Flonase vs. Zyrtec: 6 Differences Between These Allergy Medications

Flonase (fluticasone) and Zyrtec (cetirizine) are popular medications used to treat seasonal and year-round allergies. They’re both available over the counter (OTC), making them go-to choices for many people. Flonase and Zyrtec both work well to reduce allergy symptoms, such as sneezing and runny nose. But there are several differences between them.

Below are six differences to keep in mind if you’re comparing Flonase versus Zyrtec.

1. Flonase and Zyrtec work differently

Both Flonase and Zyrtec help lower your body’s reaction to allergens (substances that cause allergies). But they do this in different ways.

Flonase is a corticosteroid (steroid). It works by calming your immune system’s response to allergens. This helps reduce inflammation (swelling) in the eyes, nose, and sinuses. And less swelling means fewer allergy symptoms.

Zyrtec is an antihistamine. This means it blocks histamine in your body. Histamine is a chemical that your body releases when you come into contact with an allergen. It causes symptoms such as sneezing, itchy eyes, and runny nose. By blocking histamine, Zyrtec helps reduce these symptoms.

Good to know: Flonase and Zyrtec both work well for allergy relief and prevention. But Flonase, or another steroid nasal spray, is preferred if your symptoms are persistent or more severe.

2. Flonase is a nasal spray, and Zyrtec is an oral medication

Flonase and Zyrtec also differ in their available dosage forms. Flonase is a nasal spray, and Zyrtec is an oral medication.

Flonase is available in two formulations:

• Flonase Allergy Relief: Contains 50 mcg of fluticasone propionate per spray. It can be used by adults and children as young as age 4.

• Flonase Sensimist Allergy Relief: Contains 27.5 mcg of fluticasone furoate per spray. It can be used by adults and children as young as age 2.

Both Flonase products work similarly. The choice between the two often comes down to age, cost, and personal preference.

Zyrtec (cetirizine) is available in several dosage forms, as listed in the following table.

Good to know: The active ingredient in Zyrtec, cetirizine, is also available as a prescription-only eye drop for eye-related symptoms. But this is sold under the brand name Zerviate, not Zyrtec.

3. Zyrtec starts working faster than Flonase

People taking Zyrtec may feel relief faster than those using Flonase. Zyrtec typically starts working within 20 to 60 minutes of taking it. Effects should last for up to 24 hours. So if you’re looking for quick relief, Zyrtec is your best option.

Some people may feel initial relief with Flonase about 2 to 4 hours after using it. But it can take up to 2 weeks to experience the medication’s full effects. So it’s best to start using Flonase a few weeks before allergy season begins.

4. Zyrtec makes some people sleepy, while Flonase is nondrowsy

The likelihood of drowsiness is another thing to consider when comparing Flonase and Zyrtec.

Zyrtec can cause drowsiness for some people. It usually causes less drowsiness than older antihistamines, such as Benadryl (diphenhydramine). But it’s common to feel sleepy or fatigued after taking Zyrtec. So you may want to take your dose in the evening.

Flonase doesn’t have this side effect. It’s a nondrowsy allergy medication that can be used any time of day.

5. Flonase may be safer than Zyrtec for adults ages 65 and older

If you’re 65 or older, ask your healthcare team if Flonase or Zyrtec would be safer for you.

As mentioned, Zyrtec can cause drowsiness. It can also cause dizziness for some people. These side effects can raise the risk of falls in older adults. So your healthcare team may recommend taking a lower dose or avoiding it.

If they recommend avoiding Zyrtec, Flonase would likely be a safer option for you. This nasal spray doesn’t raise the risk of falls for older adults.

6. Flonase and Zyrtec have different side effects

Flonase and Zyrtec also have different side effects. These are typically mild. But it’s a good idea to understand what can happen while taking these medications.

The table below highlights side effects of Flonase and Zyrtec. They aren’t complete lists of all possible side effects. So be sure to discuss these risks with a healthcare professional.

Can you use Flonase and Zyrtec at the same time?

Yes, it’s safe to use Flonase and Zyrtec at the same time. But it’s not always necessary to do so. Flonase usually works better than Zyrtec for most people. And research suggests that combining the two doesn’t provide more benefit than using Flonase on its own.

But taking Zyrtec when you’re first starting Flonase could be helpful. Since Zyrtec starts working faster, it may provide relief until Flonase kicks in. Once Flonase is fully working, consider stopping Zyrtec to see if Flonase provides enough relief on its own.

Pharmacist tip: If Flonase doesn’t help enough on its own, try adding the OTC antihistamine nasal spray Astepro (azelastine). This combination may provide more relief than either medication on its own.

How to save on Flonase and Zyrtec

There are ways to save on Flonase and Zyrtec. Both are available as brand-name medications and lower-cost generics.

If a licensed healthcare professional writes you a prescription for OTC Flonase or Zyrtec, GoodRx can help you save.

• Save with GoodRx Companion. You can access discounted prescription and OTC medications with a GoodRx Companion subscription. Over 250 medications are available for free, with hundreds more for under $10. The program also includes benefits to help you cut your self-pay costs, such as lower prices for online care visits, discounts on dental care, and other health services.

• Save on cetirizine with GoodRx. GoodRx can help you save on the average retail cost. The price of 30 tablets of cetirizine (generic Zyrtec) 10 mg at certain pharmacies is as low as $4.12 with a free GoodRx discount.

• Save on Flonase with GoodRx. GoodRx can help you save over 50% on the average retail price of a 30-day supply of Flonase. The price of generic Flonase Allergy Relief at certain pharmacies is as low as $19.85 with a free GoodRx discount. Flonase Sensimist’s price at certain pharmacies may be as low as $28.55. And the prescription version of fluticasone propionate may cost as little as $14.67.

• Save on Flonase with a manufacturer coupon. If you’re purchasing brand-name Flonase without a prescription, the manufacturer has a $4 coupon available, which you can have emailed to you.

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Written by:

Kristina D. Carter, PharmD, MBA, MHA

Kristina D. Carter, PharmD, MBA, MHA, has over 25 years of experience working in healthcare. She is registered as a licensed pharmacist in Georgia, Indiana, and Tennessee.

Edited by:

Christina Aungst, PharmD, MWC

Christina Aungst, PharmD, MWC is a senior pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019.

Reviewed by:

Sheila McAdoo, PharmD

Sheila McAdoo, PharmD, is a licensed pharmacist in Virginia and New York. She has worked in the pharmacy industry for 14 years.

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