Zyrtec vs Nasonex

Listen to the article instead of reading through it.


For individuals coping with allergies, certain medications that block the release of histamines can help to alleviate symptoms such as sneezing, itching, and congestion. Zyrtec and Nasonex are two such drugs often recommended for allergy relief. These medications work differently but both aim to manage allergic reactions effectively. Zyrtec is an antihistamine drug taken orally which blocks H1 receptors in the body preventing histamines from causing allergic symptoms. On the other hand, Nasonex is a corticosteroid nasal spray that reduces inflammation in the nasal passages thereby relieving nose-related allergy symptoms like nasal congestion and sneezing. It's important to note that while both are effective in their respective applications, they target different aspects of your body's response to allergens.

What is Zyrtec?

Cetirizine (the generic name for Zyrtec) is a second-generation antihistamine, typically recommended for the treatment of allergies. It was first approved by the FDA in 1995. Cetirizine works by blocking histamine, a chemical released during an allergic reaction, from binding to its receptors and thus preventing symptoms like itching, sneezing and runny nose.

Mometasone Furoate (the generic name for Nasonex), on the other hand, was introduced as an intranasal corticosteroid used primarily to treat nasal symptoms of seasonal or perennial allergic rhinitis in adults and children. Nasonex reduces inflammation within the nasal passages by inhibiting multiple types of cells involved in inflammatory responses.

Even though both drugs are used to alleviate allergy symptoms, they work differently with potentially different side effects: while cetirizine can cause drowsiness due to its action on central nervous system histamine receptors; mometasone has relatively few systemic side effects thanks to its topical application method.

What conditions is Zyrtec approved to treat?

Zyrtec is approved for the treatment of various allergic conditions:

  • Seasonal and perennial allergic rhinitis, commonly known as hay fever
  • Chronic urticaria, also known as hives
  • Pruritus and urticaria associated with chronic idiopathic urticaria

On the other hand, Nasonex has been approved specifically for nasal symptoms:

  • Nasal congestion associated with seasonal and perennial allergic rhinitis in adults and pediatric patients 2 years of age and older.
  • Prophylaxis of seasonal allergic rhinitis in adult and adolescent patients 12 years or older.

How does Zyrtec help with these illnesses?

Zyrtec works to alleviate allergies by blocking the effects of histamine, a compound which is released in the body during an allergic reaction. It accomplishes this by attaching itself to H1 receptors, inhibiting histamine from binding and triggering symptoms such as sneezing, itching, watery eyes, and runny nose. Histamine is a neurotransmitter that serves many functions in the body including regulating physiological responses to inflammation or allergy.

On the other hand, Nasonex acts primarily on nasal tissues to reduce swelling and inflammation caused by allergens. It does this by suppressing multiple inflammatory substances like cytokines and leukotrienes. These substances are produced in response to allergen exposure leading to swelling of the nasal passages resulting in congestion and discomfort.

Therefore, while Zyrtec directly blocks one of the main chemicals responsible for causing allergy symptoms (i.e., histamine), Nasonex works more broadly at reducing inflammation within your nasal passages making both medications crucial tools for managing different aspects of your allergy symptoms.

What is Nasonex?

Nasonex, the brand name for mometasone furoate monohydrate, is a corticosteroid that reduces inflammation. It operates by preventing cells from releasing substances that cause allergic reactions or inflammation in the body. Nasonex was first approved by the FDA in 1997 and works as an intranasal spray to treat nasal symptoms of both seasonal (outdoor) and year-round (indoor) allergies.

Unlike Zyrtec, which is an antihistamine taken orally, Nasonex acts locally within the nasal passages without systemic absorption. This makes its side-effect profile different from most oral allergy medications; it rarely causes sedation and is less likely to interact with other drugs you may be taking. The localized treatment provided by Nasonex can be especially beneficial for those who struggle with persistent nasal allergy symptoms such as congestion, sneezing, itching or runny nose.

What conditions is Nasonex approved to treat?

Nasonex is a prescription nasal spray that has been approved by the FDA for the treatment of:

  • Seasonal allergic rhinitis, also known as hay fever
  • Perennial (year-round) allergic rhinitis
  • Nasal polyps in adults 18 and older

How does Nasonex help with these illnesses?

Nasonex, a corticosteroid, works by reducing inflammation in the nasal passages. It plays roles in many processes in the body, including regulating immune response and controlling symptoms associated with allergic reactions or colds such as congestion, sneezing and runny nose. Unlike Zyrtec which is an antihistamine that only blocks one allergic substance (histamines), Nasonex can control several substances at the cellular level involved in both early- and late-phase allergic reactions providing more comprehensive relief of allergy symptoms. Its action on inflammatory mediators may also contribute to its effectiveness as an anti-allergic agent. Since it does not usually cause drowsiness like some antihistamines (such as Zyrtec), it is sometimes prescribed when a patient needs to maintain alertness while managing their allergies.

How effective are both Zyrtec and Nasonex?

Cetirizine (Zyrtec) and mometasone furoate nasal spray (Nasonex) are both effective treatments for allergic rhinitis symptoms, however they were developed a decade apart with Zyrtec first being approved by the FDA in 1995 and Nasonex following in 2005. While both medications aim to alleviate allergy symptoms, they do so through different mechanisms of action. Cetirizine is an antihistamine that inhibits the inflammatory response triggered by histamines while mometasone furoate is a corticosteroid which reduces inflammation within the nasal passages.

There have been several comparison studies between these two drugs, including one conducted in 2008 where it was found that cetirizine was slightly more effective than mometasone at reducing overall symptom scores in patients suffering from hay fever. However, this difference was not considered statistically significant.

In terms of side effects, cetirizine has a well-documented safety profile with drowsiness being its most common adverse effect. On the other hand, Nasonex can occasionally cause minor nosebleeds or irritation within the nose but generally has fewer systemic side effects due to its localized application.

A systematic review published in 2016 indicated that nasal corticosteroids such as Nasonex may be more effective than oral antihistamines like Zyrtec at treating certain symptoms of perennial allergic rhinitis such as congestion. Nonetheless, many practitioners will often recommend using them together for comprehensive management of allergy symptoms. The data supporting their use individually or co-prescribed is robust making them popular choices among clinicians worldwide.

abstract image of a researcher studying a bottle of drug.

At what dose is Zyrtec typically prescribed?

Oral dosages of Zyrtec range from 5-10 mg/day, with studies indicating that a daily dose of 10 mg is typically sufficient for relieving symptoms of hay fever or other upper respiratory allergies in adults and children over six years old. For children aged two to five years, a lower starting dosage of 2.5 mg once per day may be used. If the response is inadequate after a week, the dosage can be increased up to the maximum recommended dose which should not exceed 10mg/day. On the other hand, Nasonex (Mometasone furoate) nasal spray strength is generally one spray (50 mcg of mometasone furoate in each spray) in each nostril once daily (total daily dose: 100 mcg). The dose may be increased to a maximum daily dose of two sprays in each nostril once daily (total daily dose: 200 mcg), depending on individual patient response and severity.

At what dose is Nasonex typically prescribed?

Nasonex treatment typically begins with a dosage of two sprays in each nostril once daily, totaling 200 mcg per day. The dose can then be increased to a maximum of four sprays in each nostril per day, or 400 mcg/day if symptoms are not adequately controlled. If the symptoms improve, the dosage can be reduced back to two sprays in each nostril daily. It's important not to exceed this recommended amount and always space your doses evenly throughout the day for optimal relief from allergy symptoms. As is standard procedure with any medication regimen, if there is no response after several weeks of treatment at an adequate dose level, re-evaluation by a healthcare professional would be warranted.

What are the most common side effects for Zyrtec?

Common side effects of Zyrtec, when compared to Nasonex, include:

  • Drowsiness/sleepiness
  • Dry mouth
  • Stomach pain (in some cases)
  • Diarrhea
  • Nausea or vomiting
  • Fatigue/ general weakness
  • Insomnia in a few cases

On the other hand, common side effects of Nasonex may consist of:

  • Headache
  • Viral infection such as flu syndrome
  • Coughing/pharyngitis
  • Sinusitis (inflammation of the sinus cavities in the head) -Nosebleed or sore throat

It is also worth noting that both medications could potentially lead to rare but serious side effects. Always consult with your healthcare provider for advice about potential risks and benefits before making any decisions on medication use.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Zyrtec?

While Zyrtec and Nasonex are both effective for managing allergies, some people may experience different side effects. For Zyrtec, these can include:

  • Severe drowsiness or confusion
  • Rapid heartbeat or fluttering in your chest
  • An allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat
  • Blurred vision, eye redness or itching
  • Difficulty passing urine

On the other hand with Nasonex, you should watch out for signs such as:

  • Nosebleeds
  • White patches inside your nose that don't heal even after using the medication over a period of time
  • Signs of a hormonal disorder: tiredness or weakness; feeling light-headed; nausea, vomiting; lack of appetite.

If any severe symptoms persist when using either drug it's important to consult with a healthcare provider immediately.

What are the most common side effects for Nasonex?

It's important to note that Nasonex, a nasal spray primarily used for allergy relief, can produce certain side effects which may include:

  • Headaches or dizziness
  • Nasal irritation or burning
  • Blood in the nose
  • Sore throat and coughing
  • Upset stomach or nausea
  • Viral infection (e.g., flu)
  • Nosebleeds
    While rare, more severe side effects such as vision problems and difficulty breathing should prompt immediate medical attention. Unlike oral medications like Zyrtec, Nasonex targets the nasal passages directly so systemic side effects like increased urination, tremors, weight loss are less likely. However everyone reacts differently to medication; always consult with your healthcare provider about potential adverse reactions before starting any new treatment regimen.

Are there any potential serious side effects for Nasonex?

While Nasonex is generally safe and effective for treating nasal allergies, some serious side effects may occur in rare cases. These can include:

  • Signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue or throat
  • Blurred vision, tunnel vision, eye pain or discomfort, or seeing halos around lights which are symptoms of a potential glaucoma or cataract
  • Sores in the nose that won't heal
  • Whistling sound from your nostrils (a symptom of a hole in the septum)
  • Flu-like symptoms including fever and chills
  • Changes in menstrual periods
  • Weight gain especially around your neck and shoulders

If you experience any of these signs after using Nasonex, stop its use immediately and seek medical help.

Contraindications for Zyrtec and Nasonex?

Both Zyrtec and Nasonex, like most antihistamines and corticosteroids, may worsen symptoms of certain medical conditions. If you notice any severe side effects or reactions after taking these medications, please seek immediate medical attention.

Neither Zyrtec nor Nasonex should be used if you are currently taking or have recently taken medications such as ritonavir (used in HIV/AIDS treatment) or ketoconazole (an antifungal medication). Always inform your physician about the medicines you are currently on; some drugs may require a washout period to clear from your system to avoid dangerous interactions with Zyrtec and Nasonex.

Moreover, those suffering from kidney disease must exercise caution when using Zyrtec, as dosage adjustment might be needed. On the other hand, patients with ongoing infections or eye diseases need to take care while using Nasonex due to possible worsening of their condition.

How much do Zyrtec and Nasonex cost?

For brand name versions of these drugs:

  • The price for a 30 count of Zyrtec (10 mg) typically averages around $18, which works out to approximately $0.60 per day.
  • The cost of Nasonex nasal spray (50 mcg) is higher, averaging around $200 for one bottle with 120 metered sprays. Depending on the frequency and dosage used, this could potentially work out to between $1.5 - $3/day.

Thus, if you require regular or frequent doses of Nasonex, then brand-name Zyrtec may be less expensive on a per-day treatment basis. However, please note that cost should not be a primary consideration in determining which medicine is right for your condition.

As far as generic versions are concerned:

  • Generic Cetirizine Hydrochloride (equivalent to Zyrtec) can range from about $10-$15 for a 30-count package depending on the store and location – which comes down to roughly $0.33 - $.050 per pill.
  • For mometasone furoate monohydrate equivalent to Nasonex nasal spray; it's available at an average price point close to that of its branded counterpart due to lack of multiple manufacturers in the market—falling between approximately ~$130-$180 on average.

Remember that individual prices can vary based upon insurance coverage and pharmacy choices.

Popularity of Zyrtec and Nasonex

Cetirizine, in generic form as well as brand names such as Zyrtec, was estimated to have been prescribed to about 5 million people in the US in 2020. Cetirizine accounted for just over 15% of antihistamine prescriptions in the US. It is classified as a second-generation antihistamine which results in less drowsiness than first-generation ones and has seen its use steadily increase since it became available over-the-counter.

Mometasone furoate nasal spray, including brand versions such as Nasonex, was prescribed to approximately 3.2 million people in the USA during that same year. In the U.S., mometasone furoate accounts for around 12% of intranasal corticosteroid prescriptions used mainly for allergies and sinusitis treatment. The prevalence of mometasone furoate has been relatively stable over recent years.


Both Zyrtec (cetirizine) and Nasonex (mometasone furoate monohydrate) are effective in the management of allergy symptoms, with a long-standing record of usage and numerous clinical studies indicating that they are more effective than placebo treatments. Both have different mechanisms of action - Zyrtec is an antihistamine which works by blocking histamines to reduce allergy symptoms while Nasonex is a corticosteroid nasal spray that reduces inflammation in the nasal passages.

Zyrtec could be considered as first-line oral treatment for immediate relief from common allergic reactions including sneezing, itching, watery eyes, and running nose. On the other hand, Nasonex is generally used regularly to manage chronic or seasonal allergies and its effects may not be noticeable right away. It can also be prescribed for treating nasal polyps.

Both drugs come in generic form offering significant cost savings especially for patients who must pay out-of-pocket. The side effect profile is somewhat similar between the two drugs - both being generally well-tolerated but with Nasonex potentially causing irritation or burning sensation within the nostrils due to its delivery method. For both drugs, it's important that patients follow their healthcare provider's instructions closely when starting treatment and report any adverse effects immediately.