Can you drink on Zyrtec? What the cetirizine label says

What the Zyrtec Allergy label says about alcohol

Each Zyrtec Allergy film-coated tablet lists cetirizine HCl 10 mg, an antihistamine, for temporary relief of runny nose, sneezing, itchy, watery eyes, and itching of the nose or throat due to hay fever or other upper respiratory allergies. Under "When using this product," the label says drowsiness may occur, avoid alcoholic drinks, alcohol, sedatives, and tranquilizers may increase drowsiness, and be careful when driving a motor vehicle or operating machinery. Ask a doctor or pharmacist before use if you take tranquilizers or sedatives. No line gives a number of hours to wait, or a number of drinks.

Adults and children 6 years and over: one 10 mg tablet once daily; do not take more than one 10 mg tablet in 24 hours. The 24-hour line caps tablets. The label does not call it a wait before alcohol. MedlinePlus lists Zyrtec as a cetirizine brand and calls cetirizine an antihistamine that blocks histamine. Its uses include allergy symptoms and hives. The tablet uses above do not list hives. MedlinePlus says alcohol can add to cetirizine's drowsiness and to avoid alcoholic beverages while taking it.

Sources: Zyrtec Allergy tablets: cetirizine HCl 10 mg Drug Facts; Cetirizine

Why the drowsiness warnings sit together

The label places "drowsiness may occur" next to "alcohol, sedatives, and tranquilizers may increase drowsiness." MedlinePlus lists drowsiness and excessive tiredness as side effects to tell a doctor about if they are severe or do not go away. No cited source prints a percentage for how much drowsiness increases.

NIAAA says alcohol, like some medicines, can make you sleepy, drowsy, or lightheaded, and that drinking while taking medicines can intensify these effects. Small amounts of alcohol can make it dangerous to drive. For Zyrtec (cetirizine), in the allergies, colds, and flu group, NIAAA names drowsiness, dizziness, and increased risk for overdose. That list does not include every medicine or every ingredient.

Sources: Zyrtec Allergy tablets: cetirizine HCl 10 mg Drug Facts; Cetirizine; Harmful interactions: mixing alcohol with medicines

Zyrtec-D is a different label

Each Zyrtec-D extended-release tablet lists cetirizine HCl 5 mg, an antihistamine, and pseudoephedrine HCl 120 mg, a nasal decongestant. Uses add nasal congestion, reduced swelling of nasal passages, sinus congestion and pressure, and freer breathing through the nose. The panel says drowsiness may occur, avoid alcoholic drinks, alcohol, sedatives, and tranquilizers may increase drowsiness, and do not use more than directed. No hours-to-wait figure is printed.

MedlinePlus covers cetirizine alone, lists Zyrtec-D as a combination brand, and says to read that package or ask a doctor or pharmacist. NIAAA says many cough, cold, and allergy remedies contain more than one ingredient that can react with alcohol. Age 12 and over: 1 tablet every 12 hours, not more than 2 in 24 hours, swallowed whole. Those hours are the dosing schedule, not a drinking wait.

Sources: Zyrtec-D extended-release tablets: cetirizine HCl 5 mg and pseudoephedrine HCl 120 mg Drug Facts; Cetirizine; Harmful interactions: mixing alcohol with medicines

Who the labels tell to ask a doctor or pharmacist

Do not use Zyrtec Allergy if you have ever had an allergic reaction to this product, any ingredient, or an antihistamine containing hydroxyzine. Ask a doctor before use for liver or kidney disease. Your doctor should determine if you need a different dose. Ask a doctor or pharmacist if you take tranquilizers or sedatives. Stop use and seek medical help right away if an allergic reaction occurs. Breast-feeding: not recommended. If pregnant, ask a health professional. Directions say ask a doctor at age 65 and over, under age 6, and for liver or kidney disease. Overdose: call Poison Control at 1-800-222-1222.

MedlinePlus says to tell your doctor about kidney or liver disease and pregnancy or breast-feeding, and to call if you become pregnant while taking cetirizine. It also says severe itching can follow stopping cetirizine taken regularly for months or years. This film-coated label does not print that line. Call 911 if someone has collapsed, had a seizure, has trouble breathing, or cannot be awakened. Overdose symptoms may include restlessness, irritability, and drowsiness.

Zyrtec-D says ask a doctor for heart disease, thyroid disease, diabetes, glaucoma, high blood pressure, trouble urinating due to an enlarged prostate, or liver or kidney disease. Do not use it with a prescription MAOI (certain drugs for depression, psychiatric or emotional conditions, or Parkinson's disease), or for 2 weeks after stopping one. Stop and ask a doctor if you get nervous, dizzy, or sleepless, or if symptoms do not improve within 7 days or come with fever. It does not describe a separate alcohol effect for pseudoephedrine. NIAAA says older people are at particularly high risk for harmful alcohol-medication interactions. Ask a pharmacist.

Sources: Zyrtec Allergy tablets: cetirizine HCl 10 mg Drug Facts; Zyrtec-D extended-release tablets: cetirizine HCl 5 mg and pseudoephedrine HCl 120 mg Drug Facts; Cetirizine; Harmful interactions: mixing alcohol with medicines

Antihistamines are not a hangover treatment on these labels

Hangover is not a Zyrtec Allergy use, and MedlinePlus does not describe one either. Antihistamines on these pages are not a hangover treatment. See hangover cure myths, Advil or Tylenol for a hangover, and Pepto-Bismol for a hangover.

Sources: Zyrtec Allergy tablets: cetirizine HCl 10 mg Drug Facts; Cetirizine; Harmful interactions: mixing alcohol with medicines

How to read the warning

NIAAA says alcohol and medicines can interact harmfully even if they are not taken at the same time. Azithromycin is a different label: can you drink on a Z-Pack.

• No cited source prints a number of hours to wait. Ask a pharmacist.
• Confusion, vomiting while barely responsive, slow or irregular breathing, or a person you cannot wake: call 911. That is alcohol poisoning, not a hangover.

Sources: Zyrtec Allergy tablets: cetirizine HCl 10 mg Drug Facts; Cetirizine; Harmful interactions: mixing alcohol with medicines; Understanding the dangers of alcohol overdose

Where Joyrise fits, and where it does not

These labels are not Joyrise directions. Joyrise is an Alcohol Metabolizing Aid: a DHM supplement built around dihydromyricetin. The capsule label says to take 3 capsules while consuming alcohol, or before bed. Do not exceed 3 servings (9 capsules) per day. Much of the alcohol-related DHM evidence is preclinical, and Joyrise does not lower BAC, reverse impairment, or make driving safe. Read the full directions and warnings on our Alcohol Metabolizing Aid capsules page before you buy.

Sources: Joyrise capsules: product page and current label; Shen et al., 2012: DHM and alcohol-related signaling