Head-to-head comparisons of medication uses, side effects, warnings, and more.
Key takeaways
Azelastine nasal spray and cetirizine (Zyrtec) are both antihistamines used to treat allergy symptoms like a runny nose and sneezing. However, they differ in several ways. Azelastine is a nasal spray, while cetirizine is taken orally in forms like tablets and liquids. Azelastine is available by prescription and over-the-counter, but only the 0.15% strength is available without a prescription. Cetirizine is available both over-the-counter and by prescription. Azelastine is typically used twice a day, whereas cetirizine is usually taken once a day. Common side effects of azelastine include a bitter taste and nasal discomfort, while cetirizine can cause sleepiness and dry mouth. Both medications can cause drowsiness, so you should avoid alcohol and be cautious when driving. Azelastine is not known to cause weight gain, but cetirizine is considered safe during pregnancy.
Azelastine nasal spray
Cetirizine (Zyrtec)
Azelastine nasal spray
Cetirizine (Zyrtec)
Summary of Azelastine vs. Zyrtec
Summary for Antihistamine
Prescription only
Azelastine nasal spray is an antihistamine that treats allergies and nasal symptoms, such as runny or stuffy nose. The 0.1% and 0.15% strengths of the azelastine nasal spray are available with a prescription for adults and children. It's sprayed into the nostrils typically twice a day. Prescription azelastine nasal spray is a lower-cost generic. Possible side effects include a bitter taste in the mouth and nasal discomfort.
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Note: Azelastine 0.15% nasal spray is also available over the counter under the brand name Astepro Allergy.
Summary for Antihistamine
Cetirizine (Zyrtec) is an antihistamine. It's used for relief of allergy symptoms, such as runny nose or watery eyes, in adults and children. Cetirizine (Zyrtec) is also a safe option for people who are pregnant. This medication is available in different formulations, including tablets and liquid solutions. Typically, cetirizine (Zyrtec) is taken by mouth once per day. The most common side effect of cetirizine (Zyrtec) is sleepiness. But it's less likely to make you drowsy compared to some other antihistamines, such as diphenhydramine (Benadryl).
Indications of Azelastine vs. Zyrtec
Indications for
•Seasonal allergy symptoms related to the nose
•Year-round allergy symptoms related to the nose - azelastine 0.15% spray only