Background

Seven newer or "second generation" antihistamine medications that are widely used to relieve the symptoms of hay fever (a type of allergic rhinitis), hives (urticaria), and other allergies. Studies have found these drugs to be equally effective and generally safe, but they can be misused.

To help you and your doctor choose the right antihistamine if you need one, Consumer Reports Best Buy Drugs has evaluated the seven drugs in this category based on their effectiveness, safety, and cost. This brief is a summary of an 20-page report you can access on the Internet at CRBestBuyDrugs.org. You can also learn about other drugs we’ve analyzed on this free Web site.

Our independent evaluations are based on scientific reviews conducted by the Oregon Health and Science University-based Drug Effectiveness Review Project. Grants from the Engelberg Foundation and the National Library of Medicine help fund Consumer Reports Best Buy Drugs. These materials were made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multi-state settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).

Do You Need an Antihistamine?

Some people who take allergy medicines do not have allergies, so you should see your doctor for a diagnosis before taking antihistamines on a regular basis.

The newer antihistamines cause less drowsiness than the older ones, which include nonprescription drugs such as Benadryl Allergy, Chlor-Trimeton Allergy, and Dimetapp Allergy. But the newer drugs are no more effective than the older ones at relieving symptoms.

Summary of Evidence on Antihistamines

Generic Name
(Brand names)

Usual Adult Dose

Proven Effective
Against Hay Fever and
Seasonal Allergies?

Proven Effective
Against Chronic or
Perennial Allergies?

Proven Effective
Against Hives
(Urticaria)?

Azelastine nasal spray/pump
(Astelin, Astepro)

One or two sprays per
nostril twice daily

Yes

Yes

NA2

Cetirizine (Zyrtec)

10 mg once daily

Yes

Yes

Yes

Desloratadine (Clarinex)

5 mg once daily

Yes

Yes

Yes

Fexofenadine (Allegra)

60 mg once or twice daily,
or 180 mg once daily

Yes

No1

Yes

Levocetirizine (Xyzal)

5 mg once daily

Yes

Yes

Yes

Loratadine (Alavert, Claritin)

10 mg once daily

Yes

Yes

Yes

Olopatadine nasal spray (Patanase)

Two sprays per nostril
twice daily

Yes

No

NA2

1. Sufficient evidence was not available for fexofenadine, although it is likely effective in treating perennial allergy symptoms.

2. NA = Not applicable; the nasal sprays are not used for treating hives.

Our Recommendations

Antihistamines are effective and generally safe. They ease the symptoms of hay fever, hives, and other allergies in most people, though they don’t usually relieve symptoms entirely.

The monthly cost for the newer medicines varies from about $8 to more than $200, so price might be an important factor in your choice. This report shows how you could save hundreds of dollars a year or more if you currently take an expensive brand-name antihistamine. Taking dosing convenience, cost, and effectiveness and safety into account, we have selected the following as Consumer Reports Best Buy Drugs:

All are low-cost generics available without a prescription in pharmacies and other stores that sell medications. They have been shown to effectively relieve symptoms of hay fever, hives, and other allergies. Cetirizine is also available over-the-counter in soft gel capsule and liquid formulations for people who need those. You should also be aware that some people may respond well to one antihistamine while getting no benefit from another. So if our Best Buy picks do not work for you, then try one of the other antihistamines.
Your insurance might not fully cover antihistamines or might charge you a higher than usual co-payment. Check with your insurer or health-plan administrator about its policy on antihistamines.

This report was updated in July 2013.

Cost Comparison

Note: If the price box contains a

, that indicates the dose of that drug may be available for a low monthly cost through programs offered by large chain stores. For example, Kroger, Sam’s Club, Target, and Walmart offer a month’s supply of selected generic drugs for $4 or a three-month supply for $10. Other chain stores, such as Costco, CVS, Kmart, and Walgreens, offer similar programs. Some programs have restrictions or membership fees, so check the details carefully for restrictions and to make sure your drug is covered.



Generic Name and Dose

Brand Name1

Drug is a
Generic? 2

Drug Is
OTC? 3

Usual Adult Dose 4

Average
Monthly
Cost 5

Azelastine nasal spray/pump 137 mcg

Azelastine

Yes

No

Two sprays per nostril, twice daily

$100

Azelastine nasal spray/pump 137 mcg

Astelin

No

No

Two sprays per nostril, twice daily

$203

Azelastine nasal spray/pump 205.5 mcg

Astepro

No

No

Two sprays per nostril, twice daily

$180

Cetirizine tablet 10 mg

Zyrtec

No

Yes

One

$19

Cetirizine tablet 10 mg

Generic

Yes

Yes

One

$11

Cetirizine liqui-gel capsule 10 mg

Zyrtec

No

Yes

One

$23

Desloratadine dissolving tablet 2.5 mg

Clarinex Reditabs

No

No

One

$237

Desloratadine dissolving tablet 5 mg

Clarinex Reditabs

No

No

One

$239

Desloratadine tablet 5 mg

Clarinex

No

No

One

$201

Desloratadine tablet 5 mg

Generic

Yes

No

One

$97

Desloratadine liquid 2.5 mg/5 mL

Clarinex

No

No

2.5 mg per day

$117

Fexofenadine tablet 60 mg

Allegra

No

Yes

Two

$56

Fexofenadine tablet 180 mg

Allegra

No

Yes

One

$24

Fexofenadine tablet 60 mg

Generic

Yes

Yes

Two

$36

Fexofenadine tablet 180 mg

Generic

Yes

Yes

One

$18

Fexofenadine dissolving tablet 30 mg

Allegra ODT

No

No

Two

$128

Fexofenadine liquid 30 mg/5 mL

Allegra

No

Yes

30 mg twice per day

$14

Levocetirizine tablet 5 mg

Xyzal

No

No

One

$119

Levocetirizine liquid 2.5 mg/5 mL

Xyzal

No

No

5 mg per day

$116

Levocetirizine tablet 5 mg

Generic

Yes

No

One

$59

Levocetirizine liquid 2.5 mg/5 mL

Generic

Yes

No

5 mg per day

$87

Loratadine dissolving tablet 10 mg

Alavert

BG

Yes

One

$12

Loratadine dissolving tablet 10 mg

Claritin Reditabs

No

Yes

One

$25

Loratadine dissolving tablet 10 mg

Generic

Yes

Yes

One

$13

Loratadine tablet 10 mg

Claritin

No

Yes

One

$22

Loratadine tablet 10 mg

Generic

Yes

Yes

One

$8

Loratadine liqui-gel capsules 10 mg

Claritin

No

Yes

One

$26

Loratadine liquid 1 mg/5 mL

Claritin

No

Yes

5 mg per day

$15

Loratadine liquid 1 mg/5 mL

Generic

Yes

Yes

5 mg per day

$8

Olopatadine nasal spray

Patanase

No

No

Two sprays per nostril, twice daily

$153

1. "Generic" indicates the drug is sold as a generic.

2. "Yes" means it is a generic, sold under the chemical or scientific name. "BG" means it is a branded generic, which is a generic copy of an original drug given a special name by its manufacturer. In this table, for example, Alavert is a branded generic. "No" means it is a brand-name drug.

3. OTC stands for over-the-counter. "Yes" means it is a nonprescription OTC drug.

4. Frequency of use reflects recommendations on the package insert. Some products can be used more or less frequently.

5. For drugs available by prescription only, monthly costs reflect nationwide retail average prices for February 2013, rounded to the nearest dollar. Data is provided by Symphony Health Solutions, which is not involved in our analysis or recommendations. For drugs available OTC, prices were obtained by Consumer Reports secret shoppers from five major chain pharmacies (CVS, Rite Aid, Target, Walgreens, and Walmart) and local supermarkets across the U.S. in January 2013, and in some cases, prices were obtained by Consumer Reports in June 2013 at the online sites of those chain pharmacies. The prices from the various stores were averaged to yield per pill prices, which were then converted into a monthly price based on the maximum recommended number of pills per day.

NOTE: The information contained in the Consumer Reports Best Buy Drugs™ reports is for general informational purposes and is not intended to replace consultation with a physician or other health care professional. Consumers Union is not liable for any loss or injury related to your use of the reports. The reports are intended solely for individual, non-commercial use and may not be used in advertising, promotion, or for any other commercial purpose.


Copyright 2010, Consumers Union of United States, Inc

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