasts 24 hours, and has a favorable safety profile. The most notable caution is mild drowsiness in some patients - avoid driving if affected.
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