Zyrtec-D vs. Sudafed for Nasal Congestion: Important Differences and Potential Risks.

Key takeaways

Zyrtec-D (cetirizine/pseudoephedrine) and Sudafed (pseudoephedrine) are both used to relieve nasal and sinus congestion, but they have some key differences. Zyrtec-D is a combination of an antihistamine (cetirizine) and a decongestant (pseudoephedrine), making it effective for treating both allergy symptoms and congestion. In contrast, Sudafed contains only pseudoephedrine, which is solely a decongestant. Zyrtec-D is typically taken every 12 hours, while Sudafed comes in various formulations that can be taken every 4 to 6 hours or in extended-release forms every 12 or 24 hours. Both medications can cause trouble sleeping if taken too close to bedtime and can raise blood pressure, but Zyrtec-D is more likely to cause daytime drowsiness due to the antihistamine component. Additionally, Zyrtec-D and Sudafed must both be bought at the pharmacy counter and require a photo ID to be purchased. In some states, Zyrtec-D is also considered a controlled substance.

Zyrtec-D

(cetirizine / pseudoephedrine)

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Sudafed

(pseudoephedrine)

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Summary for Zyrtec-D

Over-the-counter

Zyrtec-D is a combination medication containing cetirizine (an antihistamine) and pseudoephedrine (a decongestant). It's taken by people ages 12 years and older to relieve allergy symptoms, like runny nose and nasal congestion. This medication comes as an extended-release tablet that's taken by mouth every 12 hours. Zyrtec-D is available as a brand-name and generic medication. Side effects can include trouble sleeping and dry mouth.

Indications for Zyrtec-D

Short-term relief of allergy symptoms in adults and children ages 12 years and older:

Itchy nose or throat
Sneezing
Itchy or watery eyes
Runny or stuffy nose
Sinus congestion or pressure

Pros and Cons for Zyrtec-D

Pros

Starts working within an hour
Easier to take a combination pill instead of two separate pills to treat congestion and other allergy symptoms
Available over the counter (behind the counter)

Cons

Might need to take twice daily
Tablets can't be crushed or chewed and there isn't a liquid version available
Not the safest choice if you have certain conditions, like heart problems and trouble urinating

Common Side Effects for Zyrtec-D

Trouble sleeping (4%)
Dry mouth(4%)

Warnings for Zyrtec-D

Fast heart rate and high blood pressure
Worsening of certain medical conditions
Accidentally taking too much medication

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