Should I stop taking Zyrtec-D before my rhinoplasty?

Question

I'm about three weeks away from rhinoplasty, and I am aware that at two weeks I need to stop my multi-vitamin & ibuprofen intake. I know the list of medications to avoid (two weeks prior) is longer that that, but those are the only two things I take often. With seasonal allergies, I have started taking Zyrtec-D and it has worked wonders. would you recommend that I stop this medication at the two week mark or is it safe to continue? Thank you!

John Nguyen, MD, FACS · Answer

Zyrtec D has pseudoephedrine, which is a stimulant.  This may pose a small risk with anesthesia.  I generally ask patients to stop the medication one week prior to surgery.  However, you should refer to your surgeon's preference and his/her anesthesiologist.  Good luck and be safe.John T. Nguyen, MD, FACS, FICSDouble Board Certified Plastic Surgeon

Stephen Prendiville, MD · Answer

Although this is a question best answered by your Surgeon, taking Zyrtec-D up to 72 hours prior to surgery should not present a problem.  I disagree with Dr. Singer's remarks about only choosing a Surgeon who is Board Certified in Plastic Surgery for Rhinoplasty. Choosing a Surgeon Board certified by the American Board of Facial Plastic Surgery (ABFPRS) or the American Board of Plastic Surgery (ABPS) who also happens to make Rhinoplasty a large part of his/her practice should be the starting point in choosing your Surgeon.

Eric M. Joseph, MD · Answer

In our practice, we like to use medications without oral decongestants to control nasal congestion. Pseudoephedrine is associated with anxiety, insomnia, palpitations, and hypertension. It may be best to stop your Zyrtec-D two to three days before your surgery, and get the opinion of your surgeon about this medication.Hope this helps you.Dr. Joseph

Jamil Ahmad, MD · Answer

Zyrtec D contains cetirizine (an antihistamine) and pseudoephedrine. Pseudoephedrine can cause increased blood pressure and heart rate - this can increase bleeding during surgery and should be avoided. With regard to seasonal allergies, taking an antihistamine alone (not combined with pseudoephedrine) can provide significant relief. I will typically have my patients continue taking their antihistamine to decrease congestion and irritation of the nasal airway before and after surgery. There are many over the counter medications for allergies that contain an antihistamine alone.You should contact your surgeon and discuss this specifically to see if you can take an antihistamine or if your surgeon wants you to stop all together.

Garrett H. Bennett, MD · Answer

The Zyrtec portion is an antihistamine that will not effect surgery. The "D" is a decongestant that is a stimulant. Stopping before surgery will decrease any stimulation on your heart during surgery. After surgery the decongestant will decrease healing blood flow to the nose tissue and may inhibit healing.

Should I stop taking Zyrtec-D before my rhinoplasty?

Answers (9)