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Xyzal vs. Zyrtec: Differences, similarities and which is better for you

Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ

 

The misery of allergies: runny nose, itchy or watery eyes, sneezing, and congestion. You are not alone—allergies affect more than 50 million Americans every year. Fortunately, there are many allergy medications, both prescription and over-the-counter (OTC) to help relieve those bothersome symptoms.

Two popular FDA-approved medications are Xyzal (levocetirizine dihydrochloride) (Xyzal coupons) and Zyrtec (cetirizine hydrochloride) (Zyrtec coupons). Both medications are antihistamines, also called H1 blockers. They block the action of histamine, thereby relieving allergy symptoms. Xyzal and Zyrtec are less sedating than the first generation H1 blockers (such as Benadryl, or diphenhydramine).

Xyzal and Zyrtec are classified as non-sedating antihistamines along with other popular medications such as Claritin (loratadine) and Allegra (fexofenadine) but they still do have the potential to cause some drowsiness. However, Xyzal may cause less drowsiness than Zyrtec.

Xyzal and Zyrtec both may significantly relieve allergy symptoms, but there are some notable differences between the two drugs.

RELATED: Xyzal details | Zyrtec details

What are the main differences between Xyzal vs. Zyrtec?

Main differences between Xyzal vs. Zyrtec
Xyzal Zyrtec
Drug class Antihistamine Antihistamine
Brand/generic status Brand and generic Brand and generic
What is the generic name?

 

Levocetirizine dihydrochloride Cetirizine hydrochloride
What form(s) does the drug come in? Tablet, liquid Tablet (oral, chewable), capsule, liquid
What is the standard dosage? Adults: 2.5 to 5 mg every evening
Children: varies by age –  1.25 to 5 mg every evening
Adults: 5 to 10 mg daily
Children: varies by age – 2.5 to 10 mg daily
How long is the typical treatment? Varies – months to years Varies – months to years
Who typically uses the medication? Adults; children 6 years and older Adults; children 6 months and older

Conditions treated by Xyzal and Zyrtec

Xyzal is indicated for the relief of symptoms associated with perennial allergic rhinitis (having nasal allergy symptoms most days of the year) in patients ages six years and older. It is also indicated for the treatment of uncomplicated skin manifestations of chronic idiopathic urticaria, or chronic hives (ages six years and older).

Zyrtec is indicated for relief of symptoms from seasonal allergic rhinitis (due to allergens such as ragweed, grass, and pollen) in patients ages two years and older. It is also indicated for relief of symptoms of perennial allergic rhinitis for ages six months and older, and for the treatment of uncomplicated skin manifestations of chronic idiopathic urticaria, or chronic hives for ages six months and older.

Condition Xyzal Zyrtec
Perennial Allergic Rhinitis Yes (ages 6 years & older) Yes (ages 6 months & older)
Chronic Idiopathic Urticaria Yes (ages 6 years & older) Yes (ages 6 months & older)
Seasonal Allergic Rhinitis No Yes (ages 2 years and older)

Is Xyzal or Zyrtec more effective?

Clinical studies of Xyzal showed that the drug was significantly more effective than placebo in treating symptoms of perennial allergic rhinitis as well as chronic idiopathic urticaria.

Zyrtec clinical studies showed that the drug was significantly more effective than placebo in treating symptoms of perennial allergic rhinitis, seasonal allergic rhinitis, and chronic idiopathic urticaria.

Studies comparing Xyzal and Zyrtec have varying results, with some studies preferring Xyzal and some preferring Zyrtec. In practice, both drugs seem to be quite effective. The question of which drug is better seems to be a matter of trial and error, and personal preference.

Although both Xyzal and Zyrtec can be very effective in treating allergy symptoms, the most effective medication should only be determined by your doctor, taking into account your medical condition(s) and medical history.

Coverage and cost comparison of Xyzal vs. Zyrtec

Xyzal is available in both prescription and OTC form, and in both brand and generic. The average retail price of generic Xyazl, levocetirizine, is about $73 for 5 mg, 30 tablets but it can be purchased for about $50 with a levocetirizine coupon. Insurances and Medicare Part D typically cover the generic prescription form of levocetirizine.

Zyrtec is available over the counter in both brand and generic. The average retail price of Zyrtec for 30 – 10mg tablets ranges from $18-33. You can get the generic version of Zyrtec for as low as $4. using a SingleCare Zyrtec coupon. Zyrtec is only is typically not covered by insurance or Medicare Part D; however, some state Medicaid plans do cover generic cetirizine.

Get the SingleCare prescription discount card

  Xyzal Zyrtec
Typically covered by insurance? Yes; generic No (because it is only OTC); some states may cover generic under Medicaid
Typically covered by Medicare Part D? Yes; generic No
Standard dosage #30, 5 mg tablets #30, 10 mg tablets
Typical Medicare Part D copay $0-44 N/a
SingleCare cost $ 42-67 $4-12

Common side effects of Xyzal vs. Zyrtec

Xyzal and Zyrtec have similar adverse side effects. The most common side effects are somnolence (sleepiness), dry mouth, and fatigue.

Other side effects may occur. Consult your healthcare professional for a complete list of side effects.

  Xyzal Zyrtec
Side Effect Applicable? Frequency Applicable? Frequency
Somnolence Yes 6% Yes 14%
Nasopharyngitis (throat inflammation) Yes 4% No
Pharyngitis Yes 1% Yes 2%
Fatigue Yes 4% Yes 5.9%
Dry mouth Yes 2% Yes 5%

Source: DailyMed (Xyzal), Product Information (Zyrtec)

Drug interactions of Xyzal vs. Zyrtec

High doses of theophylline (a breathing medication) may result in slightly increased levels of Zyrtec. The same interaction is possible with Xyzal.

Alcohol should not be used in combination with Xyzal or Zyrtec. The combination can cause impairment and affect alertness.

Additionally, CNS depressants should not be taken in combination with either drug due to additive effects. CNS depressants include drugs such as anxiety medications, insomnia medications, and barbiturates. CNS depressants are sometimes called sedatives or tranquilizers.

Drug Xyzal Zyrtec
Alcohol Yes Yes
CNS (central nervous system) depressants, anxiety medications such as Xanax (alprazolam), sleeping medications such as Ambien (zolpidem), and barbiturates such as phenobarbital Yes Yes
Theophylline Yes Yes

Warnings of Xyzal and Zyrtec

Xyzal and Zyrtec warnings include somnolence, or sleepiness, and fatigue. You should avoid driving until you know how you react to Xyzal or Zyrtec. You should not drink alcohol while taking Xyzal or Zyrtec, because the combination can affect alertness and cause impairment.

Xyzal or Zyrtec may also cause urinary retention and should be used with caution in patients with a prostate condition. Consult your healthcare provider for medical advice if you have prostate problems.

Xyzal or Zyrtec can usually be used safely while pregnant, and short-term while breastfeeding, but only if approved by your doctor. You should always consult your healthcare provider for personalized advice. If you are already taking Xyzal or Zyrtec and become pregnant, consult your healthcare provider.

Frequently asked questions about Xyzal vs. Zyrtec

What is Xyzal?

Xyzal helps treat symptoms associated with perennial allergic rhinitis. It is also indicated for the treatment of uncomplicated skin manifestations of chronic idiopathic urticaria, or chronic hives.

What is Zyrtec?

Zyrtec is an antihistamine used to treat seasonal allergic rhinitis due to allergens such as ragweed, grass, and pollen. It is also used for relief from perennial allergic rhinitis and skin manifestations of chronic idiopathic urticaria or chronic hives.

Are Xyzal vs. Zyrtec the same?

Xyzal is a chemical mirror image of Zyrtec. They are very similar and have similar drug interactions and side effects. Some patients prefer one to the other. Consult your allergist or other healthcare provider for information.

Is Xyzal vs. Zyrtec better?

Everyone is different; some prefer Xyzal, while others prefer Zyrtec. It may take some trial and error to find the right medication for you. Consult your healthcare provider for advice.

Can I use Xyzal vs. Zyrtec while pregnant?

Xyzal or Zyrtec can usually be used safely in pregnancy, and short-term (with caution) while breastfeeding—only if approved by your doctor. Be sure to check with your doctor before using either drug during pregnancy or while breastfeeding. If you are already taking Xyzal or Zyrtec and become pregnant, consult your healthcare provider.

Can I use Xyzal vs. Zyrtec with alcohol?

You should not drink alcohol while taking Xyzal or Zyrtec, because the combination can affect alertness and cause impairment. You should also not take CNS depressants, such as sleeping medications or anxiety medications, with Xyzal or Zyrtec.

Is it OK to take 2 Xyzal a day?

It is not necessary to take extra doses of Xyzal. Follow the directions for your age or the directions given by your doctor. Do not exceed this dose. Doing so will increase side effects, and will not make the medicine work better.

Why is Xyzal taken at night?

The manufacturer of Xyzal, Sanofi, explains that in addition to affecting your daily life, allergies can cause sleepless nights, causing you to feel tired and unable to function. Therefore, Xyzal was designed to be taken in the evening so you sleep better and wake up rested.

What is the difference between levocetirizine and cetirizine?

Chemically, they are mirror images of each other. Levocetirizine is newer than cetirizine. However, because everyone is different, one may be better than the other for your symptoms. Although both medications are classified as non-sedating antihistamines, they still can potentially cause drowsiness. Some people find levocetirizine to be less sedating, and others find cetirizine to be less sedating. It may take some trial and error to figure out which one is better for you.