Key takeaways:
Xyzal (levocetirizine) and Zyrtec (cetirizine) are allergy medications (antihistamines) that contain similar active ingredients. But they aren’t exactly the same. Both medications require just 1 dose per day, but they come in different doses and dosage forms.
Xyzal and Zyrtec may cause drowsiness in some people. But they won’t make you as drowsy as older antihistamines, such as Benadryl (diphenhydramine).
Xyzal seems to start working faster and lasts longer than other antihistamines. So it’s a helpful option for both quick and long-lasting relief. But Xyzal and Zyrtec may not be the best option for long-term use, due to the risk of withdrawal-related itching.
Xyzal and Zyrtec are both available as lower-cost generics. With a prescription from a healthcare professional, GoodRx can help you save over 80% off the average retail price at certain pharmacies.
Save on related medications
If you’ve had allergy problems recently, you may want to rethink your current allergy medication. Among the many antihistamine brands you’ll find at your local pharmacy are household names, such as Claritin (loratadine), Allegra (fexofenadine), and Zyrtec (cetirizine). But there’s also a lesser-known contender — Xyzal (levocetirizine).
The FDA first approved Xyzal in 1995, but up until February 2017 it was a prescription-only medication. At that time, it became available over the counter (OTC) under the name Xyzal Allergy 24HR. In this article, we’ll compare Xyzal versus Zyrtec and other common allergy medications.
1. Xyzal and Zyrtec are similar, but they aren’t the same medication
Xyzal and Zyrtec are remarkably similar. Just take a look at their generic names: levocetirizine and cetirizine. But they aren’t exactly the same.
Imagine two bananas joined together at the stem. The left banana is levocetirizine and the right banana is dextrocetirizine (an inactive chemical). Together, the two bananas represent Zyrtec (cetirizine). But if we remove the right (inactive) banana, the left banana on its own represents Xyzal.
Levocetirizine is the active component in both Xyzal and Zyrtec. This means that Xyzal (left banana) and Zyrtec (both bananas) work in a similar way to treat allergies. But since Zyrtec also contains dextrocetirizine, it may have a slightly different effect on the body than Xyzal (more on this later).
When it comes to Xyzal versus other antihistamines, they’re less similar. Other antihistamines don’t contain levocetirizine. They contain different active ingredients, such as fexofenadine or loratadine.
2. Xyzal and Zyrtec come in different dosages and dosage forms
Prescription Xyzal and OTC Xyzal Allergy 24HR both come in 5 mg oral tablets you’ll take once per day. They’re approved for adults and children ages 6 and older.
Xyzal Allergy 24HR also comes in a liquid form that contains 2.5 mg of levocetirizine per 5 mL (1 tsp). It’s approved for children ages 2 and older. Children ages 2 to 5 should take 2.5 mL (½ tsp) once daily. Adults and children ages 6 and older should take 5 mL once daily.
Zyrtec comes in several different dosage forms, including:
5 mg and 10 mg oral tablet
10 mg oral capsule
2.5 mg and 10 mg chewable tablets
5 mg / 5 mL oral liquid
10 mg orally disintegrating tablets (ODTs)
Children ages 2 to 5 typically take 2.5 mg to 5 mg of Zyrtec once daily. Adults and children ages 6 and older typically take 5 mg to 10 mg once daily.
Since Zyrtec comes in a wider range of doses and dosage forms, there’s a little more flexibility when it comes to taking Zyrtec versus Xyzal. This allows you to adjust your dosage up or down as needed based on how it works and any side effects you experience.
Zyrtec is also available combined with a decongestant in a product called Zyrtec-D (cetirizine / pseudoephedrine). It’s kept behind the pharmacy counter, but you don’t need a prescription for it. This product may be especially helpful if your allergy symptoms include a stuffy nose.
3. Xyzal and Zyrtec may make you sleepy
Since Xyzal and Zyrtec are very similar medications, they also have similar side effects. This includes drowsiness. Both Xyzal and Zyrtec cause less drowsiness than older (first-generation) antihistamines, such as Benadryl (diphenhydramine). But they can still make some people feel sleepy.
Some people who reported sleepiness from Zyrtec didn’t feel drowsy when they switched to Xyzal. And a large clinical review showed no difference in drowsiness caused by Xyzal versus other newer antihistamines, such as Allegra and Claritin. But everyone responds to medication differently. So if you do experience drowsiness from Xyzal or Zyrtec, it may help to try a different non-drowsy antihistamine.
4. Xyzal and Zyrtec may work faster than other antihistamines
Xyzal and Zyrtec typically start working within 1 hour of taking them. Other antihistamines, such as Claritin or Allegra, can take 1 to 3 hours to start working. So Xyzal and Zyrtec may be useful options if you’re looking for fast relief.
Xyzal may also be more effective than other antihistamines. A data review found that Xyzal seemed to improve symptoms better than Allegra, Claritin, and Clarinex (desloratadine). However, another small study showed that Zyrtec may work better than Xyzal for allergy symptoms in children. The current guidelines don’t show a preference for any of these antihistamines over the other.
Good to know: If you take an antihistamine long term to treat chronic (ongoing) allergy symptoms, Xyzal and Zyrtec may not be the best option for you. In rare cases, people report severe itching after stopping these antihistamines, especially after long-term use. Talk to your healthcare team about the best long-term antihistamine option for your needs.
5. Xyzal and Zyrtec may last longer than other antihistamines
Benadryl and other older antihistamines typically only last for about 4 to 6 hours after you take them. Xyzal and Zyrtec, on the other hand, last a full 24 hours in the body. So they offer a more convenient, once daily dosing.
Xyzal may also last longer than certain newer antihistamines. One study found that Xyzal’s effects lasted up to 28 hours after a single dose, while Allegra’s effects lessened after 22 hours. But since most newer antihistamines also have once-daily dosing, this isn’t likely to make much of a difference for most people.
How to save on Xyzal and Zyrtec
Xyzal and Zyrtec are available as brand-name medications. But you can also find them as lower-cost generics.
GoodRx can help you save over 90% off the average retail price of generic Xyzal. You’ll just need a prescription from a healthcare professional in order to apply these savings. Generic Xyzal's price at certain pharmacies is as low as $10.50 with a free GoodRx discount. There’s also a manufacturer coupon for OTC brand-name Xyzal that offers $5 off.
If your healthcare professional writes you a prescription for OTC Zyrtec, GoodRx may be able to help you save over 80% off the average retail price. Generic Zyrtec’s price at certain pharmacies is as low as $9.83 with a free GoodRx coupon.
Frequently asked questions
The prescription version of brand-name Xyzal was discontinued. But it’s still available in the OTC version (Xyzal Allergy 24HR). Generic Xyzal (levocetirizine) is available as both a prescription and OTC medication. There wasn’t any issue with prescription Xyzal’s safety or effectiveness. It’s simply likely that once Xyzal was available OTC, the manufacturer had no financial incentive to keep making the brand-name version that was prescription only.
The FDA requires a warning on both Zyrtec and Xyzal about the risk of severe itching after stopping these medications. This isn’t a common side effect, but it becomes more likely after taking either medication long-term (for several months or longer). Slowly decreasing your dose over time may help reduce the chance of itching. It’s also recommended to take these medications for the shortest time necessary to help avoid this side effect.
The prescription version of brand-name Xyzal was discontinued. But it’s still available in the OTC version (Xyzal Allergy 24HR). Generic Xyzal (levocetirizine) is available as both a prescription and OTC medication. There wasn’t any issue with prescription Xyzal’s safety or effectiveness. It’s simply likely that once Xyzal was available OTC, the manufacturer had no financial incentive to keep making the brand-name version that was prescription only.
The FDA requires a warning on both Zyrtec and Xyzal about the risk of severe itching after stopping these medications. This isn’t a common side effect, but it becomes more likely after taking either medication long-term (for several months or longer). Slowly decreasing your dose over time may help reduce the chance of itching. It’s also recommended to take these medications for the shortest time necessary to help avoid this side effect.
The bottom line
Xyzal (levocetirizine) is an antihistamine that treats allergies. It’s closely related to Zyrtec (cetirizine), but the two medications aren’t exactly the same. Xyzal and Zyrtec are both taken just once a day, but Zyrtec comes in a wider range of doses and dosage forms.
Xyzal and Zyrtec can both cause drowsiness in some people. But they aren’t as sedating as Benadryl (diphenhydramine) and other older antihistamines. And some people reported no drowsiness with Xyzal after switching from Zyrtec.
Xyzal works faster and lasts longer than some other antihistamines. And it may be more effective than options such as Claritin (loratidine), Allegra (fexofenadine), and Clarinex (desloratidine). But other antihistamines may be a better choice than Xyzal or Zyrtec for long-term use. Your healthcare team can help you choose the best antihistamine for your allergy symptoms.
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