Search for articles or Rx savings
Key takeaways
Xyzal (levocetirizine) and Zyrtec (cetirizine) are both FDA-approved, over-the-counter antihistamines for treating allergy symptoms, with Xyzal potentially causing less drowsiness due to its chemical structure. Xyzal is also available in a generic prescription form.
Both medications are effective in treating perennial allergic rhinitis, seasonal allergic rhinitis, and chronic idiopathic urticaria, with clinical studies showing varying preferences between the two.
Xyzal and Zyrtec share common side effects such as sleepiness, dry mouth, and fatigue, but Zyrtec may cause more drowsiness compared to Xyzal.
While generic prescription Xyzal is typically covered by insurance and Medicare plans, Zyrtec, being only over-the-counter, is generally not covered, though Medicaid may cover the generic cetirizine in some states.
Xyzal and Zyrtec similarities | Xyzal and Zyrtec differences | Conditions treated | Efficacy | Coverage and cost comparison | Common side effects | Drug interactions | Warnings | Alternatives | FAQ’s
The misery of allergies: runny nose, itchy or watery eyes, sneezing, and congestion. If you experience these symptoms, 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.
Are Xyzal and Zyrtec the same?
Xyzal (levocetirizine) and Zyrtec (cetirizine) are two popular medications that are both available over-the-counter. Both drugs are approved by the US Food and Drug Administration (FDA). Xyzal is also available by prescription. Both medications are oral antihistamines, also called H1 blockers. They block the action of histamine, relieving symptoms of allergies such as runny nose and itchy/watery eyes. Xyzal and Zyrtec are considered second-generation antihistamines. They are helpful in relieving allergy symptoms. As a side effect, these drugs are known as non-sedating, however, they still may cause some drowsiness. They are less sedating, though, than first-generation antihistamines such as Benadryl (diphenhydramine).
Looking at the generic names of Xyzal and Zyrtec, levocetirizine and cetirizine, you may notice that the ingredients sound very similar. This is because they are chemically similar. Xyzal and Zyrtec are often referred to as non-sedating antihistamines, but they still do have the potential to cause some drowsiness. However, Xyzal may cause less drowsiness than Zyrtec due to its slight difference in chemical structure.
Xyzal and Zyrtec both may significantly relieve allergy symptoms, but there are some differences between the two drugs. Continue reading to learn more about Xyzal and Zyrtec.
RELATED: Xyzal details | Zyrtec details
What are the main differences between Xyzal vs. Zyrtec?
Xyzal and Zyrtec are antihistamines and are both available in brand and generic. The generic of Xyzal (and active ingredient) is levocetirizine, and the generic of Zyrtec is cetirizine. Xyzal and Zyrtec can both be used in adults and children. For children, the dosage depends on the child’s age and formulation. Consult your child’s pediatrician or pharmacist for dosing questions based on your child’s age and symptoms.
Main differences between Xyzal and Zyrtec |
||
|---|---|---|
| Xyzal | Zyrtec | |
| Drug class | Antihistamine | Antihistamine |
| Brand/generic status | Brand and generic | Brand and generic |
| What is the generic name? | Levocetirizine | Cetirizine |
| What form(s) does the drug come in? | Tablet, oral solution | Tablet (oral, chewable), capsule, oral solution |
| 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 | Varies |
| Who typically uses the medication? | Adults and children | Adults and children |
Conditions treated by Xyzal and Zyrtec
OTC Xyzal can be used to treat allergies in adults and children 2 years and older, and is not recommended for use in children under 2 years old.
Prescription 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, or for seasonal allergies in adults and children 6 months and older. It is also indicated for the treatment of chronic hives in adults and children ages six years and older.
OTC Zyrtec can be used to treat allergy symptoms or hives in adults and children 2 years and older in formulations such as oral solution or chewable tablets, and adults and children 6 years and older in tablet formulation. In some cases, healthcare providers may recommend a small dose of Zyrtec oral solution in children younger than 2 years old when needed. This should only be given if recommended by the healthcare provider.
Conditions treated by Xyzal and Zyrtec |
||
|---|---|---|
| Condition | Xyzal* | Zyrtec* |
| Perennial Allergic Rhinitis | Yes | Yes |
| Chronic Idiopathic Urticaria (chronic hives) | Yes | Yes |
| Seasonal Allergic Rhinitis | Yes | Yes |
*Consult the directions on the package or consult the child’s pediatrician or pharmacist for help with children’s dosing.
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 (hives).
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. Some studies found them to be comparable in how well they worked. 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, as well as personal preference.
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 Xyzal, levocetirizine, is about $115 for 5 mg, 30 tablets but it can be purchased for about $5 with a free SingleCare levocetirizine coupon. Insurances and Medicare prescription plans 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 costs about $25. You can purchase the generic version of Zyrtec for as low as $2 using a free SingleCare Coupon. Zyrtec is typically not covered by insurance or Medicare prescription plans; however, some state Medicaid plans may cover generic cetirizine.
In order to use a SingleCare card or coupon when purchasing an OTC version of Xyzal or Zyrtec, a prescription is required.
Cost and coverage of Xyzal vs. Zyrtec |
||
|---|---|---|
| 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 prescription plans? | Yes; generic | No |
| Standard dosage | 30, 5 mg tablets | 30, 10 mg tablets |
| Typical Medicare prescription plan copay | $0-20 | N/a |
| SingleCare cost | $5+ | $2+ |
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.
Drowsiness
Xyzal and Zyrtec are both generally tolerated very well. They can both cause drowsiness. However, they cause less drowsiness than older antihistamines like Benadryl (diphenhydramine). Since Xyzal and Zyrtec are chemically similar, they have similar side effects, including drowsiness. However, drowsiness is reported more often with Zyrtec than with Xyzal. So, if drowsiness is a concern, Xyzal may be a better option. Also, taking the antihistamine at night can help you avoid drowsiness, and the medication will help relieve symptoms while you sleep, which helps you sleep better and wake up feeling rested.
Dry mouth
Antihistamines such as Xyzal and Zyrtec can cause a dry mouth. To relieve a dry mouth, you can try sucking on sugarless candy—choosing sugarless can help you avoid cavities. You can also sip on water throughout the day, let ice chips melt in your mouth, or try a saliva substitute product. Choosing low sugar, non acidic, moist foods can help as well. If you use mouthwash, avoid products that contains alcohol. Instead, choose a mouthwash designed for people with dry mouth. You can also use a humidifier in your room at night to add moisture to the air.
Other side effects may occur. Consult your healthcare professional for a complete list of side effects.
Xyzal and Zyrtec 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, central nervous system (CNS) depressants should not be taken in combination with either drug due to additive effects on slowing down brain activity. CNS depressants include drugs such as anxiety medications, insomnia medications, opioid pain medications, and barbiturates. Certain CNS depressants are sometimes referred to as sedatives or tranquilizers.
Other drug interactions may occur with Xyzal or Zyrtec. Consult your healthcare provider for a full list of drug interactions.
Medication interactions of Xyzal vs. Zyrtec |
||
|---|---|---|
| Drug | Interacts with Xyzal? | Interacts with Zyrtec? |
| Alcohol | Yes | Yes |
| CNS (central nervous system) depressants, anxiety medications such as Xanax (alprazolam), sleeping medications such as Ambien (zolpidem), opioid pain medications such as oxycodone, 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.
Xyzal and Zyrtec alternatives
If Xyzal or Zyrtec do not work for you, there are other alternatives available. You can speak to your healthcare provider for a recommendation. Examples of other antihistamines include:
- Claritin (loratadine): Claritin can be used in adults and children two years and older.
- Allegra (fexofenadine): Allegra can be used in adults and children two years and older.
- Benadryl (diphenhydramine): This is an older antihistamine and tends to have more side effects, such as sedation, drowsiness, tiredness, and impaired concentration and memory. The dose depends on age and indication. For a child, consult the pediatrician before using.
If your symptoms include a stuffy nose (nasal congestion), you may want to try a nasal spray or an antihistamine/decongestant combination, such as:
- Claritin-D (loratadine/pseudoephedrine)
- Allegra-D (fexofenadine/pseudoephedrine)
- Zyrtec-D (cetirizine/pseudoephedrine)
Medications that contain the decongestant pseudoephedrine are generally found behind the pharmacy counter. You can ask your pharmacist for more information. Pseudoephedrine should not be used in people with certain medical conditions, such as urinary retention, or uncontrolled or severe high blood pressure, so ask your healthcare provider or pharmacist before using.
Frequently asked questions about Xyzal vs. Zyrtec
What is Xyzal?
Xyzal is an antihistamine. It treats symptoms associated with allergies (seasonal or perennial) and 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 chronic hives.
Is Xyzal, Zyrtec, or Claritin better?
Everyone is different in the way they react to antihistamines. Some people swear by Xyzal, while others prefer Zyrtec, and still others reach for Claritin. All of these medications have gone through clinical trials for safety and efficacy, so any of them would be a suitable choice for relieving allergy symptoms. However, it may take some trial and error to find which medication works best for you. You can always consult your healthcare provider for personalized 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 and 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.
Can I take Xyzal or Zyrtec together?
Generally, these drugs should not be taken together. They are very similar and treat the same conditions. Taking them together would not make the treatment more effective, and could increase the risk of impairment (for example, while driving). The combination could also increase the risk of central nervous system (CNS) depression—a slowing down of brain activity, which could cause dizziness and drowsiness, slowed heart rate, and slowed breathing.
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 referred to 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.
Does Xyzal make you more drowsy than Zyrtec?
In clinical trials, more people reported drowsiness as a side effect with Zyrtec than with Xyzal. Nevertheless, everyone is different and can have a different reaction to medication. If drowsiness is a concern, Xyzal may be a better option than Zyrtec—however, Xyzal can potentially cause drowsiness, too. You can consult your healthcare provider for more information and a recommendation.