Loratadine alternatives: which one fits your allergies?

If loratadine stopped working for you, made you drowsy, or you just want other options, there are several good choices. Some work faster, some control congestion better, and some are gentler for kids or people with liver issues. Below I’ll walk you through practical alternatives and when to try them.

Oral antihistamines — quick comparison

Cetirizine (Zyrtec) is a common step up from loratadine. It often starts working within an hour and can give stronger symptom relief, but it can cause mild drowsiness in some people. Typical adult dose is 10 mg once daily.

Fexofenadine (Allegra) is another non-sedating option. It’s less likely to make you sleepy and works well for sneezing and itching. Usual doses are 60 mg twice daily or 180 mg once daily. It also has fewer interactions with other drugs.

Desloratadine (Clarinex) is the active metabolite of loratadine. It can work when loratadine doesn’t, and it’s taken as 5 mg once daily. People who have liver problems sometimes prefer desloratadine because it’s handled differently by the body.

Levocetirizine (Xyzal) is a purified form of cetirizine. It’s often more potent at lower doses (usually 5 mg once daily) and can control symptoms that other antihistamines miss, but it has a slightly higher chance of causing drowsiness.

For short-term severe symptoms, first-generation antihistamines like diphenhydramine (Benadryl) work fast but cause strong sedation and shouldn’t be used long-term for daily allergy control.

Other effective options to consider

Intranasal corticosteroid sprays (fluticasone, mometasone, budesonide) are the best choice if nasal congestion is your main problem. They reduce inflammation and prevent symptoms when used daily. Start using them a few days before allergy season for best results.

Intranasal antihistamines (azelastine) start working faster than oral pills and help runny nose and sneezing. Eye drops (olopatadine) are useful if itchy, red eyes are your top complaint.

Montelukast (Singulair) is a leukotriene receptor blocker that helps nasal congestion and asthma-related symptoms. It can be useful if you have both asthma and allergies, but discuss possible mood or sleep changes with your doctor.

Nasal cromolyn is a safe, low-risk option for pregnancy and kids; it prevents mast cells from releasing histamine but needs multiple daily doses and works best if started before symptoms begin.

Non-drug moves also help: saline rinses, avoiding triggers, HEPA filters, and timing outdoor activities around pollen counts. If over-the-counter choices fail, allergen immunotherapy (shots or sublingual tablets) can reduce sensitivity over time.

If you’re switching meds, check interactions, pregnancy status, age, and liver or kidney issues. Talk to your doctor or pharmacist before changing treatments—especially for children, pregnant people, or if you take other medications.

Want a quick rule of thumb? Try fexofenadine if you need a low-sleep risk option, cetirizine/desloratadine if you need stronger day-to-day control, and add a nasal steroid when congestion is the main issue.