Comprehensive medication guide to Zyrtec-D XR including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$30 copay for cetirizine/pseudoephedrine ER with a valid prescription on qualifying commercial plans; most insurance plans and Medicare Part D do not cover OTC products without a prescription.
Estimated Cash Pricing
$25–$30 retail for brand Zyrtec-D XR (24-count box); generic cetirizine/pseudoephedrine ER available for as low as $6.42 with a GoodRx coupon for a 12–24 tablet supply.
Medfinder Findability Score
80/100
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Zyrtec-D XR is an over-the-counter extended-release combination tablet containing cetirizine hydrochloride 5 mg (a second-generation antihistamine) and pseudoephedrine hydrochloride 120 mg (a nasal decongestant). Each tablet provides up to 12 hours of relief from allergy symptoms and nasal congestion.
Manufactured by Kenvue Brands LLC (formerly Johnson & Johnson Consumer), Zyrtec-D XR is FDA-approved for the temporary relief of symptoms due to hay fever (seasonal allergic rhinitis) and other upper respiratory allergies, including runny nose, sneezing, itchy and watery eyes, itching of the nose or throat, and nasal and sinus congestion.
While available OTC, Zyrtec-D XR must be stored behind the pharmacy counter due to its pseudoephedrine content, per the Combat Methamphetamine Epidemic Act of 2005. Purchasers must present a government-issued photo ID and sign an electronic log. Generic versions (cetirizine/pseudoephedrine ER 5mg/120mg) are widely available and bioequivalent.
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Zyrtec-D XR works through two distinct mechanisms. Cetirizine is a selective histamine H1 receptor antagonist — it occupies and blocks H1 receptors in the nasal passages, eyes, and skin before histamine can bind to them, preventing the allergic inflammatory cascade that causes sneezing, itching, runny nose, and watery eyes.
Pseudoephedrine is a sympathomimetic amine that stimulates alpha-adrenergic receptors in nasal blood vessels, causing vasoconstriction. This shrinks the swollen tissue lining the nasal passages, opening the airway and relieving congestion and sinus pressure. It acts systemically (through the bloodstream), which is why it can also raise blood pressure.
The extended-release bilayer tablet formulation delivers cetirizine rapidly (Tmax ~2.2 hours) and pseudoephedrine in a sustained manner (Tmax ~4.4 hours), providing consistent 12-hour coverage from a single dose. This reduces dosing frequency and provides steadier symptom control compared to immediate-release formulations.
5 mg / 120 mg — extended-release oral tablet
Cetirizine HCl 5 mg + Pseudoephedrine HCl 120 mg extended-release bilayer tablet. Take 1 tablet every 12 hours; max 2 tablets per 24 hours. Swallow whole — do not cut, crush, or chew.
Zyrtec-D XR is generally available but can be harder to locate than standard OTC products. It is not on the FDA's official drug shortage list, but localized stockouts are common — particularly during spring allergy season (February–May) and fall ragweed season (August–October). Federal law (the Combat Methamphetamine Epidemic Act of 2005) requires all pseudoephedrine products to be stored behind the pharmacy counter, which limits pharmacy inventory and means online purchasing is prohibited.
If you can't find Zyrtec-D XR at your local pharmacy,
medfinder is a paid service that calls pharmacies near you to check which ones currently have your medication in stock and texts you the results. This eliminates the need to call pharmacy after pharmacy and makes finding Zyrtec-D XR much less frustrating during peak allergy season.
Zyrtec-D XR is not a controlled substance, so any licensed healthcare provider with prescribing authority can write a prescription for cetirizine/pseudoephedrine ER. While a prescription is not required to purchase Zyrtec-D XR OTC, having one can help with insurance coverage and pharmacy sourcing, especially when OTC supply is limited.
Primary Care Physicians (PCPs): Family medicine and internal medicine doctors — the most common prescribers for allergy medications
Allergists and Immunologists: Specialists who can evaluate allergic disease comprehensively and manage complex or chronic cases
Otolaryngologists (ENT specialists): Ear, nose, and throat doctors who manage chronic rhinitis and nasal congestion
Nurse Practitioners (NPs) and Physician Assistants (PAs): Authorized to prescribe in all 50 states; widely available at urgent care and primary care settings
Pediatricians: For children 12 and older; may also provide guidance for children under 12 if medically appropriate
Telehealth is a convenient option for obtaining a Zyrtec-D XR prescription when in-person visits are not feasible. Platforms such as Teladoc, MDLive, and Sesame offer same-day virtual consultations with licensed providers who can evaluate allergy symptoms and prescribe cetirizine/pseudoephedrine ER for adults 18 and older.
No. Zyrtec-D XR is not a DEA-scheduled controlled substance. It does not require a prescription and does not have the prescribing restrictions associated with controlled substances.
However, the pseudoephedrine component is classified as a
DEA List I Chemical under the Combat Methamphetamine Epidemic Act of 2005 (CMEA). This means all pseudoephedrine-containing products must be sold from behind the pharmacy counter (not from open shelves), purchasers must show a valid government-issued photo ID, sign an electronic logbook, and adhere to federal purchase limits (3.6 g pseudoephedrine per day; 9 g per 30-day period). Online direct-to-consumer sales of pseudoephedrine products are prohibited.
Drowsiness or sleepiness
Dry mouth
Insomnia or difficulty sleeping
Nervousness or restlessness
Headache
Dizziness
Nausea
Fatigue
Severely elevated blood pressure (severe headache, blurred vision, chest pain)
Fast or irregular heartbeat (palpitations, tachycardia, arrhythmia)
Severe allergic reaction (hives, swelling of face/lips/tongue/throat, difficulty breathing — call 911)
Seizures
Difficulty urinating (especially in men with enlarged prostate)
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Claritin-D (loratadine/pseudoephedrine)
Non-drowsy antihistamine + same decongestant. Available as 12-hour or 24-hour extended-release. Good alternative for patients who find cetirizine too sedating.
Allegra-D (fexofenadine/pseudoephedrine)
Non-drowsy; fexofenadine has the lowest sedation risk of any second-generation antihistamine. Available as 12-hour extended-release. Do not take with fruit juice.
Fluticasone nasal spray (Flonase)
Intranasal corticosteroid; preferred first-line for chronic allergic rhinitis. No cardiovascular side effects; safe for patients with hypertension. Takes several days to reach full effect.
Montelukast (Singulair)
Leukotriene receptor antagonist; prescription required; addresses both allergic rhinitis and asthma. FDA boxed warning regarding neuropsychiatric effects (mood changes, sleep problems).
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MAO Inhibitors (phenelzine, tranylcypromine, selegiline, isocarboxazid)
majorAbsolutely contraindicated. Combination with pseudoephedrine can cause acute hypertensive crisis. Avoid for at least 14 days after stopping an MAOI.
Antihypertensive medications (methyldopa, mecamylamine, reserpine, beta-blockers)
moderatePseudoephedrine may counteract blood pressure-lowering effects. Monitor blood pressure carefully; consider alternatives without pseudoephedrine.
Digoxin
moderateConcomitant use can increase ectopic pacemaker activity, potentially causing cardiac arrhythmias. Avoid unless cleared by cardiologist.
Tricyclic antidepressants (amitriptyline, nortriptyline, imipramine)
moderateCan amplify cardiovascular stimulant effects of pseudoephedrine (increased blood pressure and heart rate). Avoid or use under strict medical supervision.
CNS depressants (benzodiazepines, opioids, sleep aids, muscle relaxers, alcohol)
moderateAdditive CNS depression with cetirizine component. Increases drowsiness and impairs driving ability. Avoid alcohol.
Other sympathomimetics (ADHD stimulants, diet pills, phenylephrine)
moderateAdditive cardiovascular stimulant effects with pseudoephedrine. May significantly elevate blood pressure and heart rate.
Zyrtec-D XR is a well-established, effective OTC medication for patients who suffer from both allergy symptoms and nasal congestion. Its combination of a second-generation antihistamine (cetirizine) and a nasal decongestant (pseudoephedrine) in an extended-release formulation provides convenient 12-hour coverage with a single tablet.
The main challenges patients face with Zyrtec-D XR are access-related: federal pseudoephedrine regulations require behind-the-counter storage and prohibit online sales, making it harder to find than standard OTC products — especially during peak allergy season. Generic versions (cetirizine/pseudoephedrine ER 5mg/120mg) are clinically equivalent and often more widely available at significantly lower cost.
If you're struggling to locate Zyrtec-D XR at your local pharmacy,
medfinder is a paid service that calls pharmacies near you to find which ones have it in stock — saving you the time and frustration of searching on your own.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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