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Cetirizine side effects: what 163,560 FDA adverse event reports show

Cetirizine Hydrochloride · Cetirizine Hydrochloride · 1,192 reaction terms · 1,115,689 drug–reaction co-reports · data 2026-09-14
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Drug class

Not stated in label

Brand names

Cetirizine Hydrochloride

openFDA label

Who reports

163,560 reports · 55% serious · 10,788 with death outcome · 72% female

openFDA FAERS counts, all years, deduplication not applied

Used for

Perennial Allergic Rhinitis: Cetirizine hydrochloride is indicated for the relief of symptoms associated with perennial allergic rhinitis due to allergens such as dust mites, animal dander and molds in children 6 to 23 months of age. Symptoms treated effectively include sneezing, rhinorrhea, postnasal discharge, nasal pruritus, ocular pruritus, and tearing.

FDA label, Indications and Usage

What it is

Cetirizine is a member of the class of piperazines that is piperazine in which the hydrogens attached to nitrogen are replaced by a (4-chlorophenyl)(phenyl)methyl and a 2-(carboxymethoxy)ethyl group respectively.

PubChem CID 2678 (ChEBI)

Boxed warning

None in the current label

How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled (related wording) 2Reporting / coding artifact 1Lab value / disease marker 7Not in label — unassessed 30
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only and flags pairs whose reports are unusually skewed by sex or come mostly from consumers rather than clinicians. 1,152 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Anti-cyclic citrullinated peptide antibody positive5,442433.3
409.7–458.2ROR 448.1 · χ² 526,347 / p <1e-300
97.9 EB05 95.7 · IC025 +6.6
3/3 methods agree
Lab value / disease markerserious PRR 102.8 · ♀ 100% (drug 72%) · 93% cliniciannot reported in cached trials
Swollen joint count increased2,279356.8
329.2–386.6ROR 361.8 · χ² 210,008 / p <1e-300
93.4 EB05 90.2 · IC025 +6.4
3/3 methods agree
Lab value / disease markerserious n=2,278 · ♀ 100% (drug 72%) · 96% cliniciannot reported in cached trials
Anti-cyclic citrullinated peptide antibody477328.2
276.7–389.3ROR 329.2 · χ² 42,886 / p <1e-300
91.0 EB05 84.4 · IC025 +6.2
3/3 methods agree
Lab value / disease markerserious n=477 · ♀ 100% (drug 72%) · 100% cliniciannot reported in cached trials
Cardiospasm397322.8
268.0–388.8ROR 323.6 · χ² 35,511 / p <1e-300
90.6 EB05 83.3 · IC025 +6.2
3/3 methods agree
Not in label — unassessedserious n=396not reported in cached trials
Rheumatic fever3,089316.3
296.1–337.9ROR 322.4 · χ² 275,346 / p <1e-300
90.4 EB05 87.7 · IC025 +6.4
3/3 methods agree
Not in label — unassessedserious n=3,088 · ♀ 100% (drug 72%) · 95% cliniciannot reported in cached trials
Pemphigus8,560289.0
278.1–300.2ROR 304.8 · χ² 743,055 / p <1e-300
88.0 EB05 86.5 · IC025 +6.4
3/3 methods agree
Not in label — unassessedserious PRR 92.4 · ♀ 100% (drug 72%)not reported in cached trials
Duodenal ulcer perforation4,996278.1
264.6–292.2ROR 286.8 · χ² 428,356 / p <1e-300
87.0 EB05 85.0 · IC025 +6.4
3/3 methods agree
Not in label — unassessedserious PRR 91.0 · ♀ 100% (drug 72%) · 94% cliniciannot reported in cached trials
Deep vein thrombosis postoperative1,299255.4
232.3–280.7ROR 257.4 · χ² 108,226 / p <1e-300
84.6 EB05 80.8 · IC025 +6.3
3/3 methods agree
Not in label — unassessedserious n=1,299 · ♀ 100% (drug 72%) · 94% cliniciannot reported in cached trials
Lupus vulgaris785252.1
223.3–284.6ROR 253.3 · χ² 65,078 / p <1e-300
84.2 EB05 79.3 · IC025 +6.2
3/3 methods agree
Not in label — unassessedserious n=785 · ♀ 100% (drug 72%) · 100% cliniciannot reported in cached trials
C-reactive protein564212.7
185.8–243.6ROR 213.5 · χ² 43,966 / p <1e-300
79.3 EB05 73.9 · IC025 +6.1
3/3 methods agree
Lab value / disease markerserious n=564 · ♀ 100% (drug 72%) · 100% cliniciannot reported in cached trials
Immunisation257188.2
155.1–228.4ROR 188.5 · χ² 19,046 / p <1e-300
75.4 EB05 68.0 · IC025 +5.8
3/3 methods agree
Not in label — unassessedserious n=255not reported in cached trials
Rheumatoid factor positive3,411187.0
177.4–197.2ROR 191.0 · χ² 253,120 / p <1e-300
75.6 EB05 73.5 · IC025 +6.2
3/3 methods agree
Lab value / disease markerserious n=3,409 · ♀ 100% (drug 72%) · 94% cliniciannot reported in cached trials
Grip strength135179.9
138.2–234.0ROR 180.0 · χ² 9,783 / p <1e-300
73.7 EB05 63.8 · IC025 +5.6
3/3 methods agree
Not in label — unassessedserious n=135 · ♀ 100% (drug 72%) · 100% cliniciannot reported in cached trials
Facet joint syndrome1,826177.8
165.6–190.9ROR 179.8 · χ² 132,621 / p <1e-300
74.0 EB05 71.2 · IC025 +6.1
3/3 methods agree
Not in label — unassessedserious n=1,826 · ♀ 100% (drug 72%) · 95% cliniciannot reported in cached trials
Vaginal flatulence171163.5
130.2–205.2ROR 163.6 · χ² 11,907 / p <1e-300
70.9 EB05 62.4 · IC025 +5.6
3/3 methods agree
Not in label — unassessedserious n=171 · ♀ 100% (drug 72%) · 100% cliniciannot reported in cached trials
Swollen joint count134154.0
119.6–198.2ROR 154.1 · χ² 9,065 / p <1e-300
69.0 EB05 59.7 · IC025 +5.5
3/3 methods agree
Not in label — unassessedserious n=134 · ♀ 100% (drug 72%) · 100% cliniciannot reported in cached trials
Hand deformity7,039150.1
145.0–155.3ROR 156.8 · χ² 474,372 / p <1e-300
68.8 EB05 67.5 · IC025 +6.1
3/3 methods agree
Not in label — unassessedserious PRR 78.3 · ♀ 100% (drug 72%) · 92% cliniciannot reported in cached trials
Palmoplantar keratoderma384147.1
126.9–170.4ROR 147.4 · χ² 25,554 / p <1e-300
68.0 EB05 62.4 · IC025 +5.8
3/3 methods agree
Not in label — unassessedserious n=384not reported in cached trials
Adjustment disorder with depressed mood1,046138.8
127.1–151.5ROR 139.7 · χ² 67,807 / p <1e-300
66.3 EB05 63.0 · IC025 +5.9
3/3 methods agree
Not in label — unassessedserious n=1,043 · ♀ 100% (drug 72%) · 96% cliniciannot reported in cached trials
Helicobacter infection4,960121.7
117.1–126.6ROR 125.5 · χ² 301,273 / p <1e-300
62.2 EB05 60.8 · IC025 +5.9
3/3 methods agree
Not in label — unassessedserious PRR 68.8 · ♀ 100% (drug 72%) · 93% cliniciannot reported in cached trials
Dislocation of vertebra1,024109.4
100.6–119.0ROR 110.1 · χ² 58,658 / p <1e-300
58.8 EB05 55.8 · IC025 +5.7
3/3 methods agree
Not in label — unassessedserious n=1,024 · ♀ 100% (drug 72%) · 95% cliniciannot reported in cached trials
Sleep disorder due to general medical condition, insomnia type2,78297.5
92.8–102.4ROR 99.2 · χ² 149,397 / p <1e-300
55.2 EB05 53.5 · IC025 +5.7
3/3 methods agree
Not in label — unassessedserious n=2,763 · ♀ 100% (drug 72%) · 94% cliniciannot reported in cached trials
Folliculitis4,36293.7
90.1–97.4ROR 96.2 · χ² 228,821 / p <1e-300
54.0 EB05 52.7 · IC025 +5.7
3/3 methods agree
Not in label — unassessedserious PRR 66.3 · ♀ 99% (drug 72%) · 94% cliniciannot reported in cached trials
X-ray abnormal74291.1
82.9–100.1ROR 91.5 · χ² 38,228 / p <1e-300
53.1 EB05 50.0 · IC025 +5.6
3/3 methods agree
Lab value / disease markerserious n=742 · ♀ 100% (drug 72%) · 100% cliniciannot reported in cached trials
Subcutaneous drug absorption impaired22187.3
73.5–103.7ROR 87.4 · χ² 11,059 / p <1e-300
51.6 EB05 46.2 · IC025 +5.3
3/3 methods agree
Not in label — unassessedserious n=220 · ♀ 100% (drug 72%) · 100% cliniciannot reported in cached trials
Retinitis67186.0
78.0–94.9ROR 86.4 · χ² 33,375 / p <1e-300
51.3 EB05 48.1 · IC025 +5.5
3/3 methods agree
Not in label — unassessedserious n=671 · ♀ 100% (drug 72%) · 100% cliniciannot reported in cached trials
Pericarditis6,45680.9
78.5–83.5ROR 84.2 · χ² 309,770 / p <1e-300
49.5 EB05 48.5 · IC025 +5.6
3/3 methods agree
Not in label — unassessedserious PRR 52.3 · ♀ 97% (drug 72%) · 91% cliniciannot reported in cached trials
Peripheral venous disease1,37667.2
62.9–71.7ROR 67.7 · χ² 58,341 / p <1e-300
44.0 EB05 42.1 · IC025 +5.4
3/3 methods agree
Not in label — unassessedserious n=1,373 · ♀ 100% (drug 72%) · 94% cliniciannot reported in cached trials
Synovitis6,16766.3
64.3–68.4ROR 68.9 · χ² 259,576 / p <1e-300
43.7 EB05 42.8 · IC025 +5.4
3/3 methods agree
Not in label — unassessedserious PRR 47.8 · ♀ 100% (drug 72%) · 93% cliniciannot reported in cached trials
Seronegative arthritis32952.9
46.5–60.2ROR 53.0 · χ² 11,740 / p <1e-300
37.4 EB05 34.1 · IC025 +5.0
3/3 methods agree
Not in label — unassessedserious n=329 · ♀ 100% (drug 72%) · 100% cliniciannot reported in cached trials
C-reactive protein abnormal1,66644.8
42.4–47.4ROR 45.2 · χ² 52,521 / p <1e-300
33.2 EB05 31.9 · IC025 +5.0
3/3 methods agree
Lab value / disease markerserious n=1,666 · ♀ 100% (drug 72%) · 95% cliniciannot reported in cached trials
Systemic lupus erythematosus8,89142.8
41.8–43.8ROR 45.2 · χ² 270,890 / p <1e-300
32.1 EB05 31.6 · IC025 +5.0
3/3 methods agree
Not in label — unassessedserious PRR 34.5 · ♀ 100% (drug 72%)not reported in cached trials
Wound6,91342.2
41.1–43.3ROR 44.0 · χ² 208,141 / p <1e-300
31.8 EB05 31.2 · IC025 +4.9
3/3 methods agree
Not in label — unassessedserious PRR 39.4 · ♀ 99% (drug 72%) · 91% cliniciannot reported in cached trials
Breast cancer stage iii1,49038.4
36.2–40.7ROR 38.7 · χ² 41,510 / p <1e-300
29.6 EB05 28.4 · IC025 +4.8
3/3 methods agree
Not in label — unassessedserious n=1,490 · ♀ 100% (drug 72%) · 94% cliniciannot reported in cached trials
Contraindicated product administered6,68736.3
35.3–37.3ROR 37.8 · χ² 178,122 / p <1e-300
28.4 EB05 27.8 · IC025 +4.8
3/3 methods agree
Reporting / coding artifactserious PRR 36.7 · ♀ 99% (drug 72%) · 90% cliniciannot reported in cached trials
Temperature regulation disorder45933.9
30.5–37.5ROR 33.9 · χ² 11,495 / p <1e-300
26.8 EB05 24.8 · IC025 +4.6
3/3 methods agree
Not in label — unassessedserious n=456 · ♀ 100% (drug 72%)not reported in cached trials
Irritable bowel syndrome4,42633.3
32.2–34.4ROR 34.2 · χ² 109,538 / p <1e-300
26.5 EB05 25.8 · IC025 +4.7
3/3 methods agree
Not in label — unassessedserious PRR 34.8 · ♀ 98% (drug 72%) · 91% cliniciannot reported in cached trials
Lip dry1,85433.2
31.6–35.0ROR 33.6 · χ² 45,781 / p <1e-300
26.5 EB05 25.5 · IC025 +4.6
3/3 methods agree
Not in label — unassessedserious n=1,807 · ♀ 99% (drug 72%) · 94% cliniciannot reported in cached trials

Trial evidence (ClinicalTrials.gov)

✓ Trial adverse-event data found on ClinicalTrials.gov

Largest completed trials with posted results that list Cetirizine as a study intervention. The right-hand column of the signal table shows whether each FAERS term was also recorded in these trials, with a real denominator (0 of 40 signal terms matched).

Caveats: trial populations, doses and follow-up differ from the reporting population; AE terms are sponsor-coded and matched here by wording; absence from a trial list means the term was not reported above the sponsor's frequency threshold, not that it cannot occur.

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Drug ineffective (drug did not work)21,7032.1
2.1–2.2ROR 2.3 · χ² 13,604 / p <1e-300
2.1 EB05 2.1 · IC025 +1.1
3/3 methods agree
Reporting / coding artifactserious PRR 3.6not reported in cached trials
Fatigue (tiredness)18,8623.2
3.1–3.2ROR 3.4 · χ² 28,192 / p <1e-300
3.1 EB05 3.1 · IC025 +1.6
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 4.8NCT01916226: 1/170 (0.6%) on Cetirizine
Pain15,9343.4
3.3–3.4ROR 3.6 · χ² 26,716 / p <1e-300
3.3 EB05 3.3 · IC025 +1.7
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 4.9NCT01916226: 1/170 (0.6%) on Cetirizine
Off label use (used outside approved label)14,2682.1
2.1–2.2ROR 2.2 · χ² 8,680 / p <1e-300
2.1 EB05 2.1 · IC025 +1.0
3/3 methods agree
Reporting / coding artifactserious PRR 2.8not reported in cached trials
Rash13,4414.1
4.0–4.1ROR 4.3 · χ² 30,676 / p <1e-300
4.0 EB05 3.9 · IC025 +2.0
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 7.3not reported in cached trials
Headache12,6552.6
2.6–2.7ROR 2.8 · χ² 12,783 / p <1e-300
2.6 EB05 2.5 · IC025 +1.3
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 4.1NCT00974571: 8/122 (6.6%) on Cetirizine; 36/613 (5.9%) control
Pruritus (itching)12,5494.4
4.3–4.4ROR 4.6 · χ² 31,981 / p <1e-300
4.2 EB05 4.2 · IC025 +2.1
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious PRR 7.2not reported in cached trials
Nausea11,8911.9
1.9–2.0ROR 2.0 · χ² 5,563 / p <1e-300
1.9 EB05 1.9 · IC025 +0.9Labeled adverse reaction
exact term
serious PRR 2.8not reported in cached trials
Dyspnoea (shortness of breath)11,1842.6
2.5–2.6ROR 2.7 · χ² 10,714 / p <1e-300
2.5 EB05 2.5 · IC025 +1.3
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 3.1not reported in cached trials
Abdominal discomfort10,7308.7
8.5–8.9ROR 9.3 · χ² 69,041 / p <1e-300
8.2 EB05 8.1 · IC025 +3.0
3/3 methods agree
Not in label — unassessedserious PRR 17.7 · ♀ 94% (drug 72%)not reported in cached trials
Alopecia (hair loss)10,6127.2
7.1–7.4ROR 7.7 · χ² 54,456 / p <1e-300
6.9 EB05 6.8 · IC025 +2.8
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 14.3 · ♀ 97% (drug 72%)not reported in cached trials
Arthralgia (joint pain)10,4163.3
3.2–3.3ROR 3.4 · χ² 16,350 / p <1e-300
3.2 EB05 3.2 · IC025 +1.7
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 5.2NCT01916226: 1/170 (0.6%) on Cetirizine
Diarrhoea (diarrhea)9,9442.0
2.0–2.0ROR 2.1 · χ² 4,997 / p <1e-300
2.0 EB05 1.9 · IC025 +1.0Labeled adverse reaction
exact term
serious PRR 2.7not reported in cached trials
Hypersensitivity (allergic reaction)9,9137.2
7.0–7.3ROR 7.6 · χ² 50,274 / p <1e-300
6.8 EB05 6.7 · IC025 +2.7
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 11.7 · ♀ 92% (drug 72%)not reported in cached trials
Rheumatoid arthritis9,37611.5
11.3–11.7ROR 12.1 · χ² 82,670 / p <1e-300
10.6 EB05 10.4 · IC025 +3.4
3/3 methods agree
Not in label — unassessedserious PRR 13.4 · ♀ 99% (drug 72%)not reported in cached trials

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Cetirizine?

In FDA FAERS, the most frequently co-reported reaction terms for Cetirizine are fatigue, pain, rash, headache, pruritus, nausea. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Cetirizine have an FDA boxed warning?

No. The FDA label retrieved for Cetirizine has no boxed warning; see the label's Warnings and Precautions for the recognised risks.

Do FAERS signals prove that Cetirizine causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-08. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.