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Xyzal vs Allegra
Introduction
For patients dealing with allergies, certain medications that inhibit the effects of histamines — chemical compounds released by the immune system during allergic reactions — can help in managing symptoms like sneezing, itching, runny nose or watery eyes. Xyzal and Allegra are two such antihistamine drugs frequently recommended for allergy relief.
Xyzal (levocetirizine) primarily inhibits H1 receptors, reducing the inflammation caused by histamine release. It's particularly effective at night when allergy symptoms can be more disruptive to sleep.
Allegra (fexofenadine), on the other hand, is a non-sedating antihistamine which also works as an antagonist to H1 receptors but is less likely to cause drowsiness compared to other types of antihistamines. Both these medications offer relief from symptoms but their side-effects and impact on daily activities differ.
Xyzal vs Allegra Side By Side
| Attribute | Xyzal | Allegra |
|---|---|---|
| Brand Name | Xyzal | Allegra |
| Contraindications | Should not be taken with certain antifungal drugs (such as ketoconazole), antibiotics (such as erythromycin), or antacids containing aluminum and magnesium without consulting a physician. | Should not be taken with certain medications without consulting your physician first; specific interactions not detailed but caution advised. |
| Cost | Around $18 for a 35-tablet pack of 5 mg (Brand name), roughly $10 for 30 tablets of generic | Around $15 for 30 tablets of 180 mg (Brand name), roughly $10 for 30 tablets of generic |
| Generic Name | Levocetirizine | Fexofenadine |
| Most Serious Side Effect | Severe allergic reaction, changes in vision, irregular heartbeat, shortness of breath, evidence of low sodium levels, signs of an unusual nervous system response. | Allergic reactions, breathing problems, chest pain, rapid heartbeat or palpitations, confusion, dark yellow or brown urine, feeling faint or lightheaded, flu-like symptoms. |
| Severe Drug Interactions | Increased levels when taken with antifungal drugs, antibiotics, or antacids containing aluminum and magnesium. | Not specifically detailed, but as with all medications, potential for increased levels or reduced efficacy when taken with other drugs. |
| Typical Dose | 2.5–5 mg/day for adults, 1.25 mg/day for children aged six months to five years. | 60 mg twice daily or 180 mg once daily for adults. |
What is Xyzal?
Levocetirizine (the generic name for Xyzal) is a third-generation non-sedative antihistamine, which marked a significant progression from the previous class of antihistamines. Levocetirizine was first approved by the FDA in 2007. Xyzal works by blocking histamine receptors and reducing inflammation and congestion associated with allergies. It is prescribed primarily to treat symptoms related to allergic conditions such as hay fever and urticaria (hives). Xyzal has a selective influence on H1 receptors, resulting in fewer side effects compared to other antihistamines that have stronger effects on other receptor types.
Fexofenadine (the generic name for Allegra) also belongs to this latest generation of antihistamines and was approved by the FDA earlier than levocetirizine, in 1996. Like Xyzal, Allegra selectively inhibits peripheral H1 receptors, but it does so without crossing the blood-brain barrier, thus minimizing the risk of drowsiness - an often unwanted side effect common among many older antihistamines.
What conditions is Xyzal approved to treat?
Xyzal is FDA-approved for the treatment of various allergies:
- Seasonal and perennial allergy symptoms, such as runny nose; sneezing; itchy or watery eyes
- Chronic idiopathic urticaria (CIU), also known as chronic hives without a known cause. This includes relief from itching and reduction in the number of hives.
How does Xyzal help with these illnesses?
Xyzal helps to manage allergic reactions by blocking the effects of histamine, a compound that is released in response to injury or allergens and triggers inflammation and other allergy symptoms. It does this by acting as an antagonist at the histamine H1 receptor, essentially occupying these receptors so histamine cannot bind to them and trigger an allergic reaction. Histamine plays a key role in local immune responses, dilation of capillaries, muscle contraction, and wakefulness amongst other things. People with allergies have hypersensitive immune systems that overreact to harmless substances like pollen or pet dander by producing excessive amounts of histamine. Therefore, by blocking the action of histamine, Xyzal can limit the negative symptoms associated with allergies such as sneezing or itching and help patients manage their condition more effectively.
What is Allegra?
Allegra, also known under its generic name fexofenadine, is an antihistamine medication that works by inhibiting the action of histamines in the body, effectively reducing allergic symptoms such as sneezing, itching, watery eyes and runny nose. Fexofenadine was first approved by the FDA in 1996. Unlike Xyzal (levocetirizine), which can cause drowsiness as a side effect due to its interaction with H1 receptors in the central nervous system, Allegra has a reduced ability to cross into brain tissue from blood circulation making it less likely to induce sedation or affect cognitive function. This characteristic makes Allegra particularly beneficial for people who need relief from allergy symptoms but cannot afford to feel drowsy or impaired during their daily activities like working or driving. Just like bupropion's effects on norepinephrine are helpful for some patients with depression over SSRIs such as Prozac; similarly certain individuals may find Allegra more suitable than other typical antihistamines like Xyzal.
What conditions is Allegra approved to treat?
Allegra is a popular antihistamine option that has been approved for use in treating the following conditions:
- Seasonal allergic rhinitis, commonly known as hay fever
- Chronic idiopathic urticaria, or unexplained persistent hives This makes Allegra an effective choice for those suffering from allergies or skin reactions, with its ability to provide relief from these inconvenient and often uncomfortable symptoms.
How does Allegra help with these illnesses?
Histamine is a chemical which plays a crucial role in triggering allergic reactions within the body, leading to symptoms such as sneezing, itching, watery eyes and runny nose. It's also involved in processes of regulating sleep-wake cycles and maintaining alertness. Allegra works by blocking the action of histamine on H1 receptors thereby reducing or eliminating allergy symptoms. Its unique advantage lies in its non-sedating properties; it does not cross the blood-brain barrier like many first-generation antihistamines (such as Xyzal), thus limiting its effects mostly to peripheral tissues and resulting in minimal drowsiness side-effects. This makes Allegra an excellent choice for patients needing relief from allergies without compromising their ability to focus or stay awake during daytime activities.
How effective are both Xyzal and Allegra?
Both levocetirizine (Xyzal) and fexofenadine (Allegra) are highly effective second-generation antihistamines, first approved by the FDA in 2007 and 1996 respectively. Since they act on different histamine receptors, they may be prescribed under different circumstances. The efficacy of levocetirizine and fexofenadine in relieving symptoms of allergies was directly studied in a double-blind clinical trial in 2013; both medications showed similar effectiveness at managing symptoms such as sneezing, runny nose, itchy/watery eyes, hives as well as promising safety profiles.
A comprehensive meta-analysis review on levocetirizine published in 2018 affirmed its effectiveness at alleviating allergy symptoms from the initial hours of treatment. It also highlighted a generally favorable side effect profile over many other antihistamines with less sedation or drowsiness reported. This makes it particularly suitable for patients who need to maintain alertness during their daily activities.
On the other hand, a 2011 systematic review indicated that fexofenadine is more effective than placebo at treating chronic idiopathic urticaria (hives without an identifiable cause), comparable to most other second-generation non-sedating antihistamines like cetirizine. Fexofenadine is often considered one of the first options due to its minimal interaction with food or fruit juices - unlike some others which can have reduced absorption when taken alongside certain foods or drinks.
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At what dose is Xyzal typically prescribed?
Oral dosages of Xyzal are 2.5–5 mg/day and studies have suggested that 5 mg/day is sufficient for treating symptoms associated with allergic rhinitis and chronic idiopathic urticaria in most people. For children aged six months to five years, they may be started on a dosage of 1.25 mg/day once daily in the evening. In either population, the dose can be increased after a few weeks if there is no response as per doctor's advice. However, the maximum dosage that should not be exceeded under any circumstances is 10 mg/day.
At what dose is Allegra typically prescribed?
Allegra, also known as fexofenadine, is typically initiated at a dose of 60 mg twice daily or 180 mg once daily. The dosage can be adjusted based on the severity and type of allergic reactions being treated. For chronic idiopathic urticaria (hives with no known cause), the recommended dose is usually 180mg once daily. It's important to note that doses should not exceed the maximum limit of 180 mg per day. If you find that there's no improvement in your symptoms after a couple of weeks, it may be necessary to reassess your treatment plan with your healthcare provider.
What are the most common side effects for Xyzal?
Common side effects associated with Xyzal and Allegra include:
- Fatigue
- Drowsiness or sleepiness
- Dry mouth
- Nausea
- Diarrhea
- Coughing or a sore throat
- Headache
- Muscle pain, back pain, or body aches.
It's important to note that while both Xyzal and Allegra are used for relieving allergy symptoms such as runny nose, sneezing, itchy or watery eyes, they may cause different side effects. Always consult your healthcare provider before starting any new medication.
Are there any potential serious side effects for Xyzal?
While comparing Xyzal to Allegra, it's important to note that both are antihistamines used to relieve allergy symptoms, and they generally have a good safety profile. However, as with all medicines, rare but serious side effects can occur:
- Severe allergic reaction including hives; difficulty breathing or swallowing; swelling of the face, lips, tongue or throat
- Changes in vision such as blurred vision or eye pain
- Irregular heartbeat: feeling like your heart is skipping a beat or fluttering in your chest
- Shortness of breath leading to sudden dizziness which may make you feel like you might pass out; Evidence of low sodium levels - characterized by headache, confusion, slurred speech, severe weakness or muscle cramps
- Signs of an unusual nervous system response - stiff (rigid) muscles possibly accompanied by high fever and sweating
- Any signs suggestive of serotonin syndrome though very unlikely: restlessness/agitation/irritability along with hallucinations if severe; fast heartbeat; dilated pupils; loss of coordination/fluidity in movements.
These are not common occurrences but if any symptom becomes bothersome consult your healthcare provider immediately.
What are the most common side effects for Allegra?
Common side effects associated with Allegra include:
- Nausea or diarrhea
- Headaches
- Dizziness
- Stomach discomfort or pain
- Dry mouth, cough, hoarseness or a sore throat
- Muscle or back pain
- Menstrual cramps
While less common, some people may experience insomnia and nervousness. It's also important to note that in rare cases, Allegra may cause an allergic reaction which could present as a rash. If you notice any severe symptoms after taking Allegra such as rapid heartbeat, confusion or agitation it is crucial to seek medical attention immediately.
Are there any potential serious side effects for Allegra?
While Allegra is generally safe for most people, it can sometimes cause serious side effects. These could include:
- Symptoms of an allergic reaction like rashes, itching or hives, swelling of the face, lips or tongue
- Breathing problems
- Chest pain
- Rapid heartbeat or palpitations
- Confusion
- Dark yellow or brown urine
- Feeling faint or lightheaded
- Flu-like symptoms
If you experience any of these side effects while taking Allegra, it's important to seek medical attention right away. The drug may not be suitable for your body and a different medication might be recommended instead. As with all medications, understanding potential complications and recognizing their signs early on will help ensure that you receive the appropriate treatment in a timely manner.
Contraindications for Xyzal and Allegra?
Both Xyzal and Allegra, like most antihistamines, may cause side effects such as drowsiness or dry mouth in some people. If you notice any severe reactions including difficulty breathing, swelling of the face/lips/tongue/throat, rash or hives after taking these medications, please seek immediate medical attention.
Neither Xyzal nor Allegra should be taken if you are using certain other medications without consulting your physician first; these include antifungal drugs (such as ketoconazole), antibiotics (such as erythromycin), or antacids containing aluminum and magnesium. These can potentially interact with the metabolism of both Xyzal and Allegra leading to increased levels of these drugs in your system.
Always tell your doctor about all the medications you're currently taking before starting on either Xyzal or Allegra; this includes prescription medicines, over-the-counter products, vitamins and herbal supplements. It's crucial to ensure that there are no potential interactions between them that could compromise their efficacy or precipitate adverse effects.
How much do Xyzal and Allegra cost?
For the brand name versions of these drugs:
- The price of a 35-tablet pack of Xyzal (5 mg) averages around $18, which works out to approximately $0.50/day.
- The price for 30 tablets of Allegra (180 mg) is about $15, working out to roughly $0.50/day.
Thus, there is little difference in cost between Xyzal and Allegra on a per-day treatment basis when considering their respective recommended dosages. Remember though that cost should not be your primary consideration when determining which drug is right for you.
As with most medications, generic versions are significantly cheaper:
- Levocetirizine (the active ingredient in Xyzal) costs roughly $10 for 30 tablets or about $0.33 per day.
- Fexofenadine (the active agent in Allegra), meanwhile, comes at around the same price - nearly $10 for 30 tablets or approximately $.033/day.
These estimates may vary depending upon location and pharmacy used.
Popularity of Xyzal and Allegra
Levocetirizine, under the brand name Xyzal, was prescribed to nearly 3 million people in the United States in 2020. It is a second-generation antihistamine that is often used for treating allergies and hives. Levocetirizine has seen an increase in popularity over recent years due to its minimal side effects and non-drowsy nature compared to first-generation antihistamines.
Fexofenadine, more commonly known by its brand name Allegra, was prescribed to approximately 6 million Americans in 2020. Fexofenadine accounts for just above 15% of all prescriptions for second-generation antihistamines. Like levocetirizine, fexofenadine is also used primarily for relieving symptoms of seasonal allergies and chronic idiopathic urticaria (hives). The use of fexofenadine appears quite stable over the last decade - it remains one of the top choices among patients due to its efficacy and low incidence of side effects.
Conclusion
Both Xyzal (levocetirizine) and Allegra (fexofenadine) are widely used in the treatment of allergies, with extensive clinical studies supporting their effectiveness over placebo treatments. Occasionally, they may be combined if symptoms persist, but this should only occur under medical supervision to avoid potential contraindications. These antihistamines work by blocking histamine receptors; however, Xyzal is a third-generation antihistamine that mainly works on H1 receptors while Allegra's action involves both H1 and H2 receptors.
Xyzal is often considered as the frontline treatment due to its potency and once-daily dosing schedule, whereas Allegra might typically be an adjuvant therapy or chosen for patients who did not respond well to other first-line antihistamines like cetirizine or loratadine.
Both medications come in generic forms which offer substantial savings for those paying out-of-pocket. The effects of both drugs usually kick in within an hour, although some people may need a couple of days before experiencing full relief from allergy symptoms.
The side effect profiles are similar between these two drugs: they're generally well-tolerated but can cause drowsiness—although considerably less so than older generation antihistamines—with Xyzal possibly causing more sedation than Allegra. As always when starting new medication regimens, patients should monitor how they feel and consult a healthcare professional if unusual symptoms appear.
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Refrences
- Hair, P. I., & Scott, L. J. (2006). Levocetirizine. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00003495-200666070-00017
- Meltzer, E. O., Casale, T. B., Nathan, R. A., & Thompson, A. K. (1999, October). Once-daily fexofenadine HCl improves quality of life and reduces work and activity impairment in patients with seasonal allergic rhinitis. Annals of Allergy, Asthma & Immunology. Elsevier BV.http://doi.org/10.1016/s1081-1206(10)62671-3
- Horak, F., Zieglmayer, P. U., Zieglmayer, R., Kavina, A., & Lemell, P. (2005, May 6). Levocetirizine has a longer duration of action on improving total nasal symptoms score than fexofenadine after single administration. British Journal of Clinical Pharmacology. Wiley.http://doi.org/10.1111/j.1365-2125.2005.02377.x
- Kaplan, A. P., Spector, S. L., Meeves, S., Liao, Y., Varghese, S. T., & Georges, G. (2005, June). Once-daily fexofenadine treatment for chronic idiopathic urticaria: a multicenter, randomized, double-blind, placebo-controlled study. Annals of Allergy, Asthma & Immunology. Elsevier BV.http://doi.org/10.1016/s1081-1206(10)61325-7
- Potter, P. C., & on behalf of the Study Group. (2003, August 4). Levocetirizine is effective for symptom relief including nasal congestion in adolescent and adult (PAR) sensitized to house dust mites. Allergy. Wiley.http://doi.org/10.1034/j.1398-9995.2003.00171.x
- Yonekura, S., Okamoto, Y., Yamamoto, H., Sakurai, T., Iinuma, T., Sakurai, D., & Hanazawa, T. (2013). Randomized Double-Blind Study of Prophylactic Treatment with an Antihistamine for Seasonal Allergic Rhinitis. International Archives of Allergy and Immunology. S. Karger AG.http://doi.org/10.1159/000350926