How Does Xyzal Compare to Other Allergy Medicines?

First approved by the FDA 11 years ago, Xyzal was only available with a prescription until February 2017, when drugstores started stocking it over the counter as well, under the name Xyzal Allergy 24HR. Let’s see how Xyzal stacks up against other popular antihistamines.



Identical: Prescription Xyzal vs. OTC Xyzal

Over-the-counter (OTC) Xyzal Allergy 24HR is the same strength as the prescription product; both come as tablets with 5 mg of levocetirizine each. The “24 hour relief” part of Xyzal Allergy 24 HR applies to the prescription product as well, and recommended dosing for adults and children over the age of 12 is one tablet per day.

Generic levocetirizine is also available over the counter (typically sold as store-brand). Sometimes, though, the pharmacy may carry a generic version behind the counter that may be cheaper if you use a GoodRx coupon. All you need to do is get a prescription from your doctor and bring that along with a GoodRx coupon straight to the pharmacist.




Practically the same: Xyzal vs. Zyrtec

Xyzal and Zyrtec are remarkably similar to each other. Just take a look at their generic names, levocetirizine and cetirizine. Imagine two bananas joined together at the stem. The left banana is Xyzal (levocetirizine) and the right banana is dextrocetirizine. Together, the two bananas represent Zyrtec (cetirizine).

Since levocetirizine is the active component and cetirizine contains levocetirizine (along with the inactive dextrocetirizine), Xyzal (left banana) and Zyrtec (both bananas) are effectively the same drug and should work the same. In one of Xyzal Allergy 24HR’s commercials, they say that the 5 mg Xyzal is “just as effective as [10 mg] Zyrtec at only half the size”—because it’s only one banana versus Zyrtec’s two bananas.  

A potential side effect of Xyzal and Zyrtec is drowsiness, though both are considered non-sedating antihistamines. If you feel drowsiness or fatigue on one of them, you can consider switching to the other to see if the side effect goes away.

Just like with Xyzal, you can use a GoodRx coupon to save on Zyrtec if you get a prescription for the generic version.




Very similar: Xyzal vs. newer antihistamines

Second-generation antihistamines (like Zyrtec and Claritin) and third-generation antihistamines (like Xyzal, Allegra and Clarinex) are thought to be interchangeable. You may experience each medication’s effectiveness and side effects differently, so if one isn’t working for you, you can try another one.

These antihistamines do not interact with the brain, so they are less likely to cause drowsiness than older, first-generation antihistamines, which is seen as a major upside. This means second- and third-generation antihistamines are relatively safe for children over the age of 2 when taken as indicated. All the brands mentioned above have children’s versions in liquid or syrup form with a slightly lower dose. Another advantage is that they’re relatively long-acting, so they only have to be taken once or twice a day.

Again, remember to shop around with GoodRx discounts and compare the costs of OTC and behind-the-counter versions.


Not so similar: Xyzal vs. first-generation antihistamines

First-generation antihistamines have been around for over 70 years. Medications like Benadryl (diphenhydramine) and Unisom (doxylamine) do reach the brain and commonly cause drowsiness and fatigue. Because of this, these drugs are often used as sleeping aids. The effects of these medications wear off in 4-6 hours. Elderly people, breastfeeding women and children under the age of 6 should not use first-generation antihistamines. While there is a Children’s Benadryl Allergy Liquid formulation, children under 6 years old are not recommended to take it unless directed by a doctor.


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