Xyzal--Just overpriced Zyrtec

Implications:  A bottle of 30 Generic Zyrtec can be purchased for $15.  No one is going to get Xyzal that inexpensively. There are no head to head studies showing Xyzal to be better than Zyrtec.  Even though Xyzal claims a 6% sedation rate compared to Zyrtec's 14% rate, it's not apples to apples.  In the Zyrtec study, placebo made 8% sleepy, whereas placebo only made 2% sleepy in the Xyzal study. Thus, either way, the drug was much more sedating than the placebo.

Analysis:

 

Xyzal is no better than other antihistamines for tough to treat hives (urticaria).  What is an example of tough-to-treat hives?  How about familial cold urticaria.  When it gets cold, these poor folks get itchy hives popping up all over.  An old drug, Periactin, is about all that works.  Singulair was supposed to help a little, but doesn't reliably. Now comes Xyzal, telling us it's the best antihistamine ever.  After all, Xyzal is based on Zyrtec, and Zyrtec beat Allegra in each and every quantitative competition (where they saw which one inhibited allergy skin tests the most)         

But Xyzal suffered a knockout punch by all three of my familial cold urticaria patients.  It worked no better than Zyrtec, Allegra or Claritin.  And all of those are available as Generics.