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Drug vs. Drug

Xyzal vs. Zyrtec: Which allergy medicine is better?

Learn whether Xyzal or Zyrtec may be most suitable for managing your allergy symptoms
Karen Berger medical writer and reviewer headshot
By | Updated on Jan. 7, 2025
Rx tablets: Xyzal vs. Zyrtec

Key takeaways

  • Xyzal (levocetirizine) and Zyrtec (cetirizine) are second-generation antihistamines used to relieve allergy symptoms like runny nose, watery eyes, and sneezing.

  • Both medications are available over the counter in brand and generic forms. Generic Xyzal (levocetirizine) is also available by prescription.

  • Xyzal and Zyrtec tend to cause less drowsiness and other side effects than older antihistamines like Benadryl. Xyzal tends to cause less drowsiness than Zyrtec.

  • While taking Xyzal or Zyrtec, you should not drink alcohol. You should not combine Xyzal or Zyrtec with medicines that cause central nervous system (CNS) depression, such as anxiety medicines, sleeping pills, or opioid pain relievers.

  • Consult your healthcare provider for more information and medical advice on Xyzal and Zyrtec and the best allergy treatment for you.

In this article:

Allergies can cause miserable symptoms like runny nose, itchy or watery eyes, sneezing, and congestion. If you experience these symptoms, you are not alone—allergies affect more than 100 million Americans every year. Fortunately, there are many allergy medications, both prescription and over-the-counter (OTC), to help relieve those bothersome symptoms. 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.

Are Xyzal and Zyrtec the same?

Xyzal (levocetirizine) and Zyrtec (cetirizine) are two popular medications that are both available over the counter to provide allergy relief. Both drugs are approved by the Food and Drug Administration (FDA). Xyzal, though OTC, is also available by prescription in its generic form. Both Xyzal and Zyrtec are oral antihistamines, also called H1 blockers. They block the action of histamine, relieving symptoms of allergies such as runny nose and watery or itchy eyes. Xyzal and Zyrtec are considered second-generation antihistamines. These drugs are known as non-sedating, but they still may cause some drowsiness. However, they’re less sedating 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. 

RELATED: Xyzal details | Zyrtec details

What are the main differences between Xyzal and 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 by adults and children. For children, the dosage depends on the child’s age and formulation. Consult your child’s healthcare provider 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: 2.5–5 mg every evening

Children: Varies by age, but typically 1.25–5 mg every evening

 Adults: 5–10 mg daily

Children: Varies by age, but typically 2.5–10 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 6 years and older. It is also indicated for the treatment of chronic hives in adults and children ages 6 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 a healthcare provider 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 (inactive medicine) 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 are effective. The question of which drug is better may be a matter of trial and error, as well as personal preference. 

Coverage and cost comparison of Zyrtec vs. Xyzal

Zyrtec is available over the counter in both brand and generic. The average retail price of brand-name Zyrtec for 30, 10 mg tablets costs about $25. You can purchase the generic version of Zyrtec for about $3 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.

Xyzal is available in both prescription (generic) and OTC form (both brand and generic). The average retail price of generic Xyzal, levocetirizine, is about $106 for 30, 5 mg tablets, but it can be purchased for about $7 with a free SingleCare levocetirizine coupon. Insurance and Medicare prescription plans typically cover the generic prescription form of levocetirizine. 

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 prescription form No (because it is only OTC); some states may cover generic under Medicaid
Typically covered by Medicare prescription plans? Yes; generic prescription form No
Standard dosage 30, 5 mg tablets 30, 10 mg tablets 
Typical Medicare prescription plan copay $0–20 N/A
SingleCare cost* $7  $3 
*Cost at the time of publication. Drug prices fluctuate and vary by pharmacy. 

Common side effects of Xyzal vs. Zyrtec

Xyzal and Zyrtec have similar side effects. The most common side effects are drowsiness, 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 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 chewing sugarless gum or 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 contain 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 (drowsiness) Yes 5-6% Yes 14%
Nasopharyngitis (common cold) Yes 4-6% No –
Pharyngitis (sore throat) Yes 1-2% Yes 2%
Fatigue Yes 1-4% Yes 5.9%
Dry mouth Yes 2-3% Yes 5%
*Frequency can vary by dose. Source: DailyMed (Xyzal), Pfizer (Zyrtec)

Drug interactions of Xyzal vs. Zyrtec

Do not use alcohol with Xyzal or Zyrtec. The combination can cause impairment and affect alertness. 

Additionally, central nervous system (CNS) depressant medications 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, barbiturates, and muscle relaxants. 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
Central nervous system (CNS) depressants, for example:
  • Anxiety medications such as Xanax (alprazolam)
  • Sleeping medications such as Ambien (zolpidem)
  • Opioid pain medications such as oxycodone
  • Barbiturates such as phenobarbital
  • Muscle relaxants such as cyclobenzaprine
 Yes Yes

Xyzal and Zyrtec warnings

Xyzal and Zyrtec warnings include somnolence (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 and 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. 

Consult your healthcare provider for medical advice if you are pregnant or breastfeeding. Xyzal is generally not recommended for use while breastfeeding. 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, other alternatives are available. You can speak to your healthcare provider for a recommendation. Examples of other antihistamines include: 

  • Claritin (loratadine): Claritin is a nonsedating antihistamine and can be used in adults and children 2 years and older.
  • Allegra (fexofenadine): Allegra is also a nonsedating antihistamine and can be used in adults and children 2 years and older.
  • Benadryl (diphenhydramine): This is an older antihistamine and tends to have more side effects, such as sedation, drowsiness, tiredness, and problems with concentration and memory. The dose depends on age and indication. 

 If your symptoms include a stuffy nose (nasal congestion), you may want to try a nasal spray, such as Flonase (fluticasone), 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 high blood pressure or heart disease, so ask your healthcare provider or pharmacist before using any drug with pseudoephedrine on the label. 

Frequently asked questions about Xyzal vs. Zyrtec

What is Xyzal?

Xyzal (levocetirizine) is an antihistamine. It treats symptoms associated with allergies (seasonal or perennial) and chronic hives. 

What is Zyrtec?

Zyrtec (cetirizine) 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 prefer Xyzal, while others prefer Zyrtec or 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?

If you are pregnant, ask your healthcare provider for medical advice regarding allergy treatment. If you are already taking Xyzal or Zyrtec and find out you are pregnant, ask your healthcare provider for medical advice.

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 and 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 similar, but levocetirizine may offer some additional benefits, such as higher effectiveness with fewer side effects. Although both medications are referred to as nonsedating 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.