Sudafed vs. Allegra for Nasal Congestion and Allergic Rhinitis: Important Differences and Potential Risks.

Key takeaways

Pseudoephedrine (Sudafed) and fexofenadine (Allegra) are both over-the-counter medications, but they serve different purposes and belong to different drug classes. Pseudoephedrine is a decongestant that helps relieve nasal and sinus congestion by narrowing blood vessels, while fexofenadine is an antihistamine that eases allergy symptoms like sneezing, runny nose, and itchy eyes by blocking histamine. Pseudoephedrine can be taken in immediate-release or extended-release forms, with dosing varying from every 4 to 24 hours, whereas fexofenadine is typically taken once or twice a day. Pseudoephedrine may cause side effects like anxiety and difficulty sleeping, and it can raise blood pressure, making it unsuitable for people with certain health conditions. On the other hand, fexofenadine is less likely to cause drowsiness compared to other antihistamines but can still cause headaches and dry mouth. Both medications have specific age restrictions and should be used according to the manufacturer's instructions.

Sudafed

(pseudoephedrine)

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Fexofenadine

(Allegra)

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Summary for Sudafed

Over-the-counter

Sudafed (pseudoephedrine) is a non-drowsy decongestant taken by mouth to treat nasal and sinus congestion from allergies and the common cold. It's available in a short-acting version that's taken once every 4 to 6 hours. It also comes in longer-acting versions that are taken every 12 or 24 hours, depending on the dose. Side effects of Sudafed (pseudoephedrine) include anxiety and headache. This medication might also keep you awake at night if you take it too close to bedtime. Sudafed (pseudoephedrine) is an OTC medication, but it's restricted, so you can only purchase it at the pharmacy counter.

Indications for Sudafed

Short-term relief of nasal and sinus congestion and pressure

Pros and Cons for Sudafed

Pros

Works well to treat congestion
Available in longer-acting versions that last 12 hours or 24 hours
Children's oral liquids can be taken by kids as young as 4 years old
Available as lower-cost generics

Cons

Several products have different age cut-offs for use in children, so can be confusing
Might make it hard for some people to sleep
Can raise blood pressure and heart rate
Not recommended during pregnancy

Common Side Effects for Sudafed

Sweating
Nervousness
Excitability
Difficulty sleeping
Low appetite
Difficulty urinating

Warnings for Sudafed

Fast heart rate and high blood pressure
Worsening of medical conditions
Accidental overdose

Summary for Allegra

Over-the-counter

Fexofenadine (Allegra) is an antihistamine. It's used to ease symptoms of allergy and hives in adults and children. Fexofenadine (Allegra) can be found over the counter as a tablet, fast-melting tablet, and liquid. This medication is taken once or twice per day, depending on the formulation. Fexofenadine (Allegra) starts to work in about 2 hours and its effects can last up to 24 hours. Fexofenadine (Allegra) doesn't make you as drowsy compared to some other antihistamines, such as diphenhydramine (Benadryl). Other possible side effects of fexofenadine (Allegra) include headache and dry mouth.

Indications for Allegra

Short-term relief of allergy symptoms (sneezing, runny nose, itchy or watery eyes, itchy nose or throat)
Treatment of hives

Pros and Cons for Allegra

Pros

First-choice option for relieving allergy symptoms
Some products can also be used to relieve itchiness from hives.
Available as 12-hour and 24-hour tablets, as well as a liquid and quick-dissolving tablets for those who have a hard time swallowing pills
All formulations available over the counter

Cons

Liquid form might not be the best choice for people on a low-salt diet because it contains sodium
Once-daily formulations not recommended for children younger than 12 years old
Might have a higher risk of side effects if you have liver or kidney problems
Can cause headache