Zyrtec vs. Zyrtec-D for Allergies
Medically reviewed by Femi Aremu, PharmD
Zyrtec (cetirizine) and Zyrtec-D (cetirizine and pseudoephedrine) have similar names and uses.
However, the key difference between the medications is that, in addition to cetirizine, Zyrtec-D contains an additional ingredient, pseudoephedrine, a nasal decongestant.
Cetirizine is an over-the-counter (OTC) antihistamine. Pseudoephedrine is a decongestant. Zyrtec-D is an OTC combination medication of the two. Decongestants help relieve nasal congestion by reducing swelling.
While pseudoephedrine is available OTC, there are restrictions for purchasing. In some states, pseudoephedrine may be classified as a controlled substance.
This article will discuss the similarities and differences between Zyrtec and Zyrtec-D.
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Zyrtec vs. Zyrtec-D: What’s the Difference?
The key difference between Zyrtec and Zyrtec-D is the additional ingredient, pseudoephedrine, found in Zyrtec-D.
Both Zyrtec and Zyrtec-D provide relief from allergy symptoms. They both contain cetirizine, an antihistamine. Antihistamines are a class of medications that help relieve allergy symptoms by blocking histamine, a natural body chemical that triggers these symptoms.
However, Zyrtec-D also contains pseudoephedrine, a decongestant, to minimize nasal congestion. Decongestants are a class of medication that helps relieve symptoms associated with colds, allergies, and sinus infections. They are not recommended for long-term use.
While both are used for allergies, Zyrtec-D offers targeted relief for congestion, making it suitable for individuals experiencing both allergy symptoms and nasal congestion.
The two medications also differ in the minimum age at which they can be used, purchasing restrictions, and available dosage forms.
Zyrtec can treat skin reactions (hives) associated with allergies, but Zyrtec-D has not been approved for this use.
| Zyrtec | Zyrtec-D |
Active ingredients | Cetirizine | Cetirizine, pseudoephedrine |
Drug class | Antihistamine | Antihistamine, decongestant |
Appropriate use | Adults and children 6 years and older | Adults and children 12 years and older |
Availability | OTC | OTC with restrictions |
Restrictions | None | Buyer will not have direct access to medication and there is a limit on the amount that can be purchased |
Dosage forms | Tablet, syrup, solution | Tablet |
Dosing | Once daily | Up to two times daily |
One of the major distinctions between Zyrtec and Zyrtec-D is accessibility. While pseudoephedrine-containing products do not require a prescription, the U.S. Food and Drug Administration (FDA) has restricted the amount of these products that can be purchased.
Pseudoephedrine is commonly used to make methamphetamine (meth). Meth is a highly addictive, illegal drug that is often abused and can lead to severe side effects.
Because of this, Zyrtec-D likely won't be located with other OTC medications and may be found behind the pharmacy counter.
Restrictions may vary by state, but in general, you could be required to provide additional information, such as photo identification to prove your age, name, address, and signature, to purchase Zyrtec-D, even though a prescription isn't required.
What Does the D in Zyrtec-D Stand For?
The "D" in Zyrtec-D stands for "decongestant." As the name implies, this medication contains pseudoephedrine, a decongestant that relieves nasal symptoms.
Zyrtec-D combines cetirizine with pseudoephedrine for allergy and nasal decongestion relief. Pseudoephedrine relieves congestion associated with allergies and other respiratory conditions by shrinking swollen blood vessels in the nasal passages.
What Are Zyrtec and Zyrtec-D Used For?
Both medications effectively relieve various allergy symptoms such as runny or itchy nose, sneezing, runny or itchy eyes, and itchy throat. Zyrtec and Zyrtec-D are used to relieve these symptoms in people with seasonal and perennial (year-round) allergies.
Zyrtec-D treats the same allergy symptoms as Zyrtec. Zyrtec-D provides the benefit of treating nasal congestion and sinus pressure in addition to allergy symptoms.
How Do They Work?
Zyrtec works to relieve allergy symptoms by blocking histamine receptors. Histamine is released by the body and results in allergy symptoms. Blocking these receptors helps minimize allergy symptoms.
Similarly, Zyrtec-D treats allergy symptoms and nasal congestion by blocking histamine receptors and reducing the swelling that causes congestion.
Which Is More Effective?
Determining whether Zyrtec or Zyrtec-D is more effective depends on which specific symptoms need to be treated. Both medications contain cetirizine and are effective at lessening allergy symptoms and reducing symptom severity.
Clinical trial data comparing the efficacy of cetirizine and pseudoephedrine together to either medication alone revealed that the two medications together, as found in Zyrtec-D, are more effective than with either medication alone for the treatment of allergy symptoms.
If nasal congestion or sinus pressure are concerning symptoms, Zyrtec-D may be the more effective option when compared to Zyrtec alone because it contains a decongestant. Zyrtec may be less effective than Zyrtec-D at relieving nasal congestion.
Safety and Side Effects
In general, Zyrtec and Zyrtec-D are well-tolerated medications but side effect risks do exist.
Common side effects associated with Zyrtec use include:
Drowsiness
Dry mouth
Headache
Fatigue
Stomach upset
Because Zyrtec-D contains pseudoephedrine, there are additional potential side effects, such as:
Increased heart rate
Elevated blood pressure
Dizziness
Lightheadedness
Nausea
Difficulty sleeping
Individuals with certain medical conditions, such as high blood pressure or heart disease, may need to avoid medications containing pseudoephedrine.
If side effects occur, they are usually mild. Contact your healthcare provider if side effects occur and worsen or fail to improve. Seek medical attention if symptoms have not improved after taking Zyrtec-D for seven days.
Precautions
It's important to be aware of precautions and safety warnings associated with Zyrtec and Zyrtec-D use to ensure the medications are taken appropriately and safely.
Consult with your healthcare provider before taking Zyrtec or Zyrtec-D if you have liver or kidney disease. Avoid taking other medications that make you drowsy or using alcohol while taking either medication.
Individuals with the following medical conditions should discuss the appropriateness of taking Zyrtec-D with a healthcare provider to avoid complications:
Hypertension (high blood pressure)
Glaucoma
Use caution when operating a vehicle or machinery while taking either medication until you know how the medication affects you. Neither Zyrtec nor Zyrtec-D are recommended for use in pregnant or breastfeeding people.
Adults over 65 should speak with their healthcare provider to ensure safety and appropriateness before taking Zyrtec or Zyrtec-D.
Follow the dosing recommendations and instructions provided on the medication label. Because Zyrtec-D is an extended-release or long-acting medication, tablets should be swallowed whole to ensure the medication is safely absorbed.
Drug Interactions
It is important to be mindful of potential drug interactions to avoid adverse effects.
Zyrtec-D should not be used by people taking monoamine oxidase inhibitors (MAOIs), an older class of medications used to treat Parkinson's disease, depression, and other mental health conditions.
MAOIs can cause dangerously high blood pressure when taken with Zyrtec-D due to the pseudoephedrine component.
Examples of MAOIs include:
Nardil (phenelzine)
Marplan (isocarboxazid)
Parnate (tranylcypromine)
If you are taking or have taken an MAOI, ensure that at least two weeks have passed since stopping the medication before starting Zyrtec-D.
Use caution when taking Zyrtec or Zyrtec-D with other medications or substances that may cause drowsiness, such as alcohol, opioids, benzodiazepines, and certain antidepressants.
Reviewing all medications, including OTC products and supplements, with a healthcare provider before using Zyrtec or Zyrtec-D can help ensure safe and effective treatment for allergy symptoms and congestion.
Summary
Zyrtec and Zyrtec-D are OTC medications commonly used to treat allergy symptoms. They both contain the antihistamine cetirizine. Additionally, the "D" in Zyrtec-D stands for decongestant. Zyrtec-D contains the decongestant pseudoephedrine, making it effective in treating nasal congestion.
Both medications can effectively treat allergy symptoms in adults and children, but Zyrtec-D may be preferred if symptoms include nasal congestion.
Both medications are available OTC, but because of the abuse and misuse potential of pseudoephedrine, Zyrtec-D purchases are regulated. Be prepared to provide additional information such as photo identification, your name, address, and signature at the pharmacy.
Key differences between Zyrtec and Zyrtec-D include their active ingredients, the minimum age at which they can be used, purchasing restrictions, and available dosage forms.
Moreover, because it contains pseudoephedrine, Zyrtec-D may cause additional side effects like increased heart rate and elevated blood pressure. Individuals with certain medical conditions, such as hypertension or heart disease, should talk to a provider before use.
Read the original article on Verywell Health.
