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Antihistamine Drugs: Summary of Recommendations

A relatively newer class of medications called second-generation antihistamines are widely used to relieve the symptoms of hay fever (known medically as allergic rhinitis), hives (urticaria), and other allergies. Studies have found these drugs to be equally effective and generally safe, but they can be misused.

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

We evaluate seven second-generation antihistamines in this report. These newer antihistamines cause less drowsiness than the older antihistamines, 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.

 The cost for the newer medicines varies from about $13 to more than $300 a month, so price might be an important factor in your choice. This report shows how you could save hundreds of dollar 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 Health Best Buy Drugs:
  • Loratadine 10 mg tablets
  • Loratadine dissolving 10 mg tablets
  • Loratadine liquid 10 mg
  • Alavert dissolving 10 mg tablets

All of these are low-cost generics available without a prescription in pharmacies and other stores that sell medications. All contain loratadine, the active ingredient in the nonprescription drug Claritin (a best-selling prescription drug until 2002 when it became available without a prescription), which has been shown to effectively relieve symptoms of hay fever, hives, and other allergies. You should also be aware that some people may respond well to one antihistamine while getting no benefit from another. So if loratadine does not work for you, then try cetirizine or one of the other antihistamines.

Your insurance might not fully cover antihistamines or might charge you a higher than usual copayment. Most insurers changed their policy when loratadine became a nonprescription drug. They now assume that most people will treat mild allergy symptoms just like they do a cold, the flu, or bouts of minor pain — with nonprescription medicines. Check with your insurer or healthplan administrator about its policy on antihistamines.

Antihistamine Drugs: Drug Comparison
CR Best BuyAllergies and Hay Fever -- The Antihistamines
Generic Name and Dose Brand Name1 Is Drug a Generic or Branded Generic?2 Drug is OTC?3 Usual Adult Dose4 Average Monthly Cost5 Compare Prices
  Azelastine nasal spray/pump 137 mcg Azelastine Yes No Two to four sprays, twice daily $63 - $127
  Azelastine nasal spray/pump 137 mcg Astelin No No Two to four sprays, twice daily $86 - $172
Azelastine nasal spray/pump 137 mcg Astepro No No Two to four sprays, twice daily $75 - $151
Azelastine nasal spray/pump 205.5 mcg Astepro No No Two to four sprays, twice daily $76 - $153
Cetirizine chewable tablet 10 mg Zyrtec No Yes One $30
Cetirizine tablet 10 mg Zyrtec No Yes One $25
  Cetirizine liquid 10 mg/10 ml Zyrtec No Yes 10 mg per day $95
  Cetirizine tablet 10 mg Generic Yes Yes One $17
  Cetirizine liquid 10 mg/10 ml Generic Yes Yes 10 mg per day $66
  Desloratadine dissolving tablet 2.5 mg Clarinex Reditabs No No One $206
Desloratadine dissolving tablet 5 mg Clarinex Reditabs No No One $209
Desloratadine tablet 5 mg Clarinex No No One $169
  Desloratadine liquid 2.5 mg/5 ml Clarinex No No 2.5 mg per day $103
  Desloratadine liquid 5 mg/10 ml Clarinex No No 5 mg per day $207
Fexofenadine tablet 30 mg Allegra No No Two $506
  Fexofenadine capsule 60 mg Allegra No No Two $716
Fexofenadine tablet 60 mg Allegra No No Two $117
Fexofenadine tablet 180 mg Allegra No No One $105
Fexofenadine tablet 30 mg Generic Yes No Two $53
Fexofenadine tablet 60 mg Generic Yes No Two $86
Fexofenadine tablet 180 mg Generic Yes No One $68
  Fexofenadine dissolving tablet 30 mg Allegra ODT No No Two $155
  Fexofenadine liquid 30 mg/5 ml Allegra No No 30 mg twice per day $102
  Levocetirizine tablet 5 mg Xyzal No No One $141
  Levocetirizine liquid 2.5 mg/5 ml Xyzal No No 5 mg per day $304
Loratadine dissolving tablet 10 mg Alavert BG Yes One $14
Loratadine dissolving tablet 10 mg Claritin Reditabs No Yes One $27
Loratadine dissolving tablet 10 mg Generic Yes Yes One $18
Loratadine tablet 10 mg Claritin No Yes One $25
Loratadine tablet 10 mg Generic Yes Yes One $13
Loratadine liquid 10 mg/10 ml Claritin No Yes 10 mg per day $80
Loratadine liquid 10 mg/10 ml Generic Yes Yes 10 mg per day $56
Olopatadine nasal spray Patanase No No Four sprays, twice daily $142
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. "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 on 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 July 2010, rounded to the nearest dollar. Data is provided by Wolters Kluwer Pharma Solutions, which is not involved in our analysis or recommendations. For loratadine and cetirizine drugs available OTC, monthly costs reflect average prices obtained by Consumer Reports in August 2010 from five national drugstore chains--CVS, Rite Aid, Target, Walgreens, and Walmart--in 19 cities across the U.S.

6. These average retail prices are for August 2009 to July 2010 due to low prescription volume.

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