FDA Flags Severe Itching Risk in Zyrtec, Xyzal Withdrawal After Long-Term Use

The U.S. Food and Drug Administration (FDA) has raised a red flag about two popular allergy medications, cetirizine (Zyrtec) and levocetirizine (Xyzal), warning that long-term users who stop taking them may face a rare but intense side effect: severe itching, known as pruritus. This isn’t your garden-variety itch—this is the kind that can disrupt your life, demanding medical attention and, in some cases, a swift return to the medication to find relief.

The FDA’s alert, based on 209 reported cases worldwide (197 in the U.S.) from April 2017 to July 2023, highlights that this reaction tends to strike those who’ve been using these antihistamines daily for months or years. While the numbers are small, the impact isn’t—patients described widespread, debilitating itching that threw a wrench into their daily routines. For 90% of cases, restarting the medication stopped the scratching frenzy, and 38% found success by gradually tapering off after resuming.

These drugs, available both over-the-counter and by prescription, are go-to solutions for seasonal allergies in adults and kids as young as two, as well as year-round allergies and chronic hives for those six months and older. But the FDA is now pushing for updated labeling to warn about this withdrawal risk, urging users to consult healthcare providers before going cold turkey, especially after long-term use.

Dr. Marc Siegel, a clinical professor at NYU Langone Health, noted that these medications are highly effective for allergy relief but suggested the itching could stem from a sudden surge of histamine once the drugs are stopped. Other side effects like drowsiness, dry mouth, or diarrhea are well-known, but this withdrawal itch is a rare curveball. The Consumer Healthcare Products Association and Xyzal’s manufacturer, Opella, emphasized consumer safety and the drugs’ strong track record, urging users to talk to their doctors before making changes.

For now, if you’re popping Zyrtec or Xyzal like clockwork, don’t ditch them without a plan. A quick chat with your doctor could save you from scratching your way into a frenzy.