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Key takeaways
People who are looking for Xyzal alternatives typically want to relieve unwanted side effects of Xyzal, while continuing to effectively decrease their allergy symptoms.
The best Xyzal alternatives are Allegra, Zyrtec, and Claritin. They treat the same symptoms as Xyzal but may have different or fewer side effects.
Other Xyzal alternatives include nasal sprays like Flonase and Astepro, as well as antihistamine eye drops like Pataday.
Xyzal is the brand name for levocetirizine dihydrochloride, an antihistamine medication (H1 blocker) that offers 24-hour relief from allergy symptoms like allergic rhinitis, runny nose, sneezing, itchy, watery eyes, throat irritation, and skin rash symptoms like hives. It’s available in both prescription and over-the-counter (OTC) forms.
Although Xyzal is usually well tolerated, it can have unwanted side effects like dry mouth, diarrhea, sleepiness, and dose adjustment is required in kidney impairment. If you are dealing with negative side effects after taking Xyzal, you may be looking for Xyzal alternatives.
What can I take instead of Xyzal?
If you’re looking for alternatives to Xyzal, you likely want a medication that effectively treats your allergy symptoms, but that has fewer side effects for you. The medications that are most similar to Xyzal in terms of what symptoms they treat and how they work are second-generation antihistamines, such as Allegra (fexofenadine), Zyrtec (cetirizine), or Claritin (loratadine). These all treat hay fever symptoms like runny nose, sneezing, watery, itchy eyes, and other common allergy symptoms.
Other Xyzal alternatives to consider, says Morris Nejat, MD, allergist and owner of New York Allergy and Sinus Centers, are medications applied directly to the skin (topical). “To treat topical allergies, you can also use antihistamine eye drops such as Pataday (olopatadine) and nasal sprays like Flonase (fluticasone) and Astepro (azelastine),” Dr. Nejat recommends.
Compare Xyzal alternatives |
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|---|---|---|---|
| Drug name | Price without insurance | SingleCare price | Savings options |
| Allegra (fexofenadine) | $33 for 30, 180mg tablets | $4 for 30, 180 mg tablets of generic Allegra | Allegra coupons |
| Zyrtec (cetirizine) |
$30 for 1, 10mg, 24 tablets chewable box | $59 for 1, 10 mg, 30 tablets chewable box of brand-name Zyrtec | Zyrtec coupons |
| Claritin (loratadine) | $34 for 30, 10mg tablets | $5 for 30, 10 mg tablets of generic Claritin | Claritin coupons |
| Flonase (fluticasone) | $24 for 1, 9.9ml of 50mcg/act bottle | $12 for 1, 16 gm of 50mcg/act bottle of brand name Flonase | Flonase coupons |
| Astepro (azelastine) | $34 per 1, 23ml of 205.5mcg/spray spray bottle | $18 for 1, 23 ml of 205.5mcg/spray spray bottle of generic Astepro | Astepro coupons |
| Pataday (olopatadine) | $25 for 1, 2.5ml of 0.2% bottle | $9 for 1, 2.5 ml of 0.2% bottle of brand-name Pataday | Pataday coupons |
Prescription drug prices often change. These are the most accurate medication prices at the time of publishing. The listed price without insurance references the price of brand-name drugs (unless otherwise specified). The listed SingleCare price references the price of generic drugs if available. Click the link under “Savings options” to see the latest drug prices.
Top 5 Xyzal alternatives
The following are some of the most common alternatives to Xyzal.
Allegra (fexofenadine)
Both Xyzal and Allegra are oral antihistamines that treat hay fever allergy symptoms like runny nose, sneezing, itchiness, and hives. Allegra is less likely to cause drowsiness than Xyzal, whereas Xyzal tends to offer longer-lasting relief from allergies. Both medications are available in both prescription and over-the-counter (OTC) versions, and both have generic options.
Zyrtec (cetirizine)
Zyrtec and Xyzal are both oral antihistamines used to treat allergic rhinitis (sneezing, runny nose, itchy throat, teary eyes associated with allergies) as well as chronic hives. Both Zyrtec and Xyzal cause less drowsiness than older antihistamines and first-generation antihistamines like Benadryl, but Xyzal may cause even less drowsiness than Zyrtec. Both medications have generic counterparts. While Xyzal is offered as both an over-the-counter (OTC) and prescription antihistamine, Zyrtec is only available over the counter.
Claritin (loratadine)
Both Claritin and Xyzal are antihistamines (H1 blockers) used to treat seasonal allergy symptoms and chronic hives. However, while Xyzal is indicated to treat both perennial (year-round allergies) and seasonal allergies, Claritin is FDA approved for both seasonal allergic rhinitis and chronic urticaria (hives). There are generic versions available of both these drugs. Xyzal is available as both an over-the-counter medication and a prescription medication. Claritin was once a prescription but is now available only over-the-counter.
Flonase (fluticasone)
Flonase is a nasal spray that can be used to treat some of the same allergy symptoms Xyzal does, including sneezing, nasal congestion, and runny nose associated with seasonal allergies. Flonase is a corticosteroid and not an antihistamine. Only inhaled fluticasone (different formulation) is indicated for asthma, topical forms are used for eczema/dermatitis, and a separate nasal formulation (e.g., Xhance) may be used for nasal polyps. Flonase nasal spray is FDA-approved for allergic and non-allergic rhinitis only. Unlike Xyzal, Flonase can’t treat hives. Flonase won’t make you sleepy like Xyzal can, but it can have unwanted side effects like an itchy nose and sore throat.
Astepro (azelastine)
Astepro is an antihistamine nasal spray that can treat some of the allergy symptoms that Xyzal does, such as nasal congestion, runny nose, sneezing, and itchy nose. Astepro doesn’t treat hives, whereas Xyzal can. It works faster than Xyzal, usually within 30 minutes. Astepro is only available over-the-counter, but Xyzal is available both over-the-counter and by prescription.
Natural alternatives to Xyzal
The best way to treat allergies naturally is to avoid exposure to the things you’re allergic to. If you haven’t done so already, Dr. Nejat recommends allergy testing. “Allergy testing can identify your allergens, and there are avoidance measures to avoid exposure based on your specific allergies,” he explains.
Avoiding allergens can be tricky when your allergies include pollen and other outdoor allergens, because you can’t stay inside all the time. Still, there are things you can do to minimize your exposure, including staying indoors during dry, windy days.
Kara Wada, MD, founder, CEO, and physician at the Immune Confident Institute, recommends keeping your windows closed during high pollen season. And what if your allergies include pet dander? “For pet allergies, using an indoor air purifier in the bedroom and main living spaces can be helpful along with vacuuming regularly,” Dr. Wada describes.
Dietary changes can’t cure allergies, but Dr. Wada suggests eating foods that contain natural antioxidants like quercetin (onions, apples, pears, berries, green tea) and luteolin (celery, bell peppers, herbs like thyme, oregano, and rosemary), which may decrease allergic response.
How to switch to an Xyzal alternative
In general, it’s usually okay to stop one oral allergy medication and start the new one the next day, says Dr. Wada. This means that switching from Xyzal to a medication like Allegra, Claritin, or Zyrtec can be as simple as switching to the new medication at the same time that you’d normally take Xyzal.
However, the FDA has warned that stopping Xyzal suddenly can sometimes result in increased itching, which may be severe for some people. “Occasionally, patients may notice an increase in itching when they come off Xyzal, but often this is lessened by using the alternative antihistamine,” Dr. Wada says. “If they are struggling with itching due to withdrawal, they should reach out to their allergy physician.”
Choosing the right path for allergy treatment
People who are looking for Xyzal alternatives usually want medications that work as well for them as Xyzal, but which have fewer side effects. The most common Xyzal alternatives to try are Allegra, Claritin, and Zyrtec. As for which Xyzal alternative is best for you, “there is no one best antihistamine from this list, but often patients will notice that one might work better for them or cause fewer side effects,” Dr. Wada shares.
As you navigate Xyzal alternatives, be sure to stay in touch with your healthcare provider, who can offer you medical advice about the best allergy medication for you and put together an individualized allergy treatment plan.
- Xyzal allergy 24-hour, Xyzal.com (2025)
- FDA requires warning about rare but severe itching after stopping long-term use of oral allergy medicines cetirizine or levocetirizine (Zyrtec, Xyzal, and other trade names), U.S. Food and Drug Administration (2025)
- Astepro allergy, www.asteproallergy.com (2025)
- Morris Nejat, MD, Allergist and owner of New York Allergy and Sinus Centers
- Kara Wada, MD, Founder, CEO, and physician at the Immune Confident Institute