Zyrtec

[Smit5292, BSN]

Is Zyrtec allowed/tested for during monitoring?

[Healer555]

It's an antihistamine. In my state we can take it without a " doctors note", but we have to add it to our monitoring agreement and have it approved. Additionally  we have more drug testing and can't work until it's no longer showing on our drug tests. I just suffer with allergies because it's easier. I'd ask your cm. 

[NurseJackie69]

Do not take this drug without approval or you will be in major trouble. MOST states will actually require at Least a providers note documenting the need (seasonal allergies). Not all states require a physicians note for Antihistamines, but most do, and ALL monitoring programs forbid Benadryl unless you have a prescription and even that prescription is often a problem because there are plenty of other Antihistamines to choose from. The reason why? Benadryl is actually addictive and it's use is on the rise, especially in IV form, and Benadryl and other first generation Antihistamines like Vistaril, Atarax (Hydroxyzine) produce a mild high and euphoria in some people. Antihistamines are easily tested for and they are one of the common "add ons" that case managers tack on to whatever option you were selected for and you will not know it until you turn up positive.

A common Antihistamine that is allowed, depending on which state you live in and whether it's a physicians note saying you can take it OTC and you medically need it, AND in some states, a prescription also required is Zyrtec. The later generation Antihistamines like Zyrtec don't produce the euphoric effect. 

Another reason to avoid Cough syrups. The majority contain at least one forbidden drug class such as an opioid, amphetamine, alcohol, or antihistamines and many cough syrups contain more than 1 of the 4 classes above.

That simple pack of Zyrtec when you have a stuffy nose that's OTC, or that pack of over the counter Pepcid (yes, Pepcid is an antihistamine) when you have heart burn at night due to the pizza or pasta and you need just one to get you out of misery? Do NOT do it. You will get nailed. Get permission first, and depending on which state, that permission could be a written statement by you, or possibly a providers note saying you need it medically and can take it OTC, or possibly a providers note and an actual script.

Go yp the USDTL.website. They are the gold standard for drug testing for monitoring programs and monitoring programs take a bunch, not all, but a lot of their guidance from the USDTL (U.S. Drug Testing Lab). Read what the USDTL says about Benadryl. Also, Antihistamines is a common test performed easily by Quest and Labcorp, which is who Affinity and Recovery Drug use. Lastly, Antihistamines have a fairly long half life. It's not like you can take just one and be fine the next day. You are likely to show positive if tested for all week depending on which one you take.

[Smit5292, BSN]

Thanks for the info!! And the USDTL website!!

[PaddedCellLPN, LPN]

My program allows Zyrtec, Claritin, Xyzal, etc... but no benadryl ever unless a script. Check with your case manager. My program has a list of OK otc meds. 

[Sky1217, LPN]

This is the medication guide from Affinity. I hope it helps! 

MedicationGuide1.7.pdf

[NurseJackie69]

Caution withe above medication guide. Yes, Recovery Trek uses the same thing as posted above, as does Affinity, BUT.....your monitoring program Within your state also has their own restrictions that Supercede the drug testing guide. Notice that in the guide, there's a sentence even for Class A drugs which are "safe to take," but.....they also kind of hint that.....you need permission. My state uses the above guide In Addition to instructions on clear warnings avoiding Antihistamines without prescription and for Lyrica and Neurontin, pain management is required.

[NurseJackie69]

I asked my program manager years ago about the medication guide which is very useful to have and served as a great guide. He told me that even though the Class A medications in the guide are listed as "safe to take" for addicts or people with SUD, that does NOT automatically mean you have permission to take them. He told me Tylenol, Motrin and Tums. He said that covers your pain and heartburn and you can take that OTC, but if I needed to take anything else, to call him because it might need a script, Especially as it relates to Antihistamines and Non Opioid pain meds like Lyrica and Neurontin. He told me they prefer proton pump inhibitors (Prilosec) for GERD and heartburn compared to Zantac and Pepcid (antihistamines).

Zantac and Pepcid wouldn't be a major problem (antihistamines) in and of themselves, but the initial drug test (Elisa) for antihistamines will show positive, then you get into the whole debate of whether or not you took Benadryl and Benadryl IV actually is addictive, so someone could have a valid script for Zantac, but also be using Benadryl IV, so the expected positive result for Zantac (antihistamines) would mask possible Benadryl addiction at the same time. This is how he explained it to me and it makes sense as to why the don't want antihistamines at all. 

For seasonal allergies, they will try and steer nurses to taking Leukotrine inhibitors like Singulair instead of Allegra and Zyrtec (antihistamine). Why? Same thing as stated above. They worry about Benadryl and if you have a script for an antihistamine for heartburn or allergies, the expected result on a drug test is Positive for antihistamines which can mask the possibility of someone using heavy Benadryl IV at the same time. 

They can differentiate Benadryl from other Antihistamines with a specific test for it with the USDTL (US Drug Testing Lab) and if you have a script for antihistamines, you can expect more tests in most states (not all, but Most) and an increase in expensive tests that will also look for Benadryl to be sure you aren't using it and nearly ALL state monitoring programs send out weird tests to the USDTL and they bypass Quest and Labcorp in these cases and the USDTL uses incredibly advanced detection methods far more sensitive than Labcorp and Quest. 

If you absolutely need an antihistamine and have a script, and get the OK, then take it, but I would try other options for heartburn like Prilosec or Nexium instead of Pepcid. For seasonal allergies, I would try Singulair before Zyrtec and Allegra.