Allegra vs. Allegra-D: 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

While shopping for allergy medicine at your local pharmacy you may reach for Allegra (fexofenadine). Allegra relieves persistent allergy symptoms like sneezing and itching. It’s a popular over-the-counter (OTC) option if you’re looking for quick relief. But, you might notice there are two different versions: Allegra and Allegra-D.

Allegra, or fexofenadine, is an FDA-approved antihistamine used to treat seasonal allergies. More specifically, fexofenadine is a second-generation antihistamine that can relieve symptoms like sneezing, runny nose, and itchy, watery eyes. It works by blocking the chemical histamine from binding to histamine receptors, which hinders an allergic immune response.

Read on to learn more about the differences and similarities between Allegra and Allegra-D.

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

You might think they’re practically the same since there’s only a one-letter difference, however, although both versions of Allegra contain fexofenadine, they have an important distinction: Allegra-D contains a decongestant called pseudoephedrine. Pseudoephedrine is often taken to relieve nasal congestion, or stuffy nose, associated with allergies or the common cold.

Allegra-D (What is 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 recommended for adults and children who are 12 years of age or older.

Regular Allegra (What is Allegra?) comes in an oral tablet, orally-disintegrating tablet, and liquid suspension. The 12-hour tablet contains 60 mg of fexofenadine while the 24-hour tablet contains 180 mg of fexofenadine. Adults and children who are 12 years of age and older can take Allegra tablets, but there are lower-strength versions available to treat allergic rhinitis in children aged 2 to 11 years old.

Main differences between Allegra and Allegra-D
	Allegra	Allegra-D
Drug class	Antihistamine	Antihistamine
Brand/generic status	Brand and generic available	Brand and generic available
What is the generic name?	Fexofenadine	Fexofenadine and pseudoephedrine
What form(s) does the drug come in?	Oral tablet Orally disintegrating tablet Oral liquid	Oral tablet, extended-release
What is the standard dosage?	30 mg tablet: One tablet by mouth twice daily 60 mg tablet: One tablet by mouth twice daily 180 mg tablet: One tablet by mouth once daily	12-hour tablet: One tablet by mouth twice daily 24-hour tablet: One tablet by mouth once daily
How long is the typical treatment?	Short-term	Short-term
Who typically uses the medication?	Adults and children 12 years and older	Adults and children 12 years and older

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—in adults and children. They can be useful drugs if you experience symptoms after being exposed to allergens like pollen or dust mites.

Allegra is also approved to treat hives, or urticaria. Many people break out in hives after experiencing an allergic reaction from certain foods or drugs. Allegra can treat chronic urticaria in children as young as 6 months old.

Condition	Allegra	Allegra-D
Seasonal allergic rhinitis	Yes	Yes
Hives	Yes	No

Is Allegra or Allegra-D more effective?

Both Allegra and Allegra-D are effective medications for treating allergy symptoms. However, Allegra-D is more suitable for relieving congestion and sinus pressure because of the added pseudoephedrine. Currently, there are no head-to-head trials comparing Allegra and Allegra-D.

Compared to first-generation antihistamines like Benadryl (diphenhydramine), Allegra has less sedating side effects. In this regard, Allegra can be considered safer than older antihistamines.

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. The retail cost of Allegra is usually around $15 to $90, depending on the strength and quantity of the tablets. If you have a prescription, you can get generic Allegra or Allegra-D for around $10 and $15 respectively. Check the SingleCare search tool to find out how much you can save at your local pharmacy.

	Allegra	Allegra-D
Typically covered by insurance?	No	No
Typically covered by Medicare Part D?	No	No
Standard dosage	180 mg tablet once daily	180 mg-240 mg tablet once daily
Typical Medicare copay	$1–$11	$1–$53
SingleCare cost	$9+	$15+

Get the SingleCare prescription discount card

Common side effects of Allegra vs. Allegra-D

The most common side effects of Allegra and Allegra-D include headache, nausea, drowsiness, indigestion, and upper respiratory infections. Allegra may also cause painful menstrual cramps (dysmenorrhea).

Side effects specific to Allegra-D include insomnia, dry mouth, heart palpitations, and nervousness. These unique side effects are caused by the pseudoephedrine in Allegra-D.

Serious side effects of Allegra are rare but generally involve sensitivity 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.

	Allegra		Allegra D
Side effect	Applicable?	Frequency	Applicable?	Frequency
Headache	Yes	10.6%	Yes	13%
Insomnia	No	–	Yes	13%
Upper respiratory tract infection	Yes	3.2%	Yes	1.4%
Nausea	Yes	1.6%	Yes	7.4%
Dysmenorrhea	Yes	1.5%	No	–
Drowsiness	Yes	1.3%	Yes	*
Indigestion	Yes	1.3%	Yes	2.8%
Dry mouth	No	–	Yes	2.8%
Palpitations	No	–	Yes	1.9%
Nervousness	No	–	Yes	1.4%

^*not reported

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

Antacids should be avoided within two hours before or after taking Allegra or Allegra-D. Antacids like Tums (calcium carbonate) or Alka-Seltzer (sodium bicarbonate) can decrease the absorption of fexofenadine and reduce its effectiveness. Grapefruit juice has a similar effect on fexofenadine and should also be avoided while taking Allegra or Allegra-D.

HIV drugs like cobicistat can increase blood concentrations of fexofenadine. Taking Allegra with cobicistat or antivirals may lead to increased side effects such as drowsiness or headache. Other antihistamines should not be taken with Allegra since they can also lead to worsened side effects.

Allegra-D should be avoided while taking tricyclic antidepressants or monoamine oxidase (MAO) inhibitors. The 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).

Drug	Drug class	Allegra	Allegra D
Calcium carbonate Magnesium hydroxide Sodium bicarbonate	Antacid	Yes	Yes
Carvedilol Labetalol Nadolol	Beta-blocker	Yes	Yes
Cobicistat Dasabuvir Etravirine Ritonavir	Antiviral	Yes	Yes
Desloratadine	Antihistamine	Yes	Yes
Pioglitazone	Antidiabetic	Yes	Yes
Grapefruit juice	Foods	Yes	Yes
Rifampin	Antimycobacterial	Yes	Yes
Ketoconazole Posaconazole	Antifungal	Yes	Yes
St. John’s Wort	Herbal	Yes	Yes
Amitriptyline Nortriptyline Clomipramine	Tricyclic antidepressant	No	Yes
Amlodipine Lisinopril Methyldopa Reserpine	Antihypertensive	No	Yes
Selegiline Phenelzine	MAO inhibitor	No	Yes

Consult a healthcare professional for other possible drug interactions.

Warnings of Allegra and Allegra-D

Allegra and Allegra-D should be avoided in those with a known hypersensitivity to either drug’s active ingredients. Otherwise, these drugs may cause an allergic reaction such as a severe rash or trouble breathing (anaphylaxis).

Allegra and Allegra-D should be avoided in people with kidney disease. Since fexofenadine is cleared from the body through the kidneys, altered kidney function may lead to an increased risk of toxicity and adverse effects.

The use of Allegra-D may need to be avoided or monitored in those with high blood pressure and heart disease. Pseudoephedrine works by constricting blood vessels to reduce congestion. This effect may increase the risk of complications from cardiovascular disease.

Consult your healthcare provider for other precautions to be aware of before taking Allegra or Allegra-D.

Frequently asked questions about Allegra vs. Allegra-D

What is Allegra?

Allegra is the brand name of fexofenadine. It is used to treat hay fever (allergic rhinitis) and hives (urticaria) in adults and children. Allegra can be found over the counter and is available in tablet and liquid formulations.

What is Allegra-D?

Allegra-D contains fexofenadine hydrochloride and pseudoephedrine. It can be purchased over the counter to help relieve allergy symptoms such as runny nose, watery eyes, and nasal congestion. Allegra-D is available as a 12-hour and 24-hour oral tablet.

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 may be used during pregnancy if the benefits outweigh potential risks to the fetus. Therefore, these drugs 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 contains fexofenadine, which has the potential to cause drowsiness. However, this drug also contains pseudoephedrine, which has stimulating effects on the central nervous system (CNS). Allegra-D may cause sleepiness or trouble sleeping depending on your individual response to the medication. Compared to first-generation antihistamines, Allegra-D will cause less drowsiness.

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.

Should I take Allegra at night or in the morning?

Allegra can be taken at night or in the morning, depending on which time of day you experience the worst symptoms. If you experience worse allergy symptoms at night or early in the morning, you can try taking Allegra in the evening. If you experience worse symptoms throughout the day, you can take it in the morning. Allegra comes in a 24-hour tablet that lasts for the whole day.