Taking Zyrtec (Cetirizine) With Allegra (Fexofenadine)

In our latest question and answer, the pharmacist discusses whether or not Zyrtec (cetirizine) can safely be taken with Allegra (fexofenadine).

Question

I want to take Zyrtec and Allegra at the same time as I imagine they will work better together. Can I safely combine them?

Asked by Ashley On Jul 29, 2018

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On Jul 30, 2018

Typically, it is not recommended to use cetirizine (Zyrtec) and fexofenadine (Allegra) at the same time. Both medications are second-generation antihistamines used for allergy relief. Taking them together would not provide much added benefit, but could lead to side effects such as drowsiness.


In some patients, Zyrtec may work better than Allegra, however, it also may also cause drowsiness. Zyrtec, Claritin, and Allegra are second-generation antihistamines and are still less likely to cause drowsiness than first-generation antihistamines such as Benadryl (diphenhydramine). This is because first-generation antihistamines cross the blood-brain barrier, whereas the second-generation antihistamines usually do not.


When taking fexofenadine (Allegra) it is important to avoid grapefruit, orange, and apple juice as these are known to decrease intestinal absorption. Avoid these juices at least 4 hours before and 2 hours after taking Allegra.

 

How Antihistamines Work

Antihistamines bind to histamine receptors that are found in the nose, lungs, eyes, and skin without activating the histamine response. By binding and changing the shape of the histamine receptor, antihistamines inhibit histamine from binding and creating its response. Histamine creates an immune response to essentially attempt to remove the offensive allergen.


Histamine can be triggered by a variety of things including pollen, dust, and pet dander. Some people are more sensitive to this response and may not even know what triggers their allergies. Antihistamines are useful in preventing the immune cascade so common in people suffering from allergies.

 

Flonase As An Alternative

Another option would be to switch or add fluticasone (Flonase) nasal spray. Flonase was approved by the FDA in 1990, but has only been available over-the-counter since 2014. Flonase is a type of steroid that blocks inflammation, itching, and congestion.


According to the Flonase website, it has some advantages over Claritin including working better for nasal congestion. Flonase can be used once daily with 1 or 2 sprays into each nostril or may be used as needed instead of every day.

 

Conclusion

To conclude, it is not recommended to take both Zyrtec and Allegra together due to the possibility of drowsiness without additional benefit. Flonase nasal spray may be another option to provide an alternative mechanism of action against allergies.

About the Pharmacist

Dr. Kevin Davis Pharm.D

Dr. Kevin Davis is a licensed pharmacist with experience in retail and hospital pharmacy. He graduated from the University of Florida with a Doctor of Pharmacy degree in 2015 and a Master of Healthcare Administration degree from Adventist University in 2017. He is also a Board Certified Pharmacotherapy Specialist since 2016.

About Zyrtec (Cetirizine)

Zyrtec (cetirizine) is a "second-generation" antihistamine, indicated for the treatment and prevention of perennial allergies, seasonal allergies and hives. At indicated doses (5mg and 10mg), it generally has a higher incidence of sedation than other second-generation antihistamines, such as Allegra (fexofenadine) and Claritin (loratadine). Nevertheless, it still causes less sedation than older, first-generation antihistamines such as Benadryl. Zyrtec is taken once daily, with an onset of action around one hour.

About Allegra (Fexofenadine)

Allegra (fexofenadine) is a "second-generation" non-sedating antihistamine (H1-receptor antagonist). Second-generation antihistamines like Allegra are noted for their long duration of action, up to 24 hours, and lack of sedative effects, especially when compared to "first-generation" antihistamines like Benadryl (diphenhydramine). Allegra was first FDA approved in July 1996 as a prescription only product for the treatment of seasonal allergic rhinitis (i.e. seasonal allergies). In January 2011 however, the FDA approved the over-the-counter sale of Allegra in the same formulations, strengths, and indications as available by prescription. The onset of action of Allegra is about one hour, with effects lasting around 24 hours for the 180mg dose. It may be taken with or without food but it is important to avoid grapefruit, orange, and apple juice before or after taking Allegra to avoid a potential reduction in drug absorption.

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