Table of ContentsView AllTable of ContentsZyrtec vs. Zyrtec-D: What’s the Difference?UsesWhich Is More Effective?Safety and Side EffectsDrug Interactions
Table of ContentsView All
View All
Table of Contents
Zyrtec vs. Zyrtec-D: What’s the Difference?
Uses
Which Is More Effective?
Safety and Side Effects
Drug Interactions
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 nasaldecongestant.
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.
Getty Images /Bloomberg/ Contributor
The key difference between Zyrtec and Zyrtec-D is the additional ingredient, pseudoephedrine, found in Zyrtec-D.
However, Zyrtec-D also contains pseudoephedrine, a decongestant, to minimize nasal congestion. Decongestants are a class of medication that helps relieve symptoms associated withcolds, allergies, andsinus 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.
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 makemethamphetamine(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.
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.
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?
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.
In general, Zyrtec and Zyrtec-D are well-tolerated medications but side effect risks do exist.
Common side effects associated with Zyrtec use include:
Because Zyrtec-D contains pseudoephedrine, there are additional potential side effects, such as:
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:
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.
It is important to be mindful of potential drug interactions to avoid adverse effects.
MAOIs can cause dangerously high blood pressure when taken with Zyrtec-D due to the pseudoephedrine component.
Examples of MAOIs include:
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.
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.DailyMed.Label: Zyrtec - cetirizine hydrochloride tablet, film coated.DailyMed.Label: Zyrtec D Allergy and Congestion - cetirizine hydrochloride and pseudoephedrine hydrochloride tablet, extended release.MedlinePlus.Psuedoephedrine.MedlinePlus.Antihistamines for allergies.Prescribers' Digital Reference.Zyrtec.Prescribers' Digital Reference.Zyrtec-D Allergy + Congestion.U.S. Food and Drug Administration.Legal requirements for the sale and purchase of drug products containing pseudoephedrine, ephedrine, and phenylpropanolamine.Corsico AG, Leonardi S, Licari A, et al.Focus on the cetirizine use in clinical practice: a reappraisal 30 years later.Multidiscip Respir Med. 2019;14:40. doi:10.1186/s40248-019-0203-6.Badorrek P, Dick M, Schauerte A, et al.A combination of cetirizine and pseudoephedrine has therapeutic benefits when compared to single drug treatment in allergic rhinitis.Int J Clin Pharmacol Ther. 2009;47(2):71-77. doi:10.5414/cpp47071Meltzer EO, Caballero F, Fromer LM, et al.Treatment of congestion in upper respiratory diseases.Int J Gen Med, 2010;3,69–91. doi:10.2147/ijgm.s8184Edinoff AN, Swinford CR, Odisho AS, et al.Clinically relevant drug interactions with monoamine oxidase inhibitors.Health Psychol Res. 2022;10(4):39576. doi:10.52965/001c.39576.Fiedorowicz JG, Swartz KL.The role of monoamine oxidase inhibitors in current psychiatric practice. J Psychiatr Pract. 2004;10(4):239-248. doi:10.1097/00131746-200407000-00005.
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.DailyMed.Label: Zyrtec - cetirizine hydrochloride tablet, film coated.DailyMed.Label: Zyrtec D Allergy and Congestion - cetirizine hydrochloride and pseudoephedrine hydrochloride tablet, extended release.MedlinePlus.Psuedoephedrine.MedlinePlus.Antihistamines for allergies.Prescribers' Digital Reference.Zyrtec.Prescribers' Digital Reference.Zyrtec-D Allergy + Congestion.U.S. Food and Drug Administration.Legal requirements for the sale and purchase of drug products containing pseudoephedrine, ephedrine, and phenylpropanolamine.Corsico AG, Leonardi S, Licari A, et al.Focus on the cetirizine use in clinical practice: a reappraisal 30 years later.Multidiscip Respir Med. 2019;14:40. doi:10.1186/s40248-019-0203-6.Badorrek P, Dick M, Schauerte A, et al.A combination of cetirizine and pseudoephedrine has therapeutic benefits when compared to single drug treatment in allergic rhinitis.Int J Clin Pharmacol Ther. 2009;47(2):71-77. doi:10.5414/cpp47071Meltzer EO, Caballero F, Fromer LM, et al.Treatment of congestion in upper respiratory diseases.Int J Gen Med, 2010;3,69–91. doi:10.2147/ijgm.s8184Edinoff AN, Swinford CR, Odisho AS, et al.Clinically relevant drug interactions with monoamine oxidase inhibitors.Health Psychol Res. 2022;10(4):39576. doi:10.52965/001c.39576.Fiedorowicz JG, Swartz KL.The role of monoamine oxidase inhibitors in current psychiatric practice. J Psychiatr Pract. 2004;10(4):239-248. doi:10.1097/00131746-200407000-00005.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
DailyMed.Label: Zyrtec - cetirizine hydrochloride tablet, film coated.DailyMed.Label: Zyrtec D Allergy and Congestion - cetirizine hydrochloride and pseudoephedrine hydrochloride tablet, extended release.MedlinePlus.Psuedoephedrine.MedlinePlus.Antihistamines for allergies.Prescribers' Digital Reference.Zyrtec.Prescribers' Digital Reference.Zyrtec-D Allergy + Congestion.U.S. Food and Drug Administration.Legal requirements for the sale and purchase of drug products containing pseudoephedrine, ephedrine, and phenylpropanolamine.Corsico AG, Leonardi S, Licari A, et al.Focus on the cetirizine use in clinical practice: a reappraisal 30 years later.Multidiscip Respir Med. 2019;14:40. doi:10.1186/s40248-019-0203-6.Badorrek P, Dick M, Schauerte A, et al.A combination of cetirizine and pseudoephedrine has therapeutic benefits when compared to single drug treatment in allergic rhinitis.Int J Clin Pharmacol Ther. 2009;47(2):71-77. doi:10.5414/cpp47071Meltzer EO, Caballero F, Fromer LM, et al.Treatment of congestion in upper respiratory diseases.Int J Gen Med, 2010;3,69–91. doi:10.2147/ijgm.s8184Edinoff AN, Swinford CR, Odisho AS, et al.Clinically relevant drug interactions with monoamine oxidase inhibitors.Health Psychol Res. 2022;10(4):39576. doi:10.52965/001c.39576.Fiedorowicz JG, Swartz KL.The role of monoamine oxidase inhibitors in current psychiatric practice. J Psychiatr Pract. 2004;10(4):239-248. doi:10.1097/00131746-200407000-00005.
DailyMed.Label: Zyrtec - cetirizine hydrochloride tablet, film coated.
DailyMed.Label: Zyrtec D Allergy and Congestion - cetirizine hydrochloride and pseudoephedrine hydrochloride tablet, extended release.
MedlinePlus.Psuedoephedrine.
MedlinePlus.Antihistamines for allergies.
Prescribers' Digital Reference.Zyrtec.
Prescribers' Digital Reference.Zyrtec-D Allergy + Congestion.
U.S. Food and Drug Administration.Legal requirements for the sale and purchase of drug products containing pseudoephedrine, ephedrine, and phenylpropanolamine.
Corsico AG, Leonardi S, Licari A, et al.Focus on the cetirizine use in clinical practice: a reappraisal 30 years later.Multidiscip Respir Med. 2019;14:40. doi:10.1186/s40248-019-0203-6.
Badorrek P, Dick M, Schauerte A, et al.A combination of cetirizine and pseudoephedrine has therapeutic benefits when compared to single drug treatment in allergic rhinitis.Int J Clin Pharmacol Ther. 2009;47(2):71-77. doi:10.5414/cpp47071
Meltzer EO, Caballero F, Fromer LM, et al.Treatment of congestion in upper respiratory diseases.Int J Gen Med, 2010;3,69–91. doi:10.2147/ijgm.s8184
Edinoff AN, Swinford CR, Odisho AS, et al.Clinically relevant drug interactions with monoamine oxidase inhibitors.Health Psychol Res. 2022;10(4):39576. doi:10.52965/001c.39576.
Fiedorowicz JG, Swartz KL.The role of monoamine oxidase inhibitors in current psychiatric practice. J Psychiatr Pract. 2004;10(4):239-248. doi:10.1097/00131746-200407000-00005.
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