Ask the Pharmacist: What Type of Allergy Medication Should I Use?
Since allergy season is here, how do I know what type of allergy medication to use?
There are a variety of prescription and over-the-counter medications designed to alleviate the symptoms of seasonal and perennial (year round) allergies. Most seasonal allergies are caused by pollen that plants release in the spring, summer, or autumn.
The most effective treatment for nasal symptoms, such as stuffy/runny nose and sneezing, is steroid nasal sprays. These medications all require a prescription. Examples include fluticasone (generic Flonase®), flunisolide (generic Nasalide®), and Nasonex®, among others. They work by reducing inflammation in the nasal and sinus areas. You must use them daily to get the proper effect, as they are not meant to be used just as needed. It takes a few days to see the benefit.
The most popular treatments are oral antihistamines and oral decongestants. Many such medications are available without a prescription, including many that formerly were prescription only. When your body identifies an allergen, it attacks it; part of that attack includes the release of a substance called histamine. Histamine is responsible for many allergy symptoms, such as itchy nose/eyes, runny nose, excessively watery eyes, and sneezing. Antihistamines block the action of histamine, and therefore, reduce these symptoms. Some allergy sufferers experience congestion as well. Decongestants help to open up the swelled passages in the nasal and sinus area, allowing the user to breathe easier.
Diphenhydramine (Benadryl®) is perhaps the most effective antihistamine at reducing itchy nose/eyes, sneezing, and runny nose. However, it also can cause excessive drowsiness, and many people actually use this medication as a sleep aid. It is the PM in Tylenol PM®. So while this may not be a valid option for daytime symptom relief, it may work well if your allergy symptoms make it difficult to fall asleep.
The newer generation of antihistamines are not quite as effective as diphenhydramine, but they have the advantage of causing little to no drowsiness. These medications used to be prescription only, but now most are available over the counter. Examples include: loratadine (Claritin®), fexofenadine (Allegra®), and cetirizine (Zyrtec®). All three are available as over-the-counter generics as well. There are still two prescription only antihistamines: Clarinex® and Xyzal® (levocetirizine).
The two over-the-counter oral decongestants are pseudoephedrine (Sudafed®) and phenylephrine. Pseudoephedrine is more effective, but it is kept behind the pharmacy counter and only sold in limited amounts because it’s one of the ingredients needed to make methamphetamine. However, you don’t need a prescription. You just have to ask for it at the pharmacy and sign a register when you purchase it. Decongestants can increase blood pressure, so you shouldn’t use them if you have a heart condition or high blood pressure.
There are also some products that combine oral antihistamines with decongestants (usually either pseudoephedrine or phenylephrine). Some examples are Claritin-D®, Allegra-D®, and Zyrtec-D®. Because these contain pseudoephedrine, they are only available behind the pharmacy counter.
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Please talk to your doctor before making changes in medication.