Allergy Relief: Comparing Antihistamines and Nasal Sprays
Zyrtec, Claritin, Allegra and Xyzal are all once-a-day, non-drowsy-ish antihistamines, and the packaging does very little to explain how they differ. They genuinely are different — in how fast they work, how sedating they are, and how much they cost per day. Here is how our pharmacists compare them.
The four modern antihistamines, side by side
Cetirizine (Zyrtec) is the strongest of the group for most people and works within about an hour. The tradeoff: roughly one in ten people find it noticeably sedating. Good first pick if allergies are significant, and a good bedtime dose if it makes you sleepy.
Levocetirizine (Xyzal) is the refined half of cetirizine, dosed at night. Similar strength, similar mild sedation risk.
Loratadine (Claritin) is the least sedating and the cheapest, but it is also the mildest and takes 1–3 hours to kick in. A sensible choice for mild seasonal symptoms or if cetirizine made you drowsy.
Fexofenadine (Allegra) is essentially non-sedating and works fast — the best option if you need full alertness for driving or work. Do not take it with fruit juice, which cuts absorption by up to a third; take it with water.
All four are safe to take daily through a season. If one stops seeming to work, switching to a different one in the group often helps.
Where diphenhydramine (Benadryl) still fits — and where it does not
Diphenhydramine is a first-generation antihistamine: it works quickly but wears off in 4–6 hours and causes real sedation and next-day grogginess. It is not a good choice for daily seasonal allergies.
It is still useful for an acute allergic reaction, hives, or bug-bite itch, and topical diphenhydramine works well for localized itching.
Older adults should be careful: diphenhydramine's anticholinergic effects are linked to confusion, falls and urinary retention, and it appears on the Beers list of medicines to avoid in people over 65. A modern antihistamine is the safer swap.
For nasal congestion, a steroid spray beats any pill
For stuffiness, sneezing and post-nasal drip, a steroid nasal spray such as fluticasone is consistently more effective than any oral antihistamine — it is the first-line treatment in allergy guidelines, and it is available over the counter.
It is not fast. Expect partial relief in a day or two and full effect after one to two weeks of daily use, so start it before your season rather than during a bad week.
Aim the spray outward toward the ear on the same side, not at the septum in the middle. Aiming at the septum is what causes the nosebleeds people blame on the spray.
Steroid nasal spray and an oral antihistamine can be used together, and often are.
What you save by going store brand
These are identical active ingredients at identical strengths, held to the same FDA standard. The price gap is large:
Loratadine 30 ct: about $3.08 store brand versus $21.54 for Claritin — roughly $0.10 a day against $0.72. Taken through a six-month season that is about $110 saved.
Cetirizine 30 ct: about $3.49 store brand versus $23.28 for Zyrtec — about $120 saved over six months.
Fluticasone nasal spray is a similar story, at roughly $12.50 store brand against $17.62 for Flonase per bottle.
What we stock
- Good Sense Cetirizine All Day Allergy Relief Tablets, 10 mg — 30 ct — $3.49. Same active ingredient as Zyrtec at about a tenth of the price.
- Perrigo Loratadine Tablets, 10 mg — 30 ct — $3.08. Least sedating and cheapest per day; mildest of the four.
- Foster & Thrive 12 Hour Allergy Relief Fexofenadine HCl 60 mg — 24 ct — $8.25. Non-sedating — the pick if you drive or operate equipment. Take with water, not juice.
- Good Sense Levocetirizine Allergy Relief Tablets, 5 mg — 35 ct — $5.36. Xyzal equivalent; dose in the evening.
- Zyrtec Allergy Cetirizine HCl 10 mg 24 Hour — 30 tablets — $23.28. The name brand, if you prefer it.
- Foster & Thrive Allergy Relief Nasal Spray, Fluticasone Propionate 50 mcg — $12.50. First-line for nasal congestion. Start it a couple of weeks before your season.
- Flonase Allergy Relief Nasal Spray — 60 sprays — $17.62. Identical active ingredient to the store brand above.
- Foster & Thrive Children's Allergy Relief Cetirizine Oral Solution, Bubble Gum — 4 oz — $6.08. For ages 2 and up — check the carton for the weight-based dose.
- Good Sense Children's Loratadine Dye-Free Liquid, Grape — 4 oz — $6.23. Non-sedating option for kids; dye free.
- Benadryl Allergy Ultratab Tablets — 24 ct — $5.97. For hives or an acute reaction — not for daily seasonal use, and avoid in adults over 65.
Frequently asked questions
What is the difference between Zyrtec, Claritin, Allegra and Xyzal?
All four are once-daily antihistamines. Cetirizine (Zyrtec) is generally the strongest and works within about an hour but makes roughly one in ten people drowsy. Levocetirizine (Xyzal) is similar and taken in the evening. Loratadine (Claritin) is the least sedating and cheapest but the mildest, taking one to three hours to work. Fexofenadine (Allegra) is essentially non-sedating and fast, but should be taken with water rather than fruit juice, which reduces absorption.
Which allergy medicine is best for a stuffy nose?
A steroid nasal spray such as fluticasone is more effective than any oral antihistamine for congestion, sneezing and post-nasal drip, and it is the first-line treatment in allergy guidelines. It takes one to two weeks of daily use to reach full effect, so start before your allergy season. It can be combined with an oral antihistamine.
Are store-brand allergy pills as good as the name brands?
Yes. Store-brand cetirizine, loratadine and fexofenadine contain the same active ingredients at the same strengths and must meet the same FDA standards. The saving is substantial — loratadine costs about $0.10 a day store brand against roughly $0.72 for Claritin, which is over $100 across a six-month season.
Is it safe to take Benadryl every day for allergies?
It is not a good choice for daily allergy control. Diphenhydramine lasts only four to six hours, causes real drowsiness and next-day grogginess, and in adults over 65 is linked to confusion, falls and urinary retention. Use a once-daily second-generation antihistamine instead, and keep diphenhydramine for hives or acute reactions.
Can I take an antihistamine and a nasal spray together?
Yes. An oral antihistamine and a steroid nasal spray work by different mechanisms and are commonly used together for moderate to severe allergies. Check with your pharmacist if you take other medicines, and aim the nasal spray outward toward the ear on the same side to avoid nosebleeds.
This guide is general information, not medical advice. Talk with your pharmacist or provider about your situation.