Side Effects: 4 Drugs That Can Cause Anxiety

Anxiety and panic disorders can heighten the risk for sensitivity to the effects of certain medications.

Before taking medications, those affected by anxiety should speak with their health care providers to evaluate side effects and adverse reactions, and how they might contribute to existing anxiety.

Here are four medications that may worsen the symptoms of anxiety:

Decongestants

Decongestants are used in the management of allergies and upper respiratory infections to help diminish nasal congestion. While these drugs are highly effective in restoring an effective breathing pattern, they can lead to unwanted side effects.

These side effects are tolerated by people without anxiety. However, those affected by a panic disorder or generalized anxiety disorder may need to consider alternative treatments for their nasal congestion.

In addition to anxiety sufferers, decongestant medications may not be suitable for people diagnosed with high blood pressure or glaucoma because they can worsen hypertension and raise intra-ocular eye pressure.

Side effects from decongestant medications may include a fast heart rate, rapid breathing, chest discomfort, increased sweating, blurred vision, and dizziness. All of these adverse reactions can mimic the symptoms of anxiety, and in sensitive individuals, may even precipitate panic attacks.

While oral decongestant drugs may be more likely to lead to unwanted side effects, decongestant nasal sprays may also cause side effects to a lesser extent.

Alternatives to using decongestant drugs include inhaling steam, massaging the sinuses, using warm compresses on the forehead and over the nasal bridge, eating spicy foods, and drinking hot beverages.

Antihistamines

Like decongestants, antihistamines are used in the treatment of allergies and upper respiratory infections. They do not, however, treat nasal congestion, but are highly effective in treating a runny nose, sneezing, watery eyes, and scratchy throat.

Antihistamines are known to cause extreme drowsiness; however, in certain people, they can cause insomnia, excitability, anxiety, restlessness, and a rapid heart rate. People with anxiety or panic disorder who wish to take antihistamines should start out with the lowest possible dose to help reduce the risk of side effects.

If side effects are not tolerated well or if they lead to increased anxiety, alternative treatments for allergies should be considered. These include using drug-free saline nasal sprays, keeping the doors and windows closed when outdoor allergens such as mold, pollen, and ragweed are high, and using an indoor air purifier.

Beta Blockers

Beta blockers are used in the treatment of high blood pressure, cardiac arrhythmia, migraine headaches, hyperthyroidism, and chest pain. They are also prescribed to help reduce the risk for a second heart attack, and in some cases, to treat the symptoms of anxiety and panic disorder.

While beta blockers such as propranolol are very effective in relieving the physical symptoms of anxiety such as a fast heart rate, excessive sweating, and shaking, they can sometimes cause an abnormal heart rate or rhythm, very low blood pressure, pain or tightness in the chest, and insomnia.

All of these adverse reactions can intensify symptoms of anxiety. Taking beta blockers can also interfere with the body’s production of melatonin, a hormone essential for recuperative sleep.

People with anxiety or panic disorder may notice a worsening of their symptoms when they fail to get enough restorative sleep.

Migraine Medication

Migraine pain medication may also raise the risk for increasing anxiety. A migraine drug known as ergotamine tartrate is usually taken at the first sign of an impending migraine headache. This medication will help lessen pain from an existing migraine; however, it will do little to prevent future migraines.

Ergotamine tartrate works by narrowing or constriction the blood vessels that are located around the brain, and it may also help correct abnormal blood flow that is often seen in those with migraines. While highly effective in treating the symptoms of a migraine, this medication can cause serious side effects which can worsen existing anxiety or cause a panic attack.

These side effects include extreme dizziness, vertigo or spinning sensations, fast heart rate, vomiting, and numbness and tingling sensations in the arms, legs, and face. In addition to prescription migraine medication, over-the-counter migraine medications can also heighten the risk for anxiety episodes.

Most migraine pain relievers contain caffeine, which can cause cardiac palpitations, sweating, shaking, and insomnia. People affected by migraine headaches should speak with their physicians about the best treatment options that are less likely to contribute to increased anxiety or panic attacks.

Anxiety and panic disorder can be debilitating. While monitoring the side effects of medications can help prevent an increase in symptoms, other treatments such as cognitive behavioral therapy, exercise, proper nutrition, and adequate sleep can also help dramatically reduce the frequency and intensity of anxious episodes.

Working with a qualified physician and experienced mental health professional will help ensure that the patient has the tools and skills to better manage the symptoms of generalized anxiety disorder.

Anxiety | Symptoms, Causes, Treatment

Your GP may ask you questions about your worries, fears, and emotions. They may also ask about your personal life. Make sure that you tell your GP about all of your symptoms, and also explain how long you have been experiencing them.

You may find it difficult to talk about your feelings, emotions, and personal life, but it is important that your GP has a good understanding of your symptoms and circumstances, so that the correct diagnosis can be made.

You are most likely to be diagnosed with GAD if you have displayed the symptoms of the condition for six months, or more. Finding it difficult to manage your feelings of anxiety is also an indication that you may have developed the condition.

To help with the diagnosis, your GP may also carry out a physical examination in order to rule out any other conditions which may be causing your symptoms.

There are two main forms of treatment for generalised anxiety disorder (GAD) – psychological therapy and medication. Depending on your individual circumstances, you may require either one of these types of treatment, or a combination of the two.

Before you begin any form of treatment, your GP will discuss all of your options with you, outlining the pros and cons of each form of treatment, while also making you aware of any possible risks, or side effects. It is important that you understand what your treatment will involve. If you do not understand something your GP has told you, make sure that you ask them to explain it in more detail.

Psychological treatment

If you have been diagnosed with GAD, you will usually be advised to undergo psychological treatment before you are prescribed medication. The main form of psychological treatment for GAD is cognitive behavioural therapy.

Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) is one of the most effective types of treatment for GAD. Research suggests that CBT improves the symptoms of over half of all those with the condition.

CBT works by helping you to identify any unhelpful and unrealistic beliefs and behavioural patterns you might have. Your therapist then shows you ways in which you can replace these beliefs with more realistic and balanced ones. This type of therapy does not concentrate on dealing with events from your past, but instead focuses on the difficulties that you are experiencing in the present. CBT teaches you new skills, and helps you to understand how to react more positively to situations which would usually cause you anxiety.

The National Institute for Health and Clinical Excellence (NICE) recommend that you should have at total 16-20 hours of CBT. Your treatment will usually involve having a 1-2 hour long session, once a week.

Self-help

There are some ways that you can help to ease the symptoms of GAD yourself. Regular exercise, particularly aerobic exercise, will help you to combat stress and release tension.

You should be aiming to do a minimum of 30 minutes of moderate exercise, at least five days a week. Moderate exercise should make you feel slightly out of breath and tired, but not to the point where it is unbearable. Going for a brisk walk is a good example of moderate exercise. Regular exercise also encourages your brain to release the chemical serotonin, which can help to improve your mood.

As well as getting regular exercise, learning how to relax is also important. You may find relaxation and breathing exercises helpful, or you may prefer activities such as yoga or pilates to help you unwind.

Changing your diet may also help to ease your symptoms. Too much caffeine in your diet can make you more anxious than normal. This is because caffeine can disrupt your sleep, and also speed up your heartbeat. If you are tired, you are less likely to be able to control your anxious feelings.

Smoking and alcohol have also been shown to worsen feelings of anxiety, so you should make sure that you drink in moderation, and try your best to give up smoking.

Drink in moderation

The Department of Health recommends that men should not drink more than 3-4 units of alcohol a day, and women no more than 2-3 units a day. A unit of alcohol is equivalent to half a pint of ordinary strength larger, a pub measure (25ml) of spirits, or a small (125ml) glass of wine. If you drink alcohol, you should try to stay within these recommended limits.

Stopping smoking

Giving up smoking will not only help you to feel less anxious, it will also improve your general health. Stopping smoking also reduces the risk of you developing smoking-related conditions, such as lung cancer and heart disease.

If you plan to give up smoking, contact your GP, who will be able to give you advice and guidance about the best ways for you to quit.

Alternatively, you can call the NHS smoking helpline, on 0800 022 4 332, where a specially trained advisor can offer free and confidential advice. The phone line is open seven days a week, from 7am-11pm. The NHS ‘go smokefree’ website also offers lots of helpful information about ways you can give up smoking.

Support groups

Support groups will be able to provide you with useful advice about how you can effectively manage your anxiety, and they are also a good way of meeting other people with similar experiences of the condition.

Support groups often involve face to face meetings where you can talk about your difficulties and problems with others. Many support groups can also provide support and guidance over the telephone, or in writing. Ask your GP about local support groups for anxiety in your area.

Medication

There are a variety of different types of medication that your GP can prescribe for you to help treat your GAD. Some medication is designed to be taken on a short-term basis, while you may have to take other medicines for longer periods of time. Depending on your symptoms, you may require medicine to help treat your physical symptoms, as well as your psychological ones.

Short-term medication

If your anxiety is severely affecting you, you may be given medication on a short-term basis to help provide immediate relief from your symptoms. The types of short-term medication you may be prescribed are outlined below.

Benzodiazepines:
Benzodiazepines are a type of sedative which help to ease the symptoms of anxiety within 30-90 minutes of taking the medication.

Although benzodiazepines are very effective in treating the symptoms of anxiety, they cannot be used for long periods of time. This is because they have the potential to become addictive if they are used for longer than four weeks. Benzodiazepines also start to lose their effectiveness after this time.

For these reasons, you will usually only be prescribed benzodiazepines to help you cope during a particularly severe, or intense, attack of anxiety. Benzodiazepines can cause side effects including:

• confusion,
• loss of balance,
• memory loss,
• drowsiness, and light-headedness.

Due to the above side effects of benzodiazepines, this type of medication can affect your ability to drive or operate machinery. You should therefore avoid these activities when taking this form of medication.

Speak to your GP if, while you are taking benzodiazepines, you experience any of the side effects that are listed above. They may be able to adjust your dose of medication, or prescribe an alternative.

Antihistamines:
Antihistamines are usually prescribed to treat allergic reactions. However, some are also used to treat anxiety on a short-term basis. Antihistamines work by having a calming effect on the brain, helping you to feel less anxious.

As with benzodiazepines, this type of medicine is only effective when used for a short period of time. They are therefore only prescribed for several weeks at a time. Hydroxyzine is the most commonly prescribed antihistamine for treating anxiety. This antihistamine can make you feel drowsy so it is best not drive or operate machinery when taking the medication. Other side effects of hydroxyzine include:

• dizziness,
• blurred vision,
• headache, and
• dry mouth.

Long-term medication

Some people who have GAD require long-term treatment in order to help manage their anxiety, rather than treatment for the immediate relief of their symptoms. The types of long-term medication that you may be prescribed are outlined below.

Selective serotonin reuptake inhibitors (SSRIs):
Selective serotonin reuptake inhibitors (SSRIs) are a form of antidepressant which work by increasing the level of a chemical in your brain called serotonin.

As with any antidepressant, it will usually take several weeks before your SSRI medication starts to work. SSRIs are usually started at a low dose, and then the dose is gradually increased as your body adjusts to the medicine. Common side effects of SSRIs include:

• nausea,
• low sex drive,
• blurred vision,
• diarrhoea, or constipation,
• dizziness,
• dry mouth,
• loss of appetite,
• sweating,
• feeling agitated, and
• insomnia (not being able to sleep).

When you start taking an SSRI, you should see your GP after two, four, six, and 12 weeks to check your progress, and to see if you are responding to the medicine. Not everyone responds well to antidepressant medicines, so it is important that your progress is carefully monitored.

If your GP feels it is necessary, you may require regular blood tests, or blood pressure checks, when taking antidepressant medication. If, after 12 weeks of taking the medication, you do not show any signs of improvement, your GP may try prescribing an alternative SSRI for you, to see if that has any effect.

When you and your GP decide that it is appropriate for you to stop taking your SSRI medication, you will gradually be weaned off the medication, by slowly reducing your dosage. However, you should never stop taking your medication unless your GP specifically advises you to.

Venlafaxine:
If SSRIs do not help to ease your anxiety, you may have to be prescribed a different type of antidepressant known as venlafaxine.

Venlafaxine belongs to a group of medicines known as selective serotonin and norepinephrine reuptake inhibitors (SNRIs). This type of medicine works by increasing the amount of serotonin and norepinephrine in your brain, helping to restore the chemical imbalance that sometimes causes GAD.

You cannot be prescribed venlafaxine if you:

• have high blood pressure (hypertension) which is not being treated,
• have recently had a heart attack, or
• you are at risk of having cardiac arrhythmias (irregular heart beats).

If you have any of the above conditions, you may be at risk of developing complications if you take venlafaxine. Therefore, your blood pressure will be monitored on a regular basis if you are prescribed this medicine.

Common side effects of venlafaxine may include:

• nausea,
• headache,
• drowsiness,
• dizziness,
• dry mouth,
• constipation,
• indigestion,
• insomnia, and
• sweating.

Other types of medication

Buspirone

Buspirone is a medicine which can help to ease the psychological symptoms of anxiety. It belongs to a group of medicines known as anxiolytics. You will normally have to take buspirone for four to nine weeks before you notice an improvement. It will be up to your GP how long you continue to take the medicine after this.

Buspirone works in a similar way to benzodiazepines, but unlike benzodiazepines, buspirone does not become addictive, which means that you will be able to take it for longer periods of time. However, it is still generally used as a relative short-term form of medication

Beta blockers

Beta blockers are usually used to treat conditions such as angina (chest pain) and high blood pressure (hypertension).

However, they can also help ease some of the symptoms of anxiety. Beta blockers will not affect your psychological symptoms, such as irritability and restlessness. Instead they can help you with some of your physical symptoms, such as sweating and palpitations (when you can feel your heart beating faster than normal). Beta blockers work by blocking the chemicals that can cause these physical symptoms.

Referral

If medication, CBT, or support groups fail to help improve your GAD, you may have to be referred to a mental health specialist.

A mental health specialist will carry out an overall re-assessment of your condition. They will ask you about your previous treatment, and how effective you found it. They may also ask you about things in your life that may be affecting your condition, or how much support you get from family and friends. Your specialist will then be able to devise a treatment plan for you, which will aim to effectively treat your symptoms.

The type of mental health specialist that you are referred to will depend on your individual situation. You may be referred to one, or more, of the specialists described below.

• Psychiatrists train as medical doctors, and then choose to specialise in mental health. A psychiatrist is one of the only mental health specialists who is able to prescribe medication.
• Clinical psychologists are trained in the scientific study of human behaviour and mental processes. They focus solely on the assessment and treatment of mental health conditions. A clinical psychologist will help you to manage your feelings of anxiety.

Support organisations

The information below has been added to the NHS Direct Health Encyclopaedia as part of a pilot project to make data used by NHS Direct call centres available to the public on our website. If you have any feedback relating to this pilot please contact us.

First Steps to Freedom

Helpline: 365 days a year 10.00am-10.00pm
Offers confidential help, practical advice and support to those people affected by phobias, general anxiety, panic attacks, obsessional and compulsive disorders, anorexia and bulimia or tranquilliser withdrawal. Provides help and support for carers of those with borderline personality disorder. Also offers one to one telephone counselling and self-help groups. Membership available, which offers newsletter, penpal lists, audio and visual tapes, fact sheets self-help booklets and book list.
Who for: Anyone.
Referral: Self.
Cost:£10 annual fee for members.
There is a complaints procedure.

Address

http://www.first-steps.org/

Contacts

Helpline : 08451202916

National Phobics Society

Helpline: Mon-Fri 9.30am-5.00pm, answerphone available.
NPS provides a listening service and information on phobias and all anxiety disorders including Obsessive Compulsive Disorder. Members can be put in touch locally with other members via a contact list if they wish and have access to a helpline manned by staff who have extensive knowledge of anxiety disorders. Therapy available with home visits includes, cognitive behavioural therapy, counselling, clinical hypnotherapy and complimentary therapies. Cognitive behavioural therapy and counselling is also available via telephone and on-line. Members also receive newsletters, factsheets, self-help information packs and therapy tapes.
Who for: Anyone affected by anxiety disorders, including family members, carers and friends.
Referral: Self.
Cost:£15 for annual membership.
Premises have accessible entrance and toilet. Weekly drop in support group. Provides a range of information tapes.
There is a complaints procedure.

Address

http://www.phobics-society.org.uk/

Contacts

• Helpline : 0870 7700 456
• Helpline : 01612279862

No Panic

Helpline: 7 days, 10.00am-10.00pm (recorded message out of hours)
Aims to aid the relief and rehabilitation of people affected by panic attacks, phobias, obsessive compulsive disorder, related anxiety disorders and tranquilliser withdrawal. Offers support to patients their families and carers. Provides telephone support, literature, books, audio and video cassettes and a contact service for members wishing to make phone-friends and pen pals.
Who for: Anyone affected by or with an interest in anxiety disorders.
Referral: Any method.
Cost: Optional membership fee.
Information is also available in large print and on audio cassette.

Address

http://www.nopanic.org.uk/

Contacts

Helpline : 08088080545

Useful links

NHS Choices links

External links

Zyrtec

Drug Class:

Table of Contents

Overview

Zyrtec (Cetirizine Hydrochloride) is an antihistamine used to relieve hay fever and seasonal allergy symptoms, including runny nose; sneezing; and red, itchy, tearing eyes. It also may be used to treat itching and hives that result from certain skin conditions.

It works by blocking histamine that your body makes during an allergic reaction.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

This information is for educational purposes only. Not every known side effect, adverse effect, or drug interaction is in this database. If you have questions about your medicines, talk to your health care provider.

How to Take It

Follow the directions for using this medicine provided by your doctor. It usually is taken once a day.

Side Effects

Side effects that may occur while taking this medicine include:

• dry mouth, nose and throat
• insomnia
• drowsiness
• upset stomach
• diarrhea
• headache
• dizziness

Contact your doctor immediately if you experience:

• difficulty urinating
• nervousness
• anxiety
• difficulty breathing
• shaking or tremors
• difficulty swallowing
• restlessness
• seizures
• irregular or unusually fast heartbeat

Warnings & Precautions

• Talk to your doctor if you are allergic to Hydroxyzine or Levocetirizine; or if you have any other allergies.
• DO NOT use this medication if you are allergic to Cetirizine.
• Get medical help right away if you experience seizures.
• This medicine may impair your reactions and thinking. Use caution if you are performing any activities that require you to be alert.
• Alcoholic beverages can increase the effects of this medicine and should be avoided.
• Get for medical help immediately if you experience breathing difficulties, rash, swelling or itching on the tongue, face, or throat), or severe dizziness.
• Contact your doctor immediately if symptoms do not improve or if they get worse. If you have a fever, call your doctor right away.
• For an overdose, seek medical attention immediately. For non emergencies, contact your local or regional poison control center at 1-800-222-1222.

Drug Interactions

Before taking any new medicine, either prescription or over-the-counter, check with your doctor or pharmacist. This includes supplements and herbal products.

Dosage & Missed Dose

Zyrtec should be taken once daily. It comes in 5 mg and 10 mg tablets, 1 mg/ml syrup, and 5 mg and 10 mg chewable tablets, which may be taken with water.

Take your next dose as soon as you remember. If it is time for your next dose, skip the missed dose and go back to your regular schedule. Do not double doses or take extra medicine to make up for the missed dose.

Storage

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (preferably not in the bathroom). Throw away any medication that is outdated or no longer needed.

Pregnancy/Nursing

If you plan on becoming pregnant, discuss with your doctor the benefits and risks of using this medicine during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant while taking this medication. Cetirizine can pass into breast milk and may harm a nursing baby. Do not use Zyrtec while breast feeding without first consulting with your doctor.

More Information

For more information, talk to your doctor, pharmacist or health care provider, or you can visit this website, https://www.nlm.nih.gov/medlineplus/druginfo/meds/a698026.html for additional information from the manufacturer of this drug.

Zyrtec

Drug Class:

Table of Contents

Overview

Zyrtec (Cetirizine Hydrochloride) is an antihistamine used to relieve hay fever and seasonal allergy symptoms, including runny nose; sneezing; and red, itchy, tearing eyes. It also may be used to treat itching and hives that result from certain skin conditions.

It works by blocking histamine that your body makes during an allergic reaction.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

This information is for educational purposes only. Not every known side effect, adverse effect, or drug interaction is in this database. If you have questions about your medicines, talk to your health care provider.

How to Take It

Follow the directions for using this medicine provided by your doctor. It usually is taken once a day.

Side Effects

Side effects that may occur while taking this medicine include:

• dry mouth, nose and throat
• insomnia
• drowsiness
• upset stomach
• diarrhea
• headache
• dizziness

Contact your doctor immediately if you experience:

• difficulty urinating
• nervousness
• anxiety
• difficulty breathing
• shaking or tremors
• difficulty swallowing
• restlessness
• seizures
• irregular or unusually fast heartbeat

Warnings & Precautions

• Talk to your doctor if you are allergic to Hydroxyzine or Levocetirizine; or if you have any other allergies.
• DO NOT use this medication if you are allergic to Cetirizine.
• Get medical help right away if you experience seizures.
• This medicine may impair your reactions and thinking. Use caution if you are performing any activities that require you to be alert.
• Alcoholic beverages can increase the effects of this medicine and should be avoided.
• Get for medical help immediately if you experience breathing difficulties, rash, swelling or itching on the tongue, face, or throat), or severe dizziness.
• Contact your doctor immediately if symptoms do not improve or if they get worse. If you have a fever, call your doctor right away.
• For an overdose, seek medical attention immediately. For non emergencies, contact your local or regional poison control center at 1-800-222-1222.

Drug Interactions

Before taking any new medicine, either prescription or over-the-counter, check with your doctor or pharmacist. This includes supplements and herbal products.

Dosage & Missed Dose

Zyrtec should be taken once daily. It comes in 5 mg and 10 mg tablets, 1 mg/ml syrup, and 5 mg and 10 mg chewable tablets, which may be taken with water.

Take your next dose as soon as you remember. If it is time for your next dose, skip the missed dose and go back to your regular schedule. Do not double doses or take extra medicine to make up for the missed dose.

Storage

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (preferably not in the bathroom). Throw away any medication that is outdated or no longer needed.

Pregnancy/Nursing

If you plan on becoming pregnant, discuss with your doctor the benefits and risks of using this medicine during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant while taking this medication. Cetirizine can pass into breast milk and may harm a nursing baby. Do not use Zyrtec while breast feeding without first consulting with your doctor.

More Information

For more information, talk to your doctor, pharmacist or health care provider, or you can visit this website, https://www.nlm.nih.gov/medlineplus/druginfo/meds/a698026.html for additional information from the manufacturer of this drug.

Get info about the antihistamine that also treats anxiety

Antihistamines can be used to treat more than just itchiness and the sniffles

If you have any allergies you are probably familiar with antihistamines. You may know them as Benadryl, Zyrtec, Claritin or Allegra. Many antihistamines are available over the counter, and they provide short term relief for allergic reactions such as congestion, sneezing, and hives. These drugs work by blocking the body’s receptors for histamines, a chemical released by the immune system to combat foreign substances and protect damaged tissue.

These histamines inflame nearby tissue, opening blood vessels and allowing blood flow to move quickly to the area. Unfortunately, that inflammation also causes the unwanted effects of nasal congestion and itchy or painful skin conditions. Because histamines are also utilized in regulating the body’s wakefulness, it can also contribute to symptoms such as drowsiness and dizziness. If you are a chronic allergy sufferer, you are also probably aware that this is one of the most common side effects of antihistamines and it is why you usually need a nap after taking drugs such as Benadryl (although newer drugs are often marketed as “non-drowsy.”)

There are many subsets of antihistamines that block different histamine receptors, and each has slightly different effects and side effects. Newer drugs target the receptors that are not involved in sleep regulation, which is how they avoid the drowsiness side effect. However, because of the way these receptors react with other chemicals in the brain, antihistamines can be used to treat more than just itchiness and the sniffles.

So How Do Antihistamines Treat Anxiety?

Experiencing anxiety from time to time is a part of life – and can be a positive thing when it allows you to think on your feet more quickly in a new situation or spend more time on a problem you are facing at work. There is a difference, however, between feeling occasionally anxious as a normal response to a stressful situation and a full blown anxiety disorder. There are a few different types of anxiety disorders, all of which interfere with daily life and can get worse over time. Obsessive Compulsive Disorder (OCD), Post Traumatic Stress Disorder (PTSD), and specific phobias are all types of anxiety disorders. The most common anxiety disorder is Generalized Anxiety Disorder (GAD), associated with “the presence of excessive anxiety and worry about a variety of topics, events, or activities.” according to the Diagnostic and Statistical Manual of Mental Disorders, (more commonly referred to as the DSM-5,) the manual doctors use to diagnose mental health disorders.

While the exact cause of anxiety in the brain is still unclear, anxiety disorders have been linked to an imbalance of the chemical serotonin, your brain’s natural mood stabilizer. A lower than average level of serotonin in the brain is observed in patients with anxiety, depression, and other mood disorders. One of the subsets of antihistamines, Hydroxyzine, blocks the h2 receptor, a histamine receptor of the central nervous system. However, it also blocks serotonin receptors in the same area. By blocking serotonin receptors, more serotonin stays in the bloodstream, temporarily raising serotonin levels and inducing a state of sedation.

When Would An Antihistamine Be Prescribed for Anxiety?

The most common drugs prescribed for anxiety disorders are Selective Serotonin Reuptake Inhibitors (SSRIs) because they directly and continuously increase serotonin levels, are non-addicting and are unlikely to have side effects. Zoloft and Prozac are the most well-known SSRIs. The drawback of these drugs is that they can take up to 6 weeks to become effective and generally have bad withdrawal symptoms. They are most often prescribed for long-term use with close supervision from a doctor or mental health professional.

Another class of drugs commonly prescribed for anxiety are benzodiazepines. These drugs, such as Xanax and Valium, enhance the chemical that reduces brain activity, providing a relatively strong sedative effect. Unlike SSRIs, benzodiazepines are fast acting but can be addictive and cause unwanted symptoms such as memory loss and depression. The risk of dependence on benzodiazepines is greater than any other anxiety treatment because of the “high” created as a result of its abuse. This class of drugs also can cause bad withdrawal symptoms, and should only be used as-needed, for quick symptom relief.

Antihistamines, on the other hand, are ideal for quick, periodic anxiety relief. They have a noticeable calming effect and are non-addictive with practically no withdrawal symptoms when taken as directed. The risks involved are mainly due to the drowsiness associated with most antihistamines, so care should be taken before driving or operating machinery until you know how the drug affects you.

Should I Ask My Doctor About Hydroxyzine?

Hydroxyzine is not intended to be used for more than a couple of months at a time, so if you are looking for long-term anxiety treatment, a SSRI or a non-pharmaceutical therapeutic treatment may be a better option. Hydroxyzine is a good option for patients with periodic, short-term anxiety, especially if you have a history of chemical dependence that would make the addictive benzodiazepines a risk.

If this applies to you, you may want to talk to your doctor about the drug Vistaril, the brand name for hydroxyzine. It is sold in either capsule or liquid form. Side effects to watch out for are dizziness, drowsiness, headaches, blurred vision and dry mouth. Contact your doctor if you experience any of the more serious side effects of seizures, tremors, confusion and restless facial muscle movements. As with any drug, tell your doctor before use about any pre-existing medical conditions or if you are pregnant.

Can Benadryl Be Used for Anxiety?

Can you use Benadryl (diphenhydramine) for anxiety? That might be a question you have if you are living with anxiety and don’t like traditional medications or have not yet visited your doctor. Beyond Benadryl, there are also other over-the-counter (OTC) medications that you might consider using for anxiety.

But the question is—are they safe? Do they work? What are the pros and cons? And, can you use them to supplement other treatments you might receive? Let’s consider each of these questions below to help you sort through your options in terms of over-the-counter medication for anxiety.

OTC Medications for Anxiety

First things first: You’re probably wondering if over-the-counter medications even work when it comes to treating anxiety. In order to consider this question, first let’s consider the different over-the-counter medications that you might use for anxiety because Benadryl is only one of many.

Antihistamines and Other Sedatives

Antihistamines such as diphenhydramine, the active ingredient in Benadryl, are used to manage allergic reactions, but they can also cause sedation as a side effect. Some people take Benadryl for anxiety because of the calming and sleep-inducing side effects that it can have. However, these effects are less than you would experience with prescription sedatives such as benzodiazepines.

Benadryl takes about 15 to 30 minutes to start working and its peak effect happens around 2 to 4 hours. An adult dose to obtain sedating effects is between 25 and 50 milligrams.

In addition to the sedating effects of antihistamines, other over-the-counter drugs can induce sedation and drowsiness, most notably those marketed as muscle relaxers or sleep medications.

Benadryl is not the only antihistamine that is sometimes used for anxiety relief. Doctors may also sometimes prescribe Vistaril (hydroxyzine), an antihistamine that is similar to Benadryl, for the short-term treatment of anxiety.

Herbal Remedies

There are a number of herbal remedies that are generally considered safe and may provide some relief of symptoms of anxiety. Some of these include:

Such herbal remedies are generally found in the form of teas, sprays, pills, oils, or tinctures. Herbal remedies can also have calming effects, but these are generally mild.

These remedies are not strong enough to effectively treat acute anxiety symptoms. Herbal remedies are best used to help you calm down or fall asleep, rather than as a first-line defense for intense anxiety.

Cough and Cold Medicines and Painkillers

Various painkillers may act on parts of the brain involved in the experience of emotional pain. In fact, one study from the University of British Columbia concluded that over-the-counter medication such as Tylenol (acetaminophen) had an impact on emotional distress and anxiety triggers.

Vitamins and Minerals

Most people know that vitamins and minerals are important for physical health, but can taking them reduce anxiety? Unfortunately, unless you have a deficiency in a particular vitamin or mineral (determined by your doctor), it’s unlikely that taking vitamin or mineral supplements will reduce anxiety. That being said, there is no harm in taking a daily multivitamin to support your overall health under the guidance of your doctor.

Safety of OTC Medications for Anxiety

The safety of over-the-counter medications for anxiety generally depends on what you are purchasing and how you are using it. Some of the safety concerns you should consider include:

• Drug interactions: Always tell your doctor what OTC medications and supplements you are taking, as there is always a risk of interaction among supplements or with other medicines you might be taking.
• Intended use: Most over-the-counter medications that you might take for anxiety, such as antihistamines, while approved by the Food and Drug Administration (FDA) as safe, have not been approved for alleviating symptoms of anxiety.
• Long-term effects: Most OTC medications and supplements aren’t intended to be taken long term and often, there is little to no research on long-term use. As a result, they carry risks for side effects and there is potential for misuse.
• Regulation: Herbal supplements are not regulated in the same way as medications and long-term studies on efficacy and safety are often lacking. However, most supplements are safe to use under the guidance of a physician as their effects are mild.
• Side effects: For some supplements, such as kava kava, there is concern about serious side effects such as liver damage. It is important to be aware of the potential side effects of any herbal supplements you take and to contact your doctor if you experience any of these.

Pros and Cons of OTC Medicines for Anxiety

While there are some advantages to taking OTC remedies for anxiety, there are also a number of potential drawbacks to consider. Before you take any kind of OTC medication for your anxiety, be sure to talk to your doctor to help avoid adverse effects and medication interactions.

Pros

• Risk of dependence and withdrawal is less than for prescription sedatives

• May aid sleep and relaxation

• Easy and inexpensive to obtain

• Potentially useful for short-term episodes of anxiety

• Potentially useful if you are against taking traditional medications for anxiety

• May be helpful to supplement other treatments such as psychotherapy

Cons

• Potential to cause drowsiness during the day

• Not effective for severe anxiety

• Not approved by FDA for treating anxiety, or not regulated by FDA

• Not meant for long-term use for anxiety

• Potential side effects

Advantages

Benzodiazepines, a type of prescription medication that is commonly prescribed to manage symptoms of severe anxiety, can lead to dependence, tolerance, and withdrawal, particularly when they are taken regularly for a longer period of time, so OTC options can be an appealing choice for people worried about the addiction potential of these anti-anxiety medications. OTC remedies are less likely to present this type of risk, although diphenhydramine does have the potential for misuse.

One of the biggest advantages of using an OTC medication such as Benadryl to treat anxiety is that it is fast-acting and convenient. This can be helpful if you need to reduce symptoms of mild anxiety quickly. Because Benadryl causes many people to feel drowsy, it can also help aid in sleep.

Disadvantages

However, it is also important to remember that antihistamines like Benadryl can also have unpleasant side effects. Some people may experience severe drowsiness, fatigue, and dizziness.

It is also important to remember that these OTC remedies should not be used to treat severe anxiety or be used as a long-term solution. These medications and supplements are also not FDA approved for the treatment of anxiety. If you are experiencing symptoms of anxiety, talk to your doctor about your treatment options.

OTCs to Supplement Other Anxiety Treatments

Other types of treatments you might be receiving for anxiety might include talk therapy (e.g., cognitive behavioral therapy, mindfulness, and acceptance-based therapy) and prescription medications (e.g., benzodiazepines or selective serotonin reuptake inhibitors).

You can theoretically use over-the-counter medications for anxiety while receiving other treatments. But first, ask yourself why. Some common reasons to continue to use over-the-counter remedies alongside other treatments include:

• You are in therapy and need some additional relief from your acute symptoms but you are wary of taking a prescription medication.
• You are taking a prescription medication, but are waiting for it to take effect and want short-term relief.
• You are already using an alternative treatment and want to add in over-the-counter medication.

In all these cases, it’s likely that you will be better off consulting with your doctor. They can help you determine the best course of treatment for you. If you are only receiving talk therapy and want a short-term solution to mild anxiety that bothers you mostly at night, then an over-the-counter solution might be helpful.

Never combine an over-the-counter medication with prescription medication for anxiety without the advice of your doctor, as there is the possibility of medication interaction.

Who Should Use Over-the-Counter Medications?

A study of 690 German pharmacists determined that people seeking over-the-counter treatments for anxiety and depression:

• Were more likely to be younger
• Had a shorter duration of illness
• Had less severe symptoms
• Were skeptical about psychopharmacology

However, the study wondered whether this was a logical or cost-effective solution to these problems. Most people purchasing over-the-counter treatments for anxiety would probably benefit from professional help in the form of talk therapy or prescribed medication. The exception might be for cases of very mild anxiety that seem to be helped by herbal remedies that offer relaxation at bedtime.

A Word From Verywell

While it may seem like a quick and easy solution to run to the drugstore and pick up an antihistamine or painkiller to take the edge off every time your anxiety takes hold, there are many risks associated with this practice. Be sure to discuss your symptoms with your doctor or mental health professional and get their guidance for using OTC medications and herbal supplements, if those options are the best course of action for you.

When to Stop Taking Allergy Medication

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Allergies have gone up by 40% in recent years, and allergy medications are being used more often than ever before. There are various types of allergy drugs. Some are used to control acute attacks whereas others help prevent or alleviate the severity of allergic reactions. Some of them, especially sedating antihistamines and corticosteroids, are known to produce unwanted effects that limit their use in certain conditions.

Image Credit: Lightspring / Shutterstock

Antihistamines

Antihistamines act to prevent the action of histamine, a bioactive amine, at one of the histamine receptor, to block itching, swelling, redness, nasal congestion, teary eyes, cough, nausea and dizziness.

Histamine affects smooth muscle and blood vessels, causing smooth muscle spasm and vasodilation. The administration of antihistamines blocks most of these effects, making them the most commonly used drugs in the world.

Antihistamines are drugs which treat allergic rhinitis and other allergies. Image Credit: Studio BKK / Shutterstock

These medications come in handy for a variety of allergic conditions as well as those associated with wakefulness and anxiety. Thus, in addition to treating allergies, they have been used variously to treat cold symptoms, motion sickness, nausea due to other causes, skin allergies, and to induce sleepiness in tense or anxious patients.

Antihistamines may be classified as sedating (first-generation antihistamines), and non-sedating (second-generation antihistamines). Both act on the h2 receptor, but the first-generation drugs act less selectively on other receptors as well. The difference lies in their ability to cross the blood-brain barrier.

Sedating antihistamines

These drugs have a common chemical structure with drugs which antagonize muscarinic receptors and cholinergic receptors; some antihypertensive drugs; and some tranquilizers. They are not selective to histamine receptors, as a result. They have anti-muscarinic effects, anti-alpha-adrenergic effects, and anti-serotonin effects.

Sedating antihistamines easily cross the blood-brain barrier, to act on central histamine receptors as well as those located peripherally. There are about 64,000 neurons in the human brain which secrete histamine. These regulate a host of actions, namely:

• Wakefulness
• Learning and memory
• Anti-appetite
• Regulation of body temperature
• Regulation of heart rate and blood pressure
• Involvement in stress hormone and endorphin release

Central side effects

Since these actions are disrupted by sedating antihistamines, these drugs produce sedation, drowsiness, tiredness, lack of concentration, difficulty in learning and memory tasks, poor examination performance, and difficulty with work or driving due to cognitive and coordination problems. Moreover, users continue to feel tired, inattentive, forgetful, and experience poor motor and sensory performance the morning after a night dose – mostly because histamine reduces the duration of rapid eye movement (REM) sleep.

Anticholinergic and alpha-adrenergic side effects

Moreover, sedating antihistamines also produce effects via their blockade of the cholinergic and alpha-adrenergic receptors, such as urinary retention, constipation, sinus tachycardia, inhibition of bowel motility, agitation, and worsening of narrow-angle glaucoma. They also produce or worsen dryness of the mouth, increase the appetite, and induce tolerance when used beyond 5 days or so.

Blurred vision, pupillary dilation, dryness of the mouth and skin, flushing, delirium and confusion, and hyperthermia comprise the well-known and life-endangering anticholinergic syndrome caused by high doses of these drugs. Many over-the-counter antihistamines contain a decongestant as well, and therefore if the user experiences palpitations, the medication should be stopped.

Cardiac side effects

Astemizole and terfenadine are two h2-antihistamines which prolong the cardiac QT interval, and can produce dangerous irregularities of the heart rhythm such as the characteristic ‘torsades des pointes’ in the ventricular myocardium. These are not approved for use in most countries currently, as a result. This issue is also seen with large doses or overdoses of certain sedating antihistamines like brompheniramine, promethazine, or diphenhydramine.

Side effects with geriatric use

These drugs should be used cautiously in older patients because they typically have lower numbers of cholinergic neurons in the brain, have fewer cholinergic receptors, have compromised renal and liver function, and a less stable blood-brain barrier, with increasing age. Even at lower doses, they can produce dizziness, lowering of blood pressure, and sedation carrying over to the next day. This can cause older adults to fall with related injury risks.

About 25% of older people (over 65 years) have some cognitive decline, even if this is subtle or unnoticed. These individuals may respond badly to antihistamines with pronounced anticholinergic effects, and may show signs of dementia as a result.

Delirium or impaired cognition are other associated side effects with the use of sedating antihistamines in older people. This may further result in inappropriate treatment with antipsychotics, and committal to long-term care facilities with hallucinations and other signs of agitation or aggression, caused by the anticholinergic drugs.

Doctors and other healthcare professionals, as well as older patients, should avoid these drugs now that non-sedating antihistamines are available.

Contraindications to sedating antihistamines

These drugs should be avoided in very young children and in conditions like:

• urinary retention due to benign prostatic hyperplasia
• closed-angle glaucoma
• cardiac disease

They should be used with caution and only if essential, in patients with:

• pregnancy
• constipation
• xerostomia or dryness of the mouth
• hyperthyroidism
• asthma
• chronic obstructive lung disease
• renal disease
• liver disease
• benign prostatic hyperplasia, which is associated with chronic urinary retention
• patients on antidepressants or seizure medication should also consult their doctors before taking antihistamines
• In patients who drink alcohol

With the availability of second-generation antihistamines, the older sedating antihistamines should be avoided if possible. In any case, individuals who are about to write examinations, who are learning exacting materials or tasks, and adults who must fly, drive or work at any task requiring focused concentration should avoid using these drugs.

Non-sedating antihistamines

These are also called second-generation h2-antihistamines, and include loratadine, fexofenadine, mizolastine, ebastine, azelastine, cetirizine, desloratadine, and levocetirizine. These have no currently known cardiac side effects.

Sedation

Fexofenadine and desloratidine, which, along with levocetirizine, are the most commonly used non-sedating antihistamines, cause very little sedation, as they do not cross the blood-brain barrier to any significant extent and thus have little effect on histamine receptors in the brain. Their failure to cause central sedation is due to their interaction with a pump protein, P-glycoprotein, which inhibits their translocation across the blood-brain barrier. Levocetirizine may produce sedation in a percentage of patients, though it needs to be taken at higher than recommended doses for this.

With their freedom from off-target effects, the non-sedating antihistamines are much more suitable for patients who need long-term therapy. Not only are they safer, but they have a more potent anti-allergic effect.  

Liver injury

Non-sedating antihistamines can rarely cause acute liver injury. Although the liver damage is typically mild, if it occurs, antihistamines should be stopped. The liver function is usually only slightly deranged, and returns to normal with substitution of another antihistamine or cessation of the therapy. Thankfully, stopping these drugs produces prompt reversal of most of these side effects, which are typically mild.

Conclusion

The newer antihistamines are generally safe, but should be avoided in children and in pregnancy unless essential.

Further Reading

Zyrtec drops for internal ave. 10mg / ml 10ml fl

Data obtained from clinical studies.

Review
Clinical studies have shown that the use of cetirizine at the recommended dosages leads to the development of minor adverse effects on the central nervous system, including drowsiness, fatigue, dizziness and headache. In some cases, paradoxical stimulation of the central nervous system was recorded. Despite the fact that cetirizine is a selective blocker of peripheral h2-receptors and practically does not have an anticholinergic effect, isolated cases of difficulty urinating, disturbances of accommodation and dry mouth have been reported.Abnormal liver function has been reported, accompanied by an increase in hepatic enzymes and bilirubin. In most cases, adverse events resolved after discontinuation of cetirizine dihydrochloride.

List of adverse reactions
There is evidence from double-blind controlled clinical trials comparing cetirizine and placebo or other antihistamines used in recommended doses (10 mg once daily for cetirizine) in more than 3200 patients, on the basis of which a reliable analysis of safety data can be carried out.According to the results of the pooled analysis, in placebo-controlled studies when using cetirizine at a dose of 10 mg, the following adverse reactions were identified with a frequency of 1.0% or higher:
General disorders and disorders at the injection site: fatigue;
Nervous system disorders: dizziness, headache;
Disorders from the gastrointestinal tract: abdominal pain, dry mouth, nausea. Mental disorders: drowsiness;
Disorders of the respiratory system, chest and mediastinal organs: pharyngitis.

Although the incidence of drowsiness in the cetirizine group was higher than that in the placebo group, the majority of cases were mild to moderate in severity. In an objective assessment carried out in the framework of other studies, it was confirmed that the use of cetirizine at the recommended daily dose in healthy young volunteers does not affect their daily activity.

Children
In placebo-controlled studies, in children aged 6 months to 12 years, the following adverse reactions were identified with a frequency of 1% or more:
Gastrointestinal disorders: diarrhea;
Mental disorders: drowsiness;
Disorders of the respiratory system, chest and mediastinal organs: rhinitis.General disorders and disorders at the injection site: fatigue.

Experience of post-marketing application
In addition to the adverse events identified in clinical trials and described above, the following adverse reactions were observed during the post-marketing use of the drug. Adverse events are presented below according to the classes of the MedDRA organ system and the frequency of development, based on the data of post-registration use of the drug.

The incidence of adverse events was determined as follows: very often (> 1/10), often (> 1/100, 1/1000, 1/10000,

Blood and lymphatic system disorders
Very rare: thrombocytopenia.

From the immune system
Rarely: hypersensitivity reactions;
Very rare: anaphylactic shock.

Metabolic disorders and eating disorders
Frequency unknown: increased appetite.

Mental disorders
Uncommon: agitation;
Rarely: aggression, confusion, depression, hallucinations;
Very rare: tick;
Frequency unknown: suicidal ideation, sleep disturbances (including nightmares).

From the nervous system
Uncommon: paresthesia;
Rare: convulsions;
Very rare: taste perversion, dyskinesia, dystonia, fainting, tremor;
Frequency unknown: memory impairment, including amnesia, deafness.

From the side of the organ of vision
Very rare: violation of accommodation, blurred vision, nystagmus;
Frequency unknown: vasculitis.

On the part of the hearing organs
Frequency unknown: vertigo.

From the side of the cardiovascular system
Rarely: tachycardia.

From the digestive system
Uncommon: diarrhea.

Hepatobiliary disorders
Rarely: liver failure with changes in liver function tests (increased activity of transaminases, alkaline phosphatase, gamma-glutamyltransferase and bilirubin).

Skin disorders
Uncommon: rash, itching;
Rare: urticaria;
Very rare: angioedema, persistent drug erythema.

From the urinary system
Very rare: dysuria, enuresis;
Frequency unknown: urinary retention.

From the musculoskeletal system
Frequency unknown: arthralgia.

General disorders
Uncommon: asthenia, malaise;
Rare: peripheral edema.

Research
Rare: weight gain.

Description of selected adverse reactions
After discontinuation of cetirizine, cases of pruritus, including intense pruritus and / or urticaria, have been reported.

Notification of adverse reactions
A system for notification of suspected adverse reactions after registration of a medicinal product is of great importance. This allows continuous monitoring of the benefit / risk ratio of the drug.

instructions for use, analogs, composition, indications

Possible side effects are listed below by body systems and frequency of occurrence: very often (> 1/10), often (> 1/100, <1/10), infrequently (> 1/1000, <1/100), rarely ( > 1/10000, <1/1000), very rare (<1/10000), frequency unknown (due to insufficient data).

from the immune system:

Rare: hypersensitivity reactions

Very rare: anaphylactic shock

From the nervous system Uncommon: paresthesia.

Rare: convulsions.

Very rarely, taste perversion, dyskinesia, dystonia, fainting, tremor.

Frequency unknown: deafness, amnesia, memory impairment,

Psychiatric disorders Uncommon: agitation

Rarely: aggression, confusion, depression, hallucinations, sleep disturbances.

Frequency unknown: Suicidal ideation

From the side of the organ of vision

Very rare, violation of accommodation, blurred vision, nystagmus.

Frequency unknown: vasculitis

On the part of the organ of hearing and balance: Frequency unknown: vertigo

From the digestive system Uncommon, diarrhea

From the cardiovascular system Rarely: tachycardia.

From the urinary system Very rare: dysuria, enuresis.

Frequency unknown: urinary retention

From the side of the skin

Uncommon: rash, itching

Rare: urticaria

Very rare: angioedema, persistent erythema.

On the part of laboratory parameters

Rare: changes in liver function tests (increased levels of transaminases, alkaline phosphatase, γ-glutamate transferase and bilirubin).

General disorders Uncommon: asthenia, malaise Rarely: peripheral edema

On the part of laboratory parameters:

Rare: weight gain

In case of adverse reactions, as well as reactions not mentioned in the instructions, you should consult a doctor.

90,000 Zyrtec, tab. p / o film 10 mg No. 7

film-coated tablets 10 mg; blister 7, box (box) 1; EAN code: 460314

06; No. P N011930 / 02-2002, 2002-10-10 from UCB S.A. Pharma Sector (Belgium)

Seasonal and year-round allergic rhinitis, hay fever, allergic conjunctivitis, chronic idiopathic urticaria, pruritus, angioedema; complex therapy of atopic dermatitis, chronic eczema, atopic bronchial asthma.

Hypersensitivity, including to hydroxyzine, pregnancy, breastfeeding, children under 6 months of age.

Contraindicated.

FDA action category for the fetus – B.

At the time of treatment, you should stop breastfeeding (passes into breast milk).

From the nervous system and sensory organs: drowsiness (14%), fatigue (6%), agitation, headache, dizziness, anxiety, nervousness, emotional lability, impaired concentration and thinking, insomnia, depression, euphoria, confusion, amnesia, depersonalization, ataxia, impaired coordination of movements, tremor, hyperkinesis, calf muscle cramps, paresthesia, dysphonia, myelitis, paralysis, ptosis, impaired accommodation and vision, eye pain, glaucoma, xerophthalmia, conjunctivitis, hemorrhage ototoxicity, tinnitus, deafness, impaired sense of smell.

On the part of the digestive tract: dry mouth (5%), change or lack of taste, increased appetite, anorexia, stomatitis (including ulcerative), discoloration and swelling of the tongue, increased salivation, increased cariousness, thirst, vomiting , dyspepsia, gastritis, abdominal pain, flatulence, diarrhea, constipation, hemorrhoids, melena, rectal bleeding, liver dysfunction.

From the cardiovascular system: migraine, extremely rare – palpitations, hypertension, heart failure.

Respiratory system: rhinitis, nosebleeds, nasal polyp, pharyngitis, cough, sinusitis, bronchitis, increased bronchial secretion, bronchospasm, dyspnea, upper respiratory tract infection, pneumonia, hyperventilation.

From the genitourinary system: urinary retention, edema, polyuria, dysuria, hematuria, urinary tract infection, cystitis, decreased libido, dysmenorrhea, intermenstrual bleeding, menorrhagia, vaginitis.

From the musculoskeletal system: arthralgia, arthritis, arthrosis, myalgia, back pain, muscle weakness.

Skin: dry skin, rash, blistering rash, itching, acne, furunculosis, dermatitis, eczema, hyperkeratosis, erythema, increased sweating, alopecia, angioedema, hypertrichosis, photosensitivity, seborrhea.

Other: malaise, fever, chills, hot flashes, dehydration, diabetes mellitus, lymphadenopathy, breast pain, weight gain, allergic skin reactions, incl.h. urticaria.

The simultaneous use of drugs that depress the central nervous system and alcohol consumption is not recommended. Use with caution during work for drivers of vehicles and people whose profession is associated with increased concentration of attention.

5 years.

KhiMiK.ru – ZIRTEK. Medications.