From the Guidelines
Cetirizine (Zyrtec) may provide better symptom relief for many people with allergic rhinitis compared to loratadine (Claritin), although both medications are effective. When considering the treatment of allergic rhinitis, it's essential to weigh the benefits and risks of each medication.
- Cetirizine typically works faster (within 1 hour) and may be more effective for nasal congestion compared to loratadine, which may take up to 3 hours to start working 1.
- The standard dose for both medications is 10mg once daily.
- Cetirizine is more likely to cause drowsiness (in about 10-15% of users) compared to loratadine (which rarely causes drowsiness) 1.
- If you need to drive or perform tasks requiring alertness, loratadine might be preferable, especially when first starting treatment.
- Both medications can be taken with or without food.
- For severe allergies, cetirizine might be the better choice due to its stronger effect, while loratadine may be better for mild symptoms when drowsiness is a concern.
- It's also important to note that intranasal corticosteroids are the most effective medication class in controlling symptoms of allergic rhinitis, and may be considered as an alternative or additional treatment option 1.
- A recent study found that the combination of an intranasal corticosteroid and an intranasal antihistamine may be recommended for initial treatment of moderate to severe seasonal allergic rhinitis 1.
- Ultimately, the choice between cetirizine and loratadine should be based on individual patient needs and preferences, taking into account factors such as symptom severity, lifestyle, and potential side effects.
From the Research
Comparison of Cetirizine and Loratadine for Allergic Rhinitis
- Cetirizine and loratadine are both antihistamines used to treat allergic rhinitis, but their effectiveness can vary.
- A study published in 1998 2 found that cetirizine produced a 36.7% mean reduction in total symptom complex scores, compared to 15.4% with loratadine and 12.0% with placebo.
- Another study published in 2001 3 confirmed these results, finding that cetirizine had a faster onset of action and greater symptom relief than loratadine.
- In contrast, a study published in 1994 4 found that loratadine was as effective as cetirizine in patients with allergic rhinitis, but this study did not directly compare the two medications.
Onset of Action
- The onset of action for loratadine tablets was found to be 75 minutes in a post hoc analysis published in 2018 5.
- Cetirizine has been shown to have a faster onset of action, with significant symptom relief within 1 hour 2, 3.
- Loratadine has been found to have a slower onset of action, with significant symptom relief within 3 hours 2, 3.
Efficacy
- Cetirizine has been shown to be more effective than loratadine in reducing symptoms of seasonal allergic rhinitis 2, 3.
- Loratadine has been found to be as effective as other antihistamines, such as azatadine and terfenadine, in relieving symptoms of allergic rhinitis 4, 6.
- Both cetirizine and loratadine have been found to be well-tolerated, with similar incidence of adverse events 4, 2, 3, 6.