A non-drowsy antihistamine available over the counter. When it stops working, the missing piece is usually a nasal spray.
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Cetirizine is a second-generation antihistamine. It blocks the H1 histamine receptor, which is what drives sneezing, itching, watery eyes and runny nose in an allergic reaction.
Second-generation means it crosses into the brain far less than older antihistamines such as chlorphenamine, so it causes considerably less drowsiness — though cetirizine is the most sedating of the modern ones, and a minority of people do feel it.
It is available over the counter.
Once daily. If it makes you at all drowsy, take it in the evening.
With or without food.
For hay fever, start before the season rather than after symptoms begin. Antihistamines work considerably better preventing histamine release than mopping up after it — starting two weeks ahead of your usual trigger period makes a real difference.
For chronic hives, doses above the standard one are sometimes used under medical supervision. Do not do this unsupervised.
Generally well tolerated. Drowsiness in a minority, dry mouth, headache, and occasionally fatigue.
It is much less sedating than older antihistamines, but if you do feel drowsy, do not drive. The legal position on driving while impaired applies to over-the-counter medicines exactly as it does to prescribed ones.
Alcohol adds to any sedative effect.
Long-term daily use is generally considered safe, and many people with year-round allergy take it continuously for years.
Care in pregnancy and breastfeeding — generally considered acceptable where needed, but worth discussing.
An antihistamine is not treatment for anaphylaxis. Difficulty breathing, throat or tongue swelling, or collapse after an exposure needs adrenaline and 999 — not a tablet.
Few significant interactions. Alcohol and other sedating medicines increase drowsiness.
No routine monitoring is needed.
The useful clinical point is what to do when it is not enough. Where an antihistamine alone is not controlling symptoms, the missing element is almost always a steroid nasal spray — and either it has not been offered, or it is being used with poor technique. Sprays should be aimed slightly outward, away from the septum, without sniffing hard, and they take one to two weeks of consistent daily use to reach full effect. Most people use them wrongly and stop after four days.
Cetirizine itself is available over the counter and is inexpensive, so for straightforward hay fever there is often no need to pay for a consultation at all — and we would rather say that than take the fee.
A consultation is worth it when: antihistamines and a correctly used nasal spray are not controlling symptoms; symptoms are affecting sleep, work or exams; you need allergy testing to identify a trigger; hives are chronic and unexplained; or you want to discuss immunotherapy.
What we will not do is broad allergy panel testing in someone with no suggestive history. It produces false positives, unnecessary dietary restriction and no benefit — testing should follow the history, not replace it.
Anyone with a history of anaphylaxis needs specialist immunology assessment rather than blood testing alone, and we would refer.
This page is information, not an offer to supply.
This is one of the clearest examples of paying many times over for the same molecule.
Branded cetirizine can cost several pounds for a small pack. Supermarket and pharmacy own-brand cetirizine, containing exactly the same 10mg of the same drug, often costs well under a pound for thirty tablets.
There is no difference. Ask for the generic by name and ignore the packaging.
Pharmacies can sell larger pack sizes than the small ones on general sale, and the price per tablet drops sharply. If you take it every day through the season, ask at the counter rather than picking up the front-of-shop pack.
When antihistamines and a nasal steroid together are not controlling it, when symptoms are year-round rather than seasonal, or when it is affecting sleep, work or exam performance.
Cetirizine can be stopped at any time. There is no taper and no withdrawal in the usual sense.
Some people report itching for a few days after stopping long-term daily use. It is uncommon and settles.
Antihistamines work considerably better started a week or two before your usual trigger period than reached for once symptoms are established.
Daily through the season beats as-needed — taking one only on bad days is the commonest reason people conclude antihistamines do not work for them.
Sedating antihistamines such as chlorphenamine are still widely sold and are a poor choice for daytime use — the drowsiness affects driving and concentration well into the next day.
No. Own-brand cetirizine contains the same 10mg of the same drug and works identically.
The price difference can be tenfold or more, and it buys you nothing.
It is classed as non-sedating, but a minority of people do feel sleepy on it — more so than with loratadine or fexofenadine.
If it does, try taking it at night, or switch.
Yes, and through the season you should. Daily use is more effective than dosing on bad days only.
Long-term daily use is well established as safe.
Not without advice. Higher doses are sometimes used under supervision for chronic hives, but not for hay fever.
If one is not enough, the answer is usually a nasal spray, not a second tablet.
A steroid nasal spray. For nasal congestion specifically it outperforms any antihistamine tablet.
It needs two weeks of daily use and correct technique — most people give up before either.
Alcohol adds to any drowsiness. There is no direct interaction, but the combination is more sedating than either alone.
Loratadine and cetirizine are both generally considered acceptable in pregnancy and breastfeeding, though it is worth checking for your circumstances.
Untreated symptoms that stop you sleeping are not benign either.
Yes, in age-appropriate doses, and a liquid is available. Check the pack or ask a pharmacist for anyone under six.
Not for classic seasonal hay fever. The pattern is the diagnosis.
Testing is useful when symptoms are year-round, when a specific trigger needs confirming, or where immunotherapy is being considered — not as a routine purchase.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 24, 2026
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