We investigated the suitability of
cetirizine HCl (
cetirizine) for the initial treatment of
chronic urticaria. A secondary aim was to identify the optimal alternative treatments when switching from this
drug to other drugs in patients who are dissatisfied with
cetirizine. We started
cetirizine at a once-daily dose of 10 mg for 2 weeks and then, depending on the course of symptoms in individual patients, it was either continued, titrated to a higher dose, or switched to other drugs (
antihistamines including H2 blockers) for a further 2 weeks. Degrees of patient satisfaction and ratings by physicians were analyzed, as were adverse events. At 2 weeks after the start of treatment, among 74 patients included in the final evaluation 55 (74.3%) expressed satisfaction with
cetirizine therapy. Those not satisfied included five (6.7%) who felt drowsy after taking the
drug and 14 (18.9%) in whom the
drug had not demonstrated adequate efficacy. After optimizing the treatment on a per-patient basis, including switching from
cetirizine to other drugs, the percentage satisfied with treatment at 4 weeks was 83.7% (62/74). In the group of patients who were satisfied with the
therapy at 2 weeks, attending physicians confirmed that wheals and scratches were significantly alleviated at 2 and 4 weeks, respectively. Adverse effects were mild and uncommon.
Cetirizine as an initial treatment for
chronic urticaria appears effective and safe. For patients in whom
cetirizine fails to satisfactorily alleviate symptoms as well as those who complain of drowsiness, switching to other
antihistamine drugs may be an effective strategy.