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What’s the Best Allergy Medication? Comparing Allegra, Benadryl, Claritin, and Zyrtec

Christina Aungst, PharmDJoshua Murdock, PharmD, BCBBS
Updated on January 9, 2024

Key takeaways:

  • Allergy medicines, such as intranasal steroids, are the first-choice treatment for people with persistent allergy symptoms — but some of them take time to work.

  • Consider several factors when selecting an allergy medication, including your symptoms, how quickly you need relief, and side effects.

  • Antihistamines, a popular class of allergy medicines, can cause drowsiness. But some have less sedating effects.

  • There are many ways to save on your allergy medications. Many options are available over the counter and as lower-cost generics. GoodRx can help make your medication more affordable.

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Close-up of a young woman with short hair blowing her nose while at home on the couch.
Moyo Studio/E+ via Getty Images

Sneezing, runny nose, and itchy eyes — these are all telltale signs of allergies. And whether you have them seasonally or year round, they can make you feel pretty miserable. Allergy medicine can help keep your symptoms in check.

But with so many choices, there’s a chance you could be taking the wrong one and not getting enough relief. Here are some questions to consider before popping that next allergy pill. This way, you can find one that best meets your needs.

How long do allergy symptoms last?

Allergy symptoms can last anywhere from a few hours to several months, depending on what’s causing them and how they’re treated.

For some people, allergy symptoms only appear at certain times of the year but may last for a few months (seasonal allergies). For others, symptoms can be year round (perennial allergies). People with seasonal allergies usually refer to the times when they experience symptoms as “allergy season.”

Seasonal allergies tend to be most troublesome in the spring and fall. Depending on where you live, spring allergy season can start as early as February and last into the beginning of summer. Fall allergy season usually lasts from August to November, with mid-September being the roughest time. It’s also possible to have allergy symptoms throughout the spring, summer, and fall, especially if you live in a warmer area.

Causes of allergies

Allergic rhinitis, more popularly known as hay fever, refers to allergy symptoms that affect the nose. These symptoms are caused by environmental allergens, including:

  • Pollen from trees or grass

  • Dust in a house

  • Mold

  • Pet hair

Certain foods or drinks  can also trigger allergy symptoms — but they rarely lead to perennial allergies.

Common allergy symptoms 

While allergy symptoms may vary from person to person, common ones include:

  • Itchy eyes or skin

  • Sneezing

  • Runny nose

  • Watery eyes

  • Coughing

What are the best allergy medicines to take?

Depending on how long these symptoms last, certain allergy medicines will likely work better than others. Here are the four most common kinds of allergy medicines people use.

Chart comparing popular allergy medication types: antihistamines, nasal steroids, and decongestants.

Oral antihistamines

If your allergies only appear sporadically — say, when the pollen count is high, or you have that random encounter with your friend’s cat — oral antihistamines may be your best bet.

These include over-the-counter (OTC) allergy medicines such as:

Is there a “strongest” antihistamine? Not really. However, a review of multiple studies suggests Allegra may work better for eye-related symptoms and Xyzal may help with sneezing and nasal itching more than others. Claritin seems to be slightly less effective overall.

Histamine is a chemical our immune system releases when we come into contact with something we’re allergic to. It then triggers allergy symptoms, like a runny nose or itchy eyes. Antihistamines work by blocking areas of your body where histamine would normally attach to cause these symptoms.

While some people take antihistamines as needed for allergy symptoms, daily use is currently expert-recommended and may be an option for people looking to prevent symptoms.

In the case of seasonal allergies, you can use antihistamines before you’re exposed to an allergy trigger — like pollen. Starting the medication at least 2 weeks before allergy season typically begins can help you get the best results. This can be particularly helpful if you have frequent seasonal allergy symptoms.

Nasal steroids

If you experience daily or year-round allergies, you’ll want to look into nasal steroids. They can also be helpful if you know your seasonal allergy symptoms tend to last for several weeks or months. Experts recommend trying nasal steroids before other allergy medicines, as they tend to be the most effective option.

OTC nasal steroids include:

Similar to antihistamines, there’s no “strongest” nasal steroid. However, a review of multiple studies suggests Nasonex may be the most effective for seasonal allergies. The same review found Rhinocort to be the most effective for year-round allergies.

Nasal steroids generally take longer to work than antihistamines. But healthcare providers consider them to be the most effective for keeping nasal allergy symptoms in check over time. As a group, they may also be more effective at preventing nasal congestion compared to antihistamines.

Here’s how they’re thought to work: When you have allergies, a complicated series of reactions occur in your immune system between the moment you sense an allergen and when you get that runny nose. Nasal steroids act early on in these reactions — even before histamine is made — and prevent the processes that lead to a full-blown allergic response.

Decongestants

Decongestants help improve symptoms by relieving nasal and sinus congestion. They typically work quicker than other allergy medicines. This makes them an attractive option for fast relief.

Decongestants available without a prescription include:

Some allergy medicines, such as Allegra-D (fexofenadine / pseudoephedrine) and Claritin-D (loratadine / pseudoephedrine), combine both decongestants and antihistamines into the same pill so that they can target congestion and other allergy symptoms at the same time.

Decongestants can help you breathe a little easier if you’re stuffed up, but they shouldn’t be taken long term. Also, it’s important to know that nasal decongestant sprays, like Afrin, can make your congestion worse if they’re used for more than a few days (called rebound congestion). So it’s best to use them sparingly.

Oral decongestants, like Sudafed, also shouldn’t be taken if you have certain heart conditions, including high blood pressure. If you have these health conditions, talk to a pharmacist or healthcare provider first before giving them a try.

01:40

Mast cell stabilizers

Mast cell stabilizers are another allergy medicine option. But they’re not a good option for quick relief, as they take longer to start working. Nasalcrom (cromolyn sodium nasal spray) is the only OTC nasal mast cell stabilizer currently available.

Mast cell stabilizers work by preventing certain cells (called mast cells) from releasing histamine. They’re generally less effective than other allergy medicines, especially for seasonal allergies. But they could be an option if you have year-round allergies. And they’re considered one of the safest allergy medicines to use during pregnancy.

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How long will it take for my allergy medicine to work?

When you’re experiencing allergy symptoms, you want to feel better — and fast. But because each product works differently and treats specific symptoms, it’s important that you select the allergy medicine that will help you the most.

  • Decongestants: These offer the fastest relief. Nasal spray options should work within about 10 minutes, and oral options work within 30 to 60 minutes.

  • Oral antihistamines: These are another quick-relief option. Many work within about 1 to 2 hours.

  • Nasal steroids: These take longer to start working — a few days to 2 weeks for full effects.

  • Mast cell stabilizers: These take the longest to work, sometimes up to 6 weeks.

Will my allergy medicine make me drowsy?

Like all medications, allergy medicines can have side effects. This can include drowsiness, depending on which type of medication you take. We’ve broken down the potential side effects that different allergy medicines can cause below.

Nasal steroids side effects

Nasal steroids don’t typically cause drowsiness. Serious side effects with nasal steroid sprays are rare because very little of these medicines are actually absorbed by the body. They do, however, carry the risk of nasal tissue inflammation. That’s why it’s important to have regular checkups with a provider when using these medications for long periods of time.

Decongestants side effects

Decongestants aren’t associated with drowsiness. In fact, they can even keep you awake at night. Other common side effects of oral decongestants include headache, anxiety, and raised heart rate or blood pressure.

First-generation antihistamines side effects

Drowsiness is a common side effect of older, first-generation antihistamines like Benadryl. These medications work quickly to control allergy symptoms, but they can pass into your brain and cause drowsiness along with other neurological symptoms, like dizziness.

Second-generation antihistamines side effects 

Drowsiness and other brain-related side effects are less of an issue with newer, second-generation antihistamines, such as Claritin, because they’re less likely to enter the brain.

Zyrtec, however, is an exception — while it is a second-generation antihistamine, you may be more likely to get sleepy from taking it compared to Claritin or Allegra.

Possible side effects of second-generation antihistamines include:

  • Dry mouth

  • Headache

  • Dizziness

  • Ringing in the ear (tinnitus)

Prescription vs. OTC allergy medicines

Many allergy medicines are available OTC. But there are some that you need a prescription to purchase, such as:

Prescription allergy medicines aren’t necessarily better than OTC options. Experts generally don’t recommend specific medications within a class for allergy symptoms.

However, some prescription-only medications have other uses besides allergies. For instance, Vistaril can be prescribed for itching or anxiety. And Beconase AQ can help prevent nasal polyps after surgery. So, if you have allergies and certain non-allergy symptoms, your healthcare provider may prescribe a medication that can treat both.

How to save on my allergy medicine

There are many ways to save on your allergy medication(s). GoodRx can help you navigate your options. You can find allergy medications for as low as $4 with a free GoodRx discount. And if your healthcare provider writes you a prescription for an OTC medication, you can apply a GoodRx discount to it.

The table below lists some common OTC allergy medicines and how much you might save if your provider writes a prescription for it and you use GoodRx.

Medication name

Type of allergy medicine

Savings with GoodRx

Allegra (fexofenadine)

Antihistamine

As low as $7.49

Benadryl (diphenhydramine)

Antihistamine

As low as $3.18

Claritin (loratadine)

Antihistamine

As low as $5.95

Xyzal (levocetirizine)

Antihistamine

As low as $5.00

Zyrtec (cetirizine)

Antihistamine

As low as $4.47

Flonase (fluticasone propionate)

Nasal steroid

As low as $14.74

Nasacort (triamcinolone)

Nasal steroid

As low as $25.96

Nasonex (mometasone)

Nasal steroid

As low as $40.00

Rhinocort (budesonide)

Nasal steroid

As low as $9.57

Afrin (oxymetazoline)

Decongestant

As low as $5.81

Neo-Synephrine (phenylephrine)

Decongestant

As low as $4.56

Nasalcrom (cromolyn sodium)

Mast cell stabilizer

As low as $6.89

What is the best allergy medicine?

The short answer is — it depends. As described above, there are a few things to consider when selecting the right allergy medicine for you:

  • How quickly you need relief

  • Your symptoms

  • Side effects

  • Cost

Fast-acting medications, like decongestants and antihistamines, work quickly if you’re experiencing symptoms. But while antihistamines can be taken daily, decongestants should only be taken as needed in the short term.

Antihistamines and nasal steroids can be good options for preventing symptoms if taken daily before allergy season hits. Experts currently recommend intranasal steroids as the first-choice treatment for people with persistent symptoms.

Lastly, keep in mind that not all antihistamines are created equal — Benadryl can make you feel drowsy, whereas Allegra and Claritin may be less sedating. Since all antihistamines can potentially cause drowsiness, it’s best to see how you respond to them before engaging in activities that require alertness or concentration.

The bottom line

There are many allergy medicines available. Decongestants, such as Sudafed (pseudoephedrine), provide the fastest relief but shouldn’t be taken long term. Antihistamines, such as Claritin (loratadine), can provide quick relief and can help prevent symptoms if taken every day. Nasal steroids, such as Flonase (fluticasone propionate), are generally the most effective allergy medicines but can take up to 2 weeks to fully work.

Talk to your healthcare provider or pharmacist about which medication will benefit you the most and will be compatible with any health conditions or other medications you’re taking. They can help ensure that you take them properly for the best results.

References

American Academy of Ophthalmology. (n.d.). Part V: Ocular pharmacology; Chapter 16: Ocular pharmacotherapeutics*.

American College of Allergy, Asthma, and Immunology. (2017). Seasonal allergies.

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Derendorf, H., et al. (2008). Molecular and clinical pharmacology of intranasal corticosteroids: Clinical and therapeutic implications. Allergy.

Emeryk, A., et al. (2019). New guidelines for the treatment of seasonal allergic rhinitis. Advances in Dermatology and Allergology.

FamilyDoctor.org. (2023). Decongestants: OTC relief for congestion.

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Fernandez, J. (2022). Year-round allergies. Merck Manual Consumer Version.

Greisner, W. A., 3rd. (2004). Onset of action for the relief of allergic rhinitis symptoms with second-generation antihistamines. Allergy and Asthma Proceedings.

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MedlinePlus. (2021). Nasal corticosteroid sprays.

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Scadding, G. K., et al. (2017). BSACI guideline for the diagnosis and management of allergic and non-allergic rhinitis (revised edition 2017; first edition 2007). Clinical and Experimental Allergy.

Seidman, M. D., et al. (2015). Clinical practice guideline: Allergic rhinitis. Otolaryngology-Head and Neck Surgery.

Soe, K. K., et al. (2023). Comparative efficacy and acceptability of licensed dose intranasal corticosteroids for moderate-to-severe allergic rhinitis: A systematic review and network meta-analysis. Frontiers in Pharmacology.

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GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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