Allegra vs. Xyzal

See how Allegra and Xyzal compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Allegra (fexofenadine) and Xyzal (levocetirizine) are both marketed as non-drowsy, but Xyzal carries a stronger sedation warning on its label.

  • Allegra treats seasonal allergies and chronic hives, while Xyzal also covers perennial (year-round) allergic rhinitis.

  • Xyzal is taken once daily at every approved strength, while Allegra's higher-strength regimen requires twice-daily dosing.

Allegra vs. Xyzal Drug Summary

Allegra

Allegra (fexofenadine) is a second-generation H1 antihistamine used to relieve seasonal allergy symptoms and chronic hives. It comes as a tablet, an orally disintegrating tablet, and a liquid suspension, with dosing based on age and kidney function. It is taken once or twice daily depending on the strength used.

Xyzal

Xyzal (levocetirizine) is an H1-antihistamine used for seasonal and year-round allergy symptoms as well as chronic hives. It comes as a tablet or oral solution and is taken once daily, with dosing based on age and kidney function. Xyzal's label carries a stronger drowsiness warning than many other second-generation antihistamines.

Allegra vs. Xyzal Side Effects

Allegra

Most common
Headache (≥2%)
Back pain (≥2%)
Dizziness (≥2%)
Stomach discomfort (≥2%)

Xyzal

Most common
Somnolence (≥2%)
Nasopharyngitis (≥2%)
Fatigue (≥2%)
Dry mouth (≥2%)

Allegra vs. Xyzal Dosage

Allegra

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 30 mg twice daily At the start
Maximum dose 60 mg once daily If needed
Dose changes 3 increases As tolerated

Xyzal

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 1.25 mg once daily At the start
Maximum dose 5 mg once daily If needed
Dose changes 2 increases As tolerated

Allegra vs. Xyzal Indications

Allegra

Allegra is FDA-approved to relieve symptoms of seasonal allergic rhinitis, such as sneezing and itchy, watery eyes. It is also approved to treat the itching and hives of chronic idiopathic urticaria. Dosing is adjusted by age and kidney function.

  • Seasonal allergic rhinitis symptom relief

  • Chronic idiopathic urticaria (hives) treatment

  • Available as tablet, ODT, or oral suspension

  • Dosing adjusted for renal impairment

Xyzal

Xyzal is FDA-approved to relieve symptoms of both seasonal and perennial (year-round) allergic rhinitis. It is also approved to treat the itching associated with chronic idiopathic urticaria. Dosing is adjusted by age and kidney function.

  • Seasonal allergic rhinitis symptom relief

  • Perennial (year-round) allergic rhinitis relief

  • Chronic idiopathic urticaria itching treatment

  • Available as tablet or oral solution

Allegra vs. Xyzal Pros and Cons

Allegra

Allegra is a well-established, non-sedating antihistamine available in several forms, including a chewable-style tablet and a liquid for children. Its main tradeoff is dosing frequency, since the higher-strength regimen calls for twice-daily use rather than a single daily dose.

Pros

  • Considered non-sedating with low risk of drowsiness

  • Available in tablet, ODT, and liquid suspension forms

  • Minimal liver metabolism, simpler with other medications

Cons

  • Higher-strength regimen requires twice-daily dosing

  • Not FDA-approved for perennial (year-round) allergies

  • ODT form contains phenylalanine, a concern for PKU

Xyzal

Xyzal offers once-daily dosing at every approved strength and covers both seasonal and year-round allergies. Its main tradeoff is a higher chance of drowsiness, along with label warnings about driving and mixing it with alcohol or other sedating medications.

Pros

  • Once-daily dosing at every approved strength

  • Also approved for perennial (year-round) allergies

  • Long-acting active metabolite of cetirizine

Cons

  • More likely to cause sedation and fatigue than fexofenadine

  • Contraindicated in severe kidney disease and dialysis

  • Label warns against driving and mixing with alcohol or CNS depressants

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