Lou Portero

Urban Health Today

The U.S. Food and Drug Administration has issued a <a href="https://www.fda.gov/drugs/drug-safety-and-availability/fda-requires-warning-about-rare-severe-itching-after-stopping-long-term-use-oral-allergy-medicines">new safety warning</a> about two widely used antihistamine medications, cautioning that patients may experience rare but severe itching when discontinuing long-term use of these common allergy treatments.The FDA is warning that patients stopping the oral allergy medicines cetirizine or levocetirizine after long-term use may experience rare but severe itching. Both medications are available in prescription and over-the-counter forms and are commonly used to treat seasonal allergies, year-round allergies, and chronic hives.The itching, also called pruritus, has been reported in patients who used these medicines daily, typically for at least a few months and often for years. Importantly, patients did not experience itching before starting these medications, indicating this is a withdrawal-related reaction rather than an underlying condition.The FDA identified 209 cases worldwide (197 in the United States) of pruritus after stopping use of cetirizine (n=180), levocetirizine (n=27), or both (n=2) reported to the FDA between April 25, 2017, and July 6, 2023. While this represents a rare occurrence given the millions of people who use these medications, the severity of symptoms was significant in many cases.Many reports described widespread pruritus that required medical intervention after stopping these medicines, with a large number describing significant and persistent impact on quality of life and ability to function. Some serious outcomes included disability and hospitalization.The median time to onset was 2 days, with a range of 1 to 5 days after stopping the medication. Duration of use appears to be a key risk factor: in nearly 92 percent of the 106 pruritus cases where patients reported time length of medicine usage, the length was more than 3 months.Most patients who experienced this withdrawal itching found relief by restarting their medication. Restarting the medicine resolved pruritus in 71/79 individuals (90 percent), and tapering off the medicine after restarting it resolved symptoms in 9/24 (38 percent) of those who tried this approach.The FDA is updating prescription labeling to include warnings about this risk and will request that manufacturers add similar warnings to over-the-counter versions. Patients planning long-term use of these medications should discuss the benefits and risks with their healthcare providers, particularly for use extending beyond a few months.&nbsp;
<div class="post-references"><h3>References</h3>https://www.fda.gov/drugs/drug-safety-and-availability/fda-requires-warning-about-rare-severe-itching-after-stopping-long-term-use-oral-allergy-medicines
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Cautioning that patients may experience rare but severe itching when discontinuing long-term use of these allergy treatments.

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