Allegra vs. Allegra-D: What’s the difference?

In this article:

• Main differences
• Conditions treated
• Effectiveness
• Coverage and cost comparison
• Side effects
• Drug interactions
• Contraindications
• FAQs

In this article

• Main differences
• Conditions treated
• Effectiveness
• Coverage and cost comparison
• Side effects
• Drug interactions
• Contraindications
• FAQs

Allegra (fexofenadine) and Allegra-D are second-generation antihistamines that can relieve allergy symptoms like sneezing, runny nose, and itchy, watery eyes. They work by blocking the chemical histamine from binding to histamine receptors, which hinders an allergic immune response. But Allegra-D also contains pseudoephedrine, a decongestant that helps relieve a stuffy nose. That added ingredient also brings additional side effects, interactions, and precautions.

What are the main differences between Allegra and Allegra-D?

Allegra contains fexofenadine, and Allegra-D contains fexofenadine plus a decongestant called pseudoephedrine. Pseudoephedrine is often taken to relieve nasal congestion or stuffy nose associated with allergies or the common cold.

Allegra-D comes in a 12-hour and 24-hour tablet. The 12-hour formulation contains 60 mg of fexofenadine and 120 mg of pseudoephedrine, while the 24-hour formulation contains 180 mg of fexofenadine and 240 mg of pseudoephedrine. Allegra-D is only indicated for adults and children who are 12 years of age or older. Legal restrictions on pseudoephedrine sales were enacted in 2006, because it can be used in the manufacturing of methamphetamine. As a result, pseudoephedrine containing products, like Allegra-D, must be purchased from behind the pharmacy counter.

Regular Allegra comes in an oral tablet, gelcap, orally-disintegrating tablet, and liquid suspension. The 12-hour tablet contains 60 mg of fexofenadine, while the 24-hour tablet and gelcap contain 180 mg of fexofenadine. Adults and children who are 12 years of age and older can take Allegra tablets and gelcaps, but the dissolvable tablets and liquid suspension are lower-strength versions available to treat allergic rhinitis in children, specifically for ages 6 years and older for the dissolvables and ages 2 years and older for the liquid.

Allegra vs. Allegra-D at a glance
Feature	Allegra	Allegra-D
Contains an antihistamine	Yes	Yes
Helpful for runny nose and sneezing	Yes	Yes
Contains a decongestant	No	Yes
Helpful for congestion and stuffy nose	No	Yes
Restricted availability behind the pharmacy counter	No	Yes
Common side effects	Headache	Headache, nervousness, palpitations
Drug formulations	Oral tablet and gelcap, 12 and 24-hour version Orally disintegrating tablet Oral liquid	Oral tablet, 12 and 24-hour version
Formulations available for children	Yes, ages 2 years and older for liquid and ages 6 years and older for dissolvable tablets	No

Conditions treated by Allegra and Allegra-D

Allegra and Allegra-D are allergy medications used to treat seasonal allergic rhinitis, also known as hay fever. Both products can be used in adults and children ages 12 years and old, but only Allegra has formulations for younger children. They can be useful drugs if you experience symptoms after being exposed to allergens like pollen or mold spores.

Allegra is also approved by the Food and Drug Administration (FDA) to treat hives, or urticaria. In this instance, the specific indication is for chronic, stable urticaria that occur for unknown reasons, not for an acute and potentially unstable allergic reaction. Allegra can treat chronic urticaria in children as young as 6 months old.

Compare Allegra vs. Allegra-D conditions treated
Condition	Allegra	Allegra-D
Seasonal allergic rhinitis	Yes	Yes
Hives	Yes	No

Allegra vs. Allegra-D: Which works better for allergies?

Both Allegra and Allegra-D are effective medications for treating allergy symptoms. However, for allergies without congestion, Allegra may be sufficient. For allergies with nasal congestion, Allegra-D may provide added relief due to the addition of pseudoephedrine. Allegra-D is more suitable for relieving congestion and sinus pressure because of the added pseudoephedrine.

Compared to first-generation antihistamines like Benadryl (diphenhydramine), Allegra has less sedating side effects.

According to a review of second-generation antihistamines, Allegra was found to be comparable to drugs like Zyrtec (cetirizine) and Claritin (loratadine) for treating allergic rhinitis. But, Zyrtec may be more effective than Allegra for treating hives.

The best seasonal allergy medicine is the one that works best for you and your specific symptoms. Consult with your healthcare provider to find the most effective allergy drug for you. One drug may be better depending on your overall health and other drugs you may be taking.

Coverage and cost comparison of Allegra vs. Allegra-D

Allegra and Allegra-D are over-the-counter (OTC) medicines that are not usually covered by Medicare and insurance plans. Allegra costs about $28 for 30, 180 mg tablets, while Allegra-D typically costs a bit more. If you have a prescription and a SingleCare coupon, you can get generic Allegra or Allegra-D for around $4 and $22, respectively. Check the SingleCare search tool to find out how much you can save at your local pharmacy.

Allegra vs. Allegra-D cost comparison
Cost/coverage	Allegra	Allegra-D
Typically covered by insurance?	No	No
Typically covered by Medicare Part D?	No	No
SingleCare cost	$4 for 30, 180 mg tablets at Walmart	$32 for 30, 180 mg 12-hour tablets at Publix

Get the SingleCare prescription discount card

Common side effects of Allegra vs Allegra-D

The most common side effects of the fexofenadine component of Allegra and Allegra-D include headache, nausea, drowsiness, indigestion, and upper respiratory infections. Based on the addition of pseudoephedrine, Allegra-D can also cause insomnia, nervousness, palpitations, and increased blood pressure.

Serious side effects of Allegra are rare but generally involve allergic reactions to ingredients in the drug. The pseudoephedrine in Allegra-D may cause severe palpitations or high blood pressure, which may warrant medical attention in those who have preexisting cardiovascular problems.

Compare Allegra vs. Allegra-D side effects
Side effect	Allegra	Allegra-D
Headache	Yes	Yes
Insomnia	No	Yes
Upper respiratory tract infection	Yes	Yes
Nausea	Yes	Yes
Dizziness	Yes	Yes
Drowsiness	Yes	Yes
Indigestion	Yes	Yes
High blood pressure	No	Yes
Palpitations	No	Yes
Nervousness	No	Yes

This may not be a complete list of adverse effects that can occur. Please refer to your doctor or healthcare provider to learn more about side effects. 

Source: DailyMed (Allegra), DailyMed (Allegra-D)

Drug interactions of Allegra vs. Allegra-D

Certain antacids should be avoided within two hours before or after taking Allegra or Allegra-D. Magnesium and aluminum-containing antacids like Mylanta and Gaviscon Extra Strength can decrease the absorption of fexofenadine and reduce its effectiveness. Grapefruit, orange, and apple juices have a similar effect on fexofenadine and should also be avoided while taking Allegra or Allegra-D.

Unless directed by a healthcare provider, other antihistamines should not be taken with Allegra or Allegra-D, since they can also lead to worsened side effects. The antifungal ketoconazole and antibiotic erythromycin can increase the levels of fexofenadine and therefore heighten the risk of adverse reactions.

Allegra-D should be avoided while taking and within 14 days of taking monoamine oxidase (MAO) inhibitors and can also interact with tricyclic antidepressants. Pseudoephedrine in Allegra-D can interact with these other drugs and lead to an increased risk of high blood pressure (hypertension) or irregular heartbeat (arrhythmia).

Compare Allegra vs. Allegra-D interactions
Drug or substance	Allegra	Allegra-D
Aluminum/magnesium antacids	Yes	Yes
Antifungal ketoconazole	Yes	Yes
Blood pressure medications	No	Yes
Fruit juices	Yes	Yes
MAO inhibitors	No	Yes
Other antihistamines	Yes	Yes
Tricyclic antidepressants	No	Yes

Consult a healthcare professional for other possible drug interactions.

Who should avoid Allegra and Allegra-D?

Allegra and Allegra-D may not be appropriate for everyone. People with kidney disease should ask a healthcare provider before using either medication because they may need a different dose. Anyone who’s had an allergic reaction to fexofenadine or another ingredient in either medication should also avoid taking it.

Because Allegra-D also contains the decongestant pseudoephedrine, it requires additional precautions. Ask your healthcare provider before taking Allegra-D if you have heart disease, high blood pressure, thyroid disease, glaucoma, diabetes, difficulty urinating due to an enlarged prostate, or kidney disease.

Do not take Allegra-D if you currently take a monoamine oxidase inhibitor (MAOI) or have stopped taking one within the past two weeks. If you’re pregnant or breastfeeding, ask your healthcare provider whether you should take Allegra or Allegra-D.

Frequently asked questions about Allegra vs Allegra D

Are Allegra and Allegra-D the same?

Allegra and Allegra-D both contain fexofenadine HCl. However, they are not the same drug. Allegra-D contains another active ingredient called pseudoephedrine.

Is Allegra or Allegra-D better?

Both Allegra and Allegra-D work for relieving general allergy symptoms. Since Allegra-D contains an added decongestant, it may be better for certain symptoms like congestion or stuffy nose.

Can I use Allegra or Allegra-D while pregnant?

Allegra and Allegra-D should only be used with approval from your healthcare provider. Consult your doctor before using Allegra or Allegra-D during pregnancy.

Can I use Allegra or Allegra-D with alcohol?

While occasional alcohol consumption may be fine while taking a second-generation antihistamine, it is not usually recommended. Alcohol may cause side effects such as dizziness or drowsiness, which can be intensified with an antihistamine.

Does Allegra-D make you sleepy?

Allegra-D is less likely to make you sleepy than Allegra. Although both contain fexofenadine, which has the potential to cause drowsiness, Allegra-D also contains pseudoephedrine, which can cause the opposite effect: nervousness or trouble sleeping. Individual responses vary.

Is Allegra-D an over-the-counter drug?

Allegra-D is an over-the-counter drug that can be purchased without a prescription. According to federal law, Allegra-D is kept behind the counter at the pharmacy. You may need an ID to purchase it, and there will be a limit to how much you can purchase on a given day.