Can You Take Zyrtec-D Every Day?

Answer

Thanks for your question! While taking Zyrtec-D every day for a short period of time (1 to 2 weeks) is generally considered to be safe for most individuals, there are some concerns with very long-term use.

We have to remember here that Zyrtec-D contains two drugs:

• Cetirizine
• Pseudoephedrine

Cetirizine is a second-generation antihistamine, similar to Claritin (loratadine) and Allegra (fexofenadine) while pseudoephedrine is a nasal decongestant.

Antihistamines like cetirizine are fine to take long-term and extended use isn't thought to cause any negative consequences.

Pseudoephedrine does have some concerns with long-term use and is really only intended to be used for a short period of time to help alleviate symptoms that may be caused by an acute illness (like a cold) or allergies.

Long-term use of pseudoephedrine shouldn't cause any kind of addiction, dependence, or 'rebound congestion'. The concern lies more with the fact that nasal decongestants, in general, are associated with cardiovascular risk, in addition to some other concerns in older men (which I discuss more below).

Concerns With Long-Term Pseudoephedrine Use

As mentioned, the concern with the long-term use of pseudoephedrine lies mostly with its association with cardiovascular risk.

While results from studies are certainly mixed, it has been associated with causing mild increases in blood pressure and heart rate, which would be of concern if you have been diagnosed with high blood pressure (i.e., hypertension) or other cardiac conditions, such as heart failure, cardiomyopathy, and cardiac arrhythmias.

Most medical guidelines for the treatment of high blood pressure recommend limiting the use of nasal decongestants, or avoiding them altogether if your blood pressure is uncontrolled:

Use for shortest duration possible, and avoid in severe or uncontrolled hypertensionConsider alternative therapies (eg, nasal saline, intranasal corticosteroids, antihistamines) as appropriate.

If your blood pressure is well-controlled, pseudoephedrine is generally considered safe, but, again, small changes in blood pressure can occur so it is often only recommended to use for a short period of time.

Another concern with long-term pseudoephedrine use is that in older men, it can worsen symptoms of BPH (benign prostatic hyperplasia) by causing contraction of the bladder neck, and prostate. It can also interfere with a class of medication that is used to treat an enlarged prostate, 'alpha blockers'. Pseudoephedrine stimulates alpha receptors, negating how alpha blockers work.

Considerations And Alternatives

If you find yourself needing a nasal decongestant every single day for a long period of time, it is important to talk to your doctor about what is causing your symptoms, so you can be appropriately treated.

If it is something like allergies, an antihistamine alone (not in combination with pseudoephedrine) may work well enough. Nasal steroids, like Nasacort, Flonase or Nasonex are also alternative options that aren't associated with the negative cardiovascular effects that pseudoephedrine is.

Final Words

I hope you found this answer helpful.

On the whole, Zyrtec-D is perfectly fine to take for a week or two for most individuals. An antihistamine alone is considered safe for long-term use but it's the pseudoephedrine that is the concern.

Taking a decongestant for longer than a few weeks is an indication to me that you need to be evaluated to find the underlying cause of your symptoms.