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Medically reviewed by, Russell Braun RPH
Are your eyes constantly itching and burning? Dry, itchy eyes affects an estimated 15-25% of the population! That is between 50 to 85 million people each year.
Do you wonder how can you get rid of itchy eyes fast? Symptoms can last anywhere from a few days to years depending on the allergen. Consequently, the symptoms lead to a disruption of daily life that leaves many looking to self medicate with drugs sold Over The Counter (OTC). That leaves many asking, which is better Zaditor vs Alaway?
1. What Are Itchy Eyes A Sign Of?
Itchy eyes are typically a sign of allergies. The medical term for this is allergic conjunctivitis, which simply means inflammation around the eyes. These allergic reactions can be one of two types.
- Seasonal allergies
Most common in the spring and fall when plants release large amounts of pollen.
2. Perennial allergies
These are allergies that persist throughout the year. They are more likely due to dust, dander and mold (think allergies to things indoors).
Zaditor and Alaway have long been marketed for these types of allergies. In this post we will compare these medications to answer the big question. Which of them is the better option Zaditor vs Alaway?
However, no healthcare professional should jump right into medication without first reviewing a few basic non medication tips.
2. Before Any Medication Try Lifestyle Changes!
Similar to most things in life, the choices you make can affect how severe your eye allergy symptoms are. These lifestyle changes can help lower your allergy risk and therefore the amount of medication you may need.
Knowing what triggers allergies is a key to keeping them under control. Journaling on allergy symptoms can be a cheap alternative to seeing an allergist to have tests run. I outline how to bullet journal medication effects and doing the same for allergy symptoms will have you identifying your triggers quickly.
Environment
Seasonal allergies
- Avoid being outside mid morning or early evening.
- Remember wind can blow pollens around, avoid outdoor activity on windy days.
- Limiting total time outdoors.
- Wear a hat with wide brim outside.
- Sunglasses can help keep allergens out of eyes.
- Use saline drops after being outside to wash eyes out.
Perennial allergies
- Have your home checked for mold.
- Vacuum with a HEPA filter
- Replacing furniture or pillows that can carry dust mites or feathers.
- Avoid houses with pets.
Hygiene
- Shower shortly after coming inside especially during high pollen times.
- Avoid touching and rubbing eyes.
- When having allergy problems try to avoid wearing contacts.
- Wash hands frequently with soap and water.
- Wash bed linens more frequently.
- Pets that go outside should be bathed more often.
Sleep
Get 7-9 hours of sleep
- Sleepfoundation.org recommends adults be in this range for optimal health.
- Keep bedroom windows closed.
Vises
Don’t smoke
- Small particles in cigar and cigarette smoke can cause allergic reactions in the eyes.
A great resource on what to do and not do if you suffer from dry eyes is the book Dry Eye Remedy.
3. How Do Antihistamine Eye Drops Like Zaditor and Alaway Work?
In a nutshell, antihistamine eye drops contain an active ingredient known as ketotifen. It’s a type of antihistamine that can stabilize mast cells and block the H1-histamine receptor. By blocking histamine and stabilizing mast cells it calms down the immune system reaction that causes itching.
Normally histamine and mast cells produce more chemicals that lead to itching and inflammation. It can become a process that keeps escalating as the body try to fight off the stimulus it sees as an allergen.
Using antihistamine eye drops quickly stops this process and prevents the need for taking oral medications. Those pills can have unwanted side effects.
4. Zaditor
Zaditor contains ketotifen fumarate 0.035% as the active ingredient. It is considered to be a second generation antihistamine because it is selective for the H1 receptor. There are several types of histamine receptor in the body.
| Brand name | Generic name | Strength | |
| Zaditor | Ketotifen fumarate | 0.035% |  |
Zaditor has been on the market since 1999 and is considered to be safe as it has been used by millions of people. Originally it was a prescription only product. However, the manufacturer changed it to an over the counter product in 2006.
Directions for use are to use one drop in each eye every 12 hours. This is exciting news if you do not enjoy using eye drops. Other products have to be used more frequently.
Zaditor Pros:
- Proven to be significantly better than placebo at preventing ocular itching.
- Works within minutes after applying to the eye.
- Only a small amount of the drug that gets out of the eye. Therefore, other side effects are less likely to occur.
- Other antihistamine eye drops do not last for 12 hours like Zaditor does. They must be dosed frequently, usually ever 6 hours.
- Does not contain any other active ingredients. Vasoconstrictors in some other eye drops can cause rebound effect if used too often.
Zaditor Cons:
- May cause daytime drowsiness, a side effect of the antihistamine.
- Antihistamines can cause side effects such as dry mouth, dry eyes and constipation.
- Can cause headache and runny nose.
- Should not be used for contact lens related eye problems.
Zaditor Cost:
- One 5ml (milliliter) bottle of Zaditor cost ~$12.00
- 5ml equals 100 drops, if using 1 drop in each eye twice a day one bottle is a 25 day supply.
- Buying the generic ketotifen is normally a cheaper option.
**Prices subject to change.
5. Alaway
Alaway contains ketotifen 0.025% as the active ingredient. This is equivalent to ketotifen fumarate 0.035%. Alaway is also considered to be a second generation antihistamine because it is selective for the H1 receptor.
| Brand name | Generic name | Strength | |
| Alaway | Ketotifen | 0.025% |  |
Alaway was brought to market after Zaditor was made OTC. There were bioequivalance studies done to show it produced the same amount of ketotifen in the eye as Zaditor. Alaway has always been an OTC product only.
The key takeaway is that Alaway and Zaditor are essentially the same product. The only difference being that Alaway is does not have the fumarate salt form of ketotifen. This makes the concentration of the active ingredient slightly different. However, this is not a reason to recommend one product over the other.
Directions for use are the same for Alaway as well. One drop in each affected eye every 12 hours.
Alaway Pros:
- Is typically cheaper than Zaditor.
- Only a small amount of the drug that gets out of the eye. Therefore, other side effects are less likely to occur.
- Other antihistamine eye drops do not last for 12 hours like Alaway does. They must be dosed frequently, usually ever 6 hours.
- Does not contain any other active ingredients. Vasoconstrictors in some other eye drops can cause rebound effect if used too often.
Alaway Cons:
- May cause daytime drowsiness, a side effect of the antihistamine.
- Antihistamines can cause side effects such as dry mouth, dry eyes and constipation.
- Can cause headache and runny nose.
- Should not be used for contact lens related eye problems.
Alaway Cost:
- One 5ml (milliliter) bottle of Alaway cost ~$5.50
- 5ml equals 100 drops, if using 1 drop in each eye twice a day one bottle is a 25 day supply.
- Alaway is a cheaper option than Zaditor.
**Prices subject to change.
6. Zaditor vs Alaway: The Similarities
In a general sense, these two products are very similar to each other. The main similarity is that the active ingredient is ketotifen. The difference in salt form in this case does not change how the drug works. As we mentioned above, the antihistamine effects of ketotifen with a long duration of action make this effective in treating eye allergy symptoms.
Another similarity is they are equivalent in strength. Even though Zaditor is 0.035% and Alaway is 0.025%. They both wind up providing the same amount of ketotifen in the eye. They are essentially the same drug.
Zaditor is available in combination backs where buying in bulk can bring the price down. This would be a good idea if you know that you will use the product for more than one month. Meanwhile, Alaway is sold in a 10ml bottle that provides a two month supply. In some cases you may find combination packs of those as well. Comparison shopping is a good idea to find the best deal.
7. Zaditor vs Alaway: The Differences
When it comes to differences, the salt form is the primary thing that is different. Zaditor, contains ketotifen fumarate. Alaway does not have the fumarate salt form. Again, this does not make a large difference between the two products.
Zaditor vs Alaway FAQs
Q: Are Zaditor and Alaway the same?
As noted above Zaditor and Alaway are very similar. Zaditor was the first product produced and it went from prescription to over the counter status. After that Alaway was created and has shown to be equivalent to Zaditor.
Q: Is Alaway an OTC?
Yes, Alaway is sold over the counter (OTC). In fact, Bausch + Lomb the manufacturer of Alaway never sold it as a prescription. It has always been OTC.
Q: Is it safe to use Zaditor everyday?
Zaditor has been approved by the Food and Drug Administration (FDA) for the temporary relief of eye allergy symptoms. It is safe to use every day and generally that will be during high allergy times. If you plan to use it for longer than those times when allergies are bad (more than three to four weeks) consult with your doctor.
It is also important to remember that using this product twice a day consistently will provide the most benefits. If you can’t remember to take it consistently set a timer on your phone or some other type of reminder.
Q: What are the side effects of Zaditor?
Zaditor has been proven safe for use, and this is a large reason why it can be sold over the counter. Millions of people have used Zaditor since it was released in 1999. Keep in mind there still can be side effects the most common ones include:
| Red eyes | Headache |
| Eye burning & pain | Runny nose |
| Sensitivity to light | Inflammation of the cornea |
| Eyelid pain | Dilation of the pupil |
Key points to remember for Zaditor and Alaway
- If symptoms get worse, or new symptoms appear, consult your doctor or pharmacist.
- Talk to your pharmacist before taking other Over The Counter Medications.
Q: Can I use other eye drops with Zaditor or Alaway?
Both of these products contain ketotifen, which is an antihistamine. Therefore, you should make sure that any other product you take does not also have an antihistamine. To be sure ask your pharmacist.
Another type of eye drop commonly used for allergy symptoms are called decongestants. These decongestant eye drops reliever congestion by narrowing blood vessels. This is sometimes called vasoconstriction. This reduces mucus formation and redness.
Decongestants are sold generically under the following names:
| Naphazoline | Phenylephrine |
| Oxymetolazine | Tetrahydrozoline |
These four ingredients are sold as the active ingredient in many different brand names of eye drops. Check the label before you buy! Again, make sure it does not contain a combination of decongestant and antihistamine if you are already using Zaditor or Alaway.
Q: Which antihistamine is best for itchy eyes?
There are numerous different antihistamine eye drops available. They all act in a similar way by blocking histamine receptors. However, there are differences because some do a better job of blocking histamine or work on different forms of the histamine receptor.
Typically the prescription anthisitamine drops will work better than OTC options. However many times insurance companies will want you to try the OTC before they will pay for prescription options.
A comparison study was done on ketotifen vs olopatadine, the generic form of Pataday. It was a small study that found olopatadine to be better than ketotifen at improving itching, burning and tear production. Other allergy symptoms showed no difference. Therefore, OTC olopatadine may be a good option to try also.
Generics
Even though we are comparing Zaditor and Alaway, it is important to remember that generic Zaditor is also available. Generics have been shown by the FDA to be equivalent to the brand name product. Currently, Zaditor has a generic and Alaway does not.
| Product | Strength | |
| Ketotifen fumarate (Generic Zaditor) | 0.035% |  |
BestRxforSavings Tip: Use the generic to get the best overall price, about $4.50 for a month supply.
Q: What is the best OTC allergy eye drops?
Reading reviews from online sights or forums about medications for eye allergies is one way to get your information. A better way is to listen to recommendations from reputable and authoritative organizations.
The American Academy of Allergy Asthma and Immunology (AAAA&I) is that organization when it comes to medication for eye allergies. They recommend OTC antihistamine eye drops as the first option for short term treatment of eye allergies.
Due to the dual blocking of histamine receptors and stabilizing mast cells these make the most sense to start off with. If your symptoms are long lasting then other prescription medications can be tried such as:
- Steroid eye drops
- Allergy shots
Q: What is a natural remedy for itchy eyes?
Aside from the lifestyle changes mentioned above, some natural remedies can work well. Some of these include:
| Cool compress either a hand towel or custom compresses |  |
| Humidifier |  |
| 20-20-20 Rule | After 20 minutes of viewing screens, then Look at something 20 feet away For at least 20 seconds. |
In Conclusion
Zaditor and Alaway both contain ketotifen and are virtually identical. The only real difference is how much they cost, Alaway is the cheaper of the two. However, some generic forms of Zaditor that come in large quantities may be the lowest cost option.
Final verdict
1. Be smart and use lifestyle changes to keep eye allergies under control.
2. Alaway or generic Ketotifen should be the first eye drops you reach for.
3. Other natural remedies can help you deal with symptoms.
4. Finally, prescription strength options your doctor prescribers are the other way to keep symptoms under control.
Click here to get Dr. Jason Reed’s exclusive list of medication questions you MUST ask your doctor, for FREE!
Share your story
Have you used Zaditor or Alaway? Also, please share how they worked for you. Chime in below with your comments and thoughts.