Cetirizine-Induced atrial fibrillation

My doc prescribed this antihistamine called Cetirizine, I used it a couple of times but looking into the literature there may be some concerns for Afib, I think I will stop taking it.



Atrial fibrillation (AF) is the most common observed arrhythmia in clinical practice. AF significantly increases the risk of thromboembolic ischemic stroke, and it results in affecting hemodynamic impairment.[1] Although AF is often associated with structural heart disease and other co-occurring chronic conditions, it can also occur without an identified cause (lone AF). In the literature, AF events associated with drug induction are available. For these drugs, arguments have been made on the mechanisms which can lead to AF and some drugs have been put into the riskier class.[2] Antihistamine drugs are one of them. Cetirizine is a second-generation antihistamine used in the treatment of allergies, angioedema, and urticaria. To best of our knowledge, this is the first case of cetirizine-induced AF


[www.researchgate.net]

Because of a single case history? You've used it a couple of times with no ill effect. In that case history the patient used it once and immediately developed new onset afib. Seems kind of different to me.

Quote
Carey
Because of a single case history? You've used it a couple of times with no ill effect. In that case history the patient used it once and immediately developed new onset afib. Seems kind of different to me.

Non-sedating antihistamine drugs and cardiac arrhythmias – biased risk estimates from spontaneous reporting systems?


Abstract

This study used spontaneous reports of adverse events to estimate the risk for developing cardiac arrhythmias due to the systemic use of nonsedating antihistamine drugs and compared the risk estimate before and after the regulatory action to recall the over-the-counter status of some of these drugs.

Methods
All suspected adverse drug reactions (ADRs) reported until July 1999 to the Netherlands Pharmacovigilance Foundation Lareb were used to calculate the ADR reporting odds ratio, defined as the ratio of exposure odds among reported arrhythmia cases, to the exposure odds of other ADRs (noncases), adjusted for gender, age, reporter, year of reporting and comedication, stratified for the periods before and after the governmental decision in the Netherlands.

Results
Seven-hundred and thirty-seven cases of arrhythmia were reported, out of which there were 43 instances where the patients were using nonsedating antihistamines. In general nonsedating antihistamines are associated with cardiac arrhythmia to a higher extent in comparison with other drugs (ADR reporting odds ratio 2.05 [95% CI: 1.45, 2.89]). The association between arrhythmias and nonsedating antihistamine drugs calculated before 1998 was not significantly higher than 1 (OR 1.37 [95% CI: 0.85, 2.23]), whereas the risk estimate calculated after the governmental decision did significantly differ from 1 (OR 4.19 [95% CI: 2.49, 7.05]).

Conclusions
Our data suggest that nonsedating antihistamines might have an increased risk for inducing arrhythmias. Our findings, however, strongly suggest that the increased risk identified can at least partly be explained by reporting bias as a result of publications about and mass media attention for antihistamine induced arrhythmias.



[www.ncbi.nlm.nih.gov]

I wasn't saying you're wrong. It just seems like a rash decision to me since you've used the drug before without problems.

Quote
Carey
I wasn't saying you're wrong. It just seems like a rash decision to me since you've used the drug before without problems.

I'm trying to avoid anything that could trigger it for now. I only use half of the RX dose, which 5 mg.