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Drug Info

Can you take Zyrtec and a nasal spray together?

Zyrtec and a nasal spray can be combined to treat allergies
Wendy Wisner
By | Jul. 1, 2024 Medically reviewed by Anne Jacobson, MD, MPH
Nasal spray bottle: Can you take Zyrtec and a nasal spray together?

Key takeaways

  • Zyrtec is an antihistamine and Flonase and Nasacort are nasal steroid sprays

  • Zyrtec blocks histamines from producing allergy symptoms, and nasal steroid sprays can decrease stuffy nose and congestion associated with allergies.

  • Taken together, these two classes of medication usually work better than when taken alone.

  • It is generally safe to take Zyrtec with nasal steroid sprays such as Flonase or Nasacort.

In this article:

If you are dealing with the unpleasant symptoms of respiratory allergies, such as coughing, sneezing, congestion, watery eyes, and itchy throat, you want relief, and you want it now. Many people with allergies turn to Zyrtec (cetirizine), an antihistamine that can effectively treat seasonal allergies in adults and children. But sometimes, an antihistamine alone isn’t enough, and many people want to know if Zyrtec can be used with a nasal spray.

The answer is yes. Zyrtec and nasal spray can be combined to treat allergies. Together, they can pack a punch and significantly decrease allergy symptoms. Here, we’ll take a closer look at Zyrtec and nasal spray, including safety, benefits, and any side effects to be aware of.

Can you take Zyrtec and nasal spray together?

You can use several different classes of medication to treat allergies, including antihistamines like Zyrtec. Antihistamines block the histamines released in your body when you encounter something you are allergic to.

While several different types of nasal sprays exist, such as antihistamines and saline sprays, the most common ones used with Zyrtec are nasal corticosteroid (steroid) sprays. Steroid nasal sprays work by decreasing the inflammation that occurs during an allergic episode. These sprays are especially helpful for treating the stuffy nose and congestion that come with allergies.

The following are over-the-counter steroid nasal sprays approved by the U.S. Food and Drug Administration (FDA) that are often taken with Zyrtec:

Healthcare providers frequently recommend Zyrtec and nasal sprays together. Let’s explore the benefits and safety of this combination.

Benefits

Antihistamines like Zyrtec can relieve some of the itching and sneezing associated with allergies, but they don’t always effectively treat symptoms like congestion. According to Claudia Cometa, Pharm.D., founder and CEO at Peace Advocacy Group, taking Zyrtec with nasal spray gives you more options for treating your symptoms. “Using a non-antihistamine nasal spray along with Zyrtec could provide a patient with different approaches to treat their symptoms and may be helpful,” she explains.

Soma Mandal, MD, an internist at Summit Health, agrees that Zyrtec and nasal spray have notable advantages for people with allergies. “I usually recommend that patients pair an antihistamine along with a steroid nasal spray like Flonase or Nasacort,” Dr. Mandal says, explaining that steroid nasal sprays help reduce inflammation in the nasal passages. “A combination of antihistamine and steroid nasal spray can more effectively treat nasal congestion, sneezing, and runny nose,” she says.

Data backs up these claims as well. For example, a 2016 study published in the European Archives of Oto-Rhino-Laryngology found that reducing nasal symptoms by taking an oral antihistamine like Zyrtec and pairing it with a nasal corticosteroid was more effective than taking an oral antihistamine alone.

Safety 

Dr. Mandal says that combining Zyrtec and nasal sprays is beneficial and generally not harmful. “It is typically safe to take Zyrtec and a nasal spray together,” she says. Although there isn’t robust data on the safety profile of taking these medications together, they are different medication classes, so you will not be taking too much of any one allergy medication.

Of course, everyone is different, so you should discuss this combination with your healthcare provider before taking it. This is especially important if you have underlying medical conditions if you are considering giving this combination to a child, or if you are pregnant or breastfeeding.

Can you take Zyrtec and Flonase together?

Flonase (fluticasone) is a popular nasal steroid. It’s FDA-approved to treat nasal symptoms associated with seasonal allergies and other allergies, as well as nonallergic rhinitis (congestion not related to allergies). It works by decreasing inflammation in the nose and nasal passages. Flonase can be used in adults and children four years and older. Flonase doesn’t usually cause significant side effects, but dry mouth, sore throat, and nose irritation can occur.

If you have stubborn seasonal allergies, you might wonder if Zyrtec and Flonase can be taken together. Cometa says they can. Each medication has a different mode of action—Zyrtec is an antihistamine, and Flonase is a steroid—but they work well together.

“Zyrtec will provide quicker, more immediate relief from common symptoms such as a runny nose and sneezing,” she describes. “Flonase is a more long-term medication used to decrease the inflammation often present and contributes to allergy-related symptoms.”

In adults, Zyrtec is typically dosed as a 10mg tablet taken once a day, Cometa explains. “Since it is a second-generation antihistamine and doesn’t result in significant sedation like Benadryl, morning or evening dosing is okay,” she says. Flonase is used as one or two sprays in each nostril, once per day, usually in the morning. 

Can you combine Nasacort and Zyrtec? 

Like Flonase, Nasacort (triamcinolone acetonide) is a nasal steroid spray that works by decreasing inflammation in the nasal passages. It is FDA approved to treat nasal symptoms that occur in seasonal and all-year allergies and can be used by adults and children aged two years and older. Nasacort side effects can include headache, heartburn, and GI issues.

Many wonder if Nasacort and Zyrtec can be taken together. Cometa assures, “Yes, you can take Zyrtec with Nasacort. Nasacort is a steroid, similar to Flonase, so the reasoning behind combined treatment is the same.”

According to Cometa, if you take Zyrtec with Nasacort, you should stick to a dose of Zyrtec of 10mg daily. Nasacort is taken as one or two sprays per nostril each day.

What medications should you not take with Zyrtec?

Zyrtec has a strong safety profile, but it is known to cause sleepiness, so it’s highly recommended not to take it with other medications that cause drowsiness. “I generally advise not to combine Zyrtec with sedatives or sleeping pills,” says Dr. Mandal. “Certain antidepressants like MAOIs (monoamine oxidase inhibitors) can interact with Zyrtec and increase the risk of side effects.

Cometa agrees. “While Zyrtec is not highly sedating, the effects can be amplified with medications like narcotics, anxiety medications, seizure medications, muscle relaxants, and sleeping pills,” she says. “Caution is advised with these medication combinations.”

Dr. Mandal also advises against combining Zyrtec with other antihistamines. Additionally, antifungal medications like ketoconazole and antibiotics like erythromycin “can increase the level of Zyrtec in the body and cause potential side effects,” she says. Finally, Dr. Mandal recommends that if you have kidney disease, you should talk to your healthcare provider, as your dose of Zyrtec may need to be adjusted.

You should reach out to your healthcare provider before combining Zyrtec with any new medications, especially if you are pregnant, breastfeeding, or have an underlying medical condition.

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