Published: 2017-01-16

Bilateral angioedema of eye with single dose of cetirizine

Lakhan Majhee, Md. Rashid Haider Khan, Manju Gari


The H1-antihistamine cetirizine is considered to be one of the safest drugs with well-established safety and efficacy. Very rarely cetirizine can cause adverse drug reaction in the form of dose-dependent somnolence, dizziness, or fatigue. We report a case of 27-year-old female patient with isolated angioedema on both the eye due to the administration of single dose of cetirizine 10 mg for hemorroids with pruritus ani. The mechanism of reaction remains unclear.


Adverse drug reaction, Cetirizine, Angioedema

Full Text:



Skidgel RS, Kaplan AP, Erdos EG. Histamine, Bradykinin and their antagonists. Goodman & Gillmann’s Manual of Pharmacology and Therapeutics. 12th Edition. New Delhi: Mac Graw Hill Medical; 2007: 924.

Malde B, Regalado J, Greenberger PA. Investigation of angioedema associated with use of angiotensin converting enzyme inhibitors and angiotensin receptor blockers. Ann Allergy Asthma Immunol. 2007;98:57-63.

Sabroe RA, Black AK. Angiotensin-converting enzyme (ACE) inhibitors and angio-oedema. Br J Dermatol. 1997;136(2):153-8.

Cimbollek S, Ortega Camarero M, Avila R, Quiralte J, Prados M. NSAID-sensitive antihistamine-induced urticaria/angioedema. J Investig Allergol Clin Immunol. 2011;21(6):488-90.

Cravo M, Gonçalo M, Figueiredo A. Fixed drug eruption to cetirizine with positive lesional patch tests to the three piperazine derivatives. Int J Dermatol. 2007;46(7):760-2.

Assouère MN, Mazereeuw-Hautier J, Bonafé JL. Cutaneous drug eruption with two antihistaminic drugs of a same chemical family: cetirizine and hydroxyzine. Ann Dermatol Venereol. 2002;129(11):1295-8.

Kränke B, Kern T. Multilocalized fixed drug eruption to the antihistamine cetirizine. J Allergy Clin Immunol. 2000;106(5):988.

Inamadar AC, Palit A, Athanikar SB, Sampagavi VV, Deshmukh NS. Multiple fixed drug eruptions due to cetirizine. Br J Dermatol. 2002;147(5):1025-6.

Gupta LK, Agarwal N, Khare AK, Mittal A. Fixed drug eruption to levocetirizine and cetirizine. Indian J Dermatol. 2014;59(4):411-3.

Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30(2):239-45.

Routledge PA, Lindquist M, Edwards IR. Spontaneous reporting of suspected adverse reactions to antihistamines: a national and international perspective. Clin Exp Allergy. 1999;29 Suppl 3:240-6.

Schröter S, Damveld B, Marsch WC. Urticarial intolerance reaction to cetirizine. Clin Exp Dermatol. 2002;27(3):185-7.

Chang YS, Kwon HS, Cho SH, Kim YY, Min KU. A case of urticaria induced by both hydroxyzine and cetirizine but not by levocetirizine. Allergy. 2007;62(7):819-21.

Afonso N, Shetgaonkar P, Dang A, Rataboli PV. Cetirizine-induced anaphylaxis: a rare adverse drug reaction. Br J Clin Pharmacol. 2009;67(5):577-8.

Tripathi KD. Histamine and Antihistaminics. Essentials of Medical Pharmacology. 7th Edition. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd.; 2013: 165-6.

Banerji A, Sheffer AL. The spectrum of chronic angioedema. Allergy Asthma Proc. 2009;30(1):11-6.

Frigas E, Park M. Idiopathic recurrent angioedema. Immunol Allergy Clin North Am. 2006;26(4):739-51.

Byrd JB, Adam A, Brown NJ. Angiotensin-converting enzyme inhibitor-associated angioedema. Immunol Allergy Clin North Am. 2006;26(4):725-37.

Fisher M, Baldo BA. Anaphylaxis during anaesthesia: current aspects of diagnosis and prevention. Eur J Anaesthesiol. 1994;11(4):263-84.

Nielsen PN, Skov PS, Poulsen LK, Schmelz M, Petersen LJ. Cetirizine inhibits skin reactions but not mediator release in immediate and developing late-phase allergic cutaneous reactions. A double-blind, placebo-controlled study. Clin Exp Allergy. 2001;31(9):1378-84.