Ask Dr. H: The label says 65 is too old to use Zyrtec

Question: I am over 65 and have been using Zyrtec for allergies for several years. I just noticed on the label that it says "not for over 65." Why is that? Now what do I use?

Answer: They don't mean to imply that Zyrtec is not for folks over the age of 65. What they actually recommend is that if you're over 65, or if you have liver or kidney problems, you should ask your doctor if it's OK to use it.

Since Zyrtec is now an over-the-counter antihistamine and can be taken without a doctor's knowledge, they're just advising caution in older folks. Based on the manufacturer's studies of Zyrtec metabolism in people over 65, they recommend that folks who are 77 years and older take only 5 mg per day (vs. the usual dosage of 10mg/day).

If your recent bloodwork shows that your kidney and liver function are not impaired and you're under the age of 77, you can safely take either 5 or 10 mg per day of Zyrtec - depending on your allergy needs.

Zyrtec, Claritin, Alavert, and Allegra are all now available without a doctor's prescription and they all carry the same warning that you should ask your doctor about maintaining or reducing the usual adult dosage if you're over 65 or if you have a history of liver and/or kidney impairment.

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Q: Are there really advantages to using a robot to help perform surgery? If so, what are they?

A: Definitely! Robotic-assisted surgery offers significant advantages over traditional surgery or laparoscopic surgery for many, but not all surgical procedures. Instead of directly moving the instruments, a surgeon uses a manipulator under computer control to precisely and delicately control movements.

This allows for much smaller incisions, a lower risk of bleeding, less pain, a reduced chance of surgical error, a faster recovery time, and shorter hospitalizations. What's more, since this surgery is performed using a computer and video imaging system, there's the potential for a patient in a hospital operating room in one part of the world to receive specialized surgery by a skilled surgeon in another part of the world.

Robotic-assisted surgery has been successfully used in minimally invasive coronary artery bypass surgery; fibroid surgery; hysterectomy; prostate removal in cancer; liver tumor resection; heart valve repair; hip and knee replacement surgery; kidney transplantation.

The disadvantages to robotic-surgery are equipment cost ($1.2 million and up); extensive training required by the surgeon and operating room personnel; and operating room procedures that take up to twice as long as the comparable traditional surgical procedures.