The Best Allergy Medicine for Itchy Eyes, a Runny Nose and Sneezing: Top OTC Picks Ranked

Spring allergy season is here—and if you’re one of the millions dealing with a runny nose, itchy eyes and endless sneezing, you’re probably wondering: What’s the best allergy medicine for me? To find out, we decided to pit the most popular over-the-counter options against each other in a head-to-head battle. Our expert judge: board-certified ENT and founder of SoCal Breathe Free Sinus & Allergy Centers, Matt Hershcovitch, MD. 

Dr. Hershcovitch was decisive, he was fair and he did not hold back. Keep reading to see how your tried-and-true allergy med stacked up—and if a new med might be right for you.

How does allergy medicine work?

Making their way into the ring for this Battle of the Best Allergy Meds are over-the-counter- (OTC) treatments including Zyrtec (cetirizine), Xyzal (levocetirizine), Allegra (fexofenadine), Claritin (loratadine) and Benadryl (diphenhydramine). 

Woman's World Answers

What do uterine fibroid symptoms look like after menopause? What are the top heart health concerns for women over 50? What’s the best bread for weight loss? What’s the best sugar-free candy for weight loss? Is fasting during perimenopause safe? What do uterine fibroid symptoms look like after menopause? What are the top heart health concerns for women over 50? What’s the best bread for weight loss? What’s the best sugar-free candy for weight loss? Is fasting during perimenopause safe?

Is melatonin safe? Are estrogen therapy and hormone therapy safe? What’s going on with Dolly Parton’s health? What do skid marks in my underwear mean? What causes cataracts? Is melatonin safe? Are estrogen therapy and hormone therapy safe? What’s going on with Dolly Parton’s health? What do skid marks in my underwear mean? What causes cataracts?

Powered by

They’re all antihistamines, and they all work essentially the same way, explains Dr. Hershcovitch. How? By temporarily blocking histamines, a chemical released by the immune system to flush dangerous invaders from the body via sneezing, a runny nose and watery eyes. It can be a lifesaving response—but for those with seasonal allergy symptoms, the immune system mistakes harmless allergens like pollen or ragweed as threats. So it’s usually safe to use antihistamines as long as you follow directions on packages and from your doctor. (Learn how a low-histamine diet may help with allergies too.)

Still, each antihistamine has unique benefits and drawbacks. The best one for you “depends on what your biggest issues are,” says the doc.  

Wellness

I Tried Local Honey for My Seasonal Allergies—Now I’m 50 & Symptom-Free!

After a decade of dealing with sneezing, congestion and itchy eyes, Sonal Bhatia, 50, realized her seasonal allergies only seemed to get worse with each passing year (and it’s not just a problem in the springtime—fall allergies can even be worse.) And while traditional over-the-counter allergy medications helped, they also triggered brain fog that made […]

Round 1: The best allergy medicine for fast relief 

• Winner: Zyrtec (kicks in within 20 to 30 minutes)
• Runner-up: Benadryl (30 minutes to 1 hour)
• Honorable mention: Xyzal and Allegra: 1 to 2 hours
• Last place: Claritin: 1 to 3 hours

The verdict: “Zyrtec is definitely the fastest, with its peak effect usually occurring within 20 to 30 minutes. However, Benadryl is not far behind it,” says Dr. Hershcovitch. When the speed of relief matters, they’re your best bets.

Round 2: Best allergy medicine for itchy eyes and sneezing

• Winner: Zyrtec
• Runner-up: Xyzal
• Honorable mentions: Benadryl and Allegra
• Last place: Claritin

The verdict: A study in Allergy and Asthma Proceedings backs up Zyrtec’s win here. In one well-known clinical trial, Zyrtec outperformed Allegra on itchy, watery eyes, delivering 26% better symptom relief at the 12-hour mark. A separate study found that Xyzal outlasted Allegra too, with stronger relief around the 24-hour mark. In other words, both Zyrtec and Xyzal deliver stronger, longer-lasting relief than Allegra when your eyes are itchy and watery.

But don’t discount Benadryl for occasional use. “If your problems are mostly at night, that’s probably a good one to use,” says Dr. Hershcovitch. As for Claritin? It brings up the rear. “It’s slightly less effective overall,” says Dr. Hershcovitch.

Round 3: Best allergy medicine for a runny nose and breathing trouble

• Winner: Flonase (nasal spray)
• Runners-up: Zyrtec and Xyzal
• Last place: Benadry, Allegra and Claritin

The verdict: This round has a surprise guest crashing the party. “Overall, oral antihistamines are not very good at helping with nasal congestion and trouble breathing,” reveals Dr. Hershcovitch. “You’re better off using a topical nasal spray like Flonase or the generic fluticasone—it will be a lot more effective.” Among the oral options, Zyrtec and Xyzal still outperform the rest. “They’re usually much better than Allegra in terms of drying you out,” he adds. If a stuffy nose is your main complaint, consider pairing an antihistamine with a nasal spray.

Round 4: The best allergy medicine with the fewest side effects

• Winner: Allegra
• Runner-up: Claritin
• Honorable mention: Xyzal
• Last place: Benadryl and Zyrtec

The verdict: “The way antihistamines work is the more sedating the profile, the more powerful it is,” explains Dr. Hershcovitch. “Zyrtec probably has the most side effects, short of Benadryl.” (Benadryl shouldn’t be used long term. And if you’re 65 or older, be extra careful: Benadryl can make you unsteady on your feet.) The good news? “Xyzal has similar effectiveness as Zyrtec but is less sedating. So if you get sedation from Zyrtec, you’re probably better off using Xyzal.” And if other meds make you too drowsy and your allergies are on the mild side, “Allegra’s probably your best bet.”

Round 5: Best generic allergy medicine for cost savings 

• Winner: Claritin (loratadine) — ~18¢ per tablet
• Benadryl (diphenhydramine) — ~4¢ (but more doses needed)
• Zyrtec (cetirizine) — ~24¢
• Xyzal (levocetirizine) — ~28¢
• Allegra (fexofenadine) — ~30¢

The verdict: (Diphenhydramine) Benadryl costs the least per dose, but it’s also shorter-acting than Zyrtec, Xyzal or Allegra, which all last a full 24 hours. So Claritin wins on price. But the Zyrtec generic may offer better value, balancing cost with stronger symptom relief. 

Weight Loss

These Teas Ease Allergies Naturally, Plus the Timing Trick That Boosts the Benefit

It's the most soothing way to banish sniffling, sneezing and itchy eyes

The bottom line

Deal of the Day

This Deep Conditioning Collagen Hair Mask for Has 4.9 Stars and Is 80% Off — Get It for $20! View Deal

No matter the intensity of your symptoms, you have great options. “For overall use, Zyrtec and Xyzal are probably your better choices for severe allergies,” says Dr. Hershcovitch. “Zyrtec is pretty quick-acting, and the only downside is that it’s the most sedating. Xyzal doesn’t have that problem as much, but it’s a little more expensive.”

What if nothing available over the counter is making you feel better? Talk to your doctor. “It’s fine to start with your primary care provider,” says Dr. Hershcovitch. “However, if symptoms continue despite prescription intervention, I would seek the care of a specialist like an allergist or an otolaryngologist. If something feels like it could be better, keep pushing for a better solution.” Your nose and your eyes will thank you!

Ready for more inspiration? Subscribe to our YouTube channel for video podcasts, health tips and uplifting stories designed for women 40, 50, 60 and beyond.