Xyzal vs. Astelin
See how Xyzal and Astelin compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Xyzal is a once-daily pill or liquid, while Astelin is a nasal spray used one to two times a day in each nostril.
Both drugs can cause drowsiness, so avoid driving or drinking alcohol until you know how each one affects you.
Astelin is also approved for vasomotor (nonallergic) rhinitis, a use Xyzal does not have on its label.
Xyzal vs. Astelin Drug Summary
Xyzal
Xyzal is an oral antihistamine (H1-receptor blocker) used to relieve sneezing, itchy eyes, and runny nose from seasonal and perennial allergies, and to treat chronic hives. It comes as a tablet or liquid taken once daily, usually in the evening.
Astelin
Astelin is a nasal antihistamine spray used to treat seasonal allergic rhinitis and vasomotor (nonallergic) rhinitis. It is sprayed directly into each nostril, one or two sprays per side, twice daily.
Xyzal vs. Astelin Side Effects
Xyzal
Astelin
Xyzal vs. Astelin Dosage
Xyzal
Astelin
| 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 |
| STAGE | DOSE | WHEN |
| Starting dose | 1 spray/nostril twice daily | At the start |
| Maximum dose | 2 sprays/nostril twice daily | If needed |
| Dose changes | 1 increase | As tolerated |
Xyzal
| 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 |
Astelin
| STAGE | DOSE | WHEN |
| Starting dose | 1 spray/nostril twice daily | At the start |
| Maximum dose | 2 sprays/nostril twice daily | If needed |
| Dose changes | 1 increase | As tolerated |
Xyzal vs. Astelin Indications
Xyzal
Xyzal is FDA-approved for seasonal and perennial allergic rhinitis in adults and children as young as 6 months, and for chronic idiopathic urticaria (hives) in the same age range. It relieves sneezing, itchy watery eyes, runny nose, and itchy skin from hives.
Seasonal allergic rhinitis
Perennial allergic rhinitis
Chronic idiopathic urticaria (hives)
Approved for children as young as 6 months
Astelin
Astelin is FDA-approved for seasonal allergic rhinitis in adults and children 5 and older, and for vasomotor rhinitis in adults and adolescents 12 and older. It works locally in the nose to reduce sneezing, congestion, and runny nose from allergens or irritants.
Seasonal allergic rhinitis (age 5+)
Vasomotor (nonallergic) rhinitis (age 12+)
Nasal congestion and sneezing relief
Not approved under age 5 (SAR) or 12 (vasomotor)
Xyzal vs. Astelin Pros and Cons
Xyzal
Xyzal offers once-daily oral dosing, is available over the counter, and covers both allergy symptoms and chronic hives, giving it a broader label than Astelin. It still carries a risk of sedation and needs dose adjustment in kidney disease.
Pros
Once-daily dosing, no repeat application needed
Also treats chronic hives, not just rhinitis
Available over the counter without a prescription
Cons
Requires dose adjustment or avoidance in kidney disease
Not approved for vasomotor (nonallergic) rhinitis
Systemic absorption can cause whole-body drowsiness or fatigue
Astelin
Astelin acts directly in the nose, which can bring faster relief of congestion for some patients, and it is the only one of the two approved for vasomotor rhinitis. It requires spraying into each nostril up to twice daily and often leaves a bitter taste.
Pros
Approved for vasomotor (nonallergic) rhinitis
Delivers medication directly to nasal tissue
No renal dose adjustment specified on label
Cons
Requires spraying into each nostril, twice daily
Common bitter taste after each use
Not approved for children under 5 years
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