Allergy Medications Guide

Allergies affect millions of people, causing symptoms ranging from mild sneezing to severe reactions. Whether you’re dealing with seasonal hay fever or year-round allergies, understanding the medications available can help you find effective relief.

Disclaimer: This article is for educational purposes only and is not intended as medical advice. Always consult your healthcare provider before starting any new medication.

Introduction

Allergy medications work to counteract your body’s overreaction to harmless substances like pollen, pet dander, or dust mites. When you encounter an allergen, your immune system releases histamine and other chemicals that cause allergy symptoms. Various medications target different parts of this allergic response to provide relief.

How They Work

Antihistamines block histamine from attaching to receptors in your body, preventing or reducing symptoms like sneezing, itching, and runny nose.

Nasal Corticosteroids reduce inflammation in the nasal passages, addressing congestion, sneezing, and runny nose at the source.

Decongestants narrow blood vessels in the nasal passages, reducing swelling and allowing easier breathing.

Mast Cell Stabilizers prevent immune cells from releasing histamine in the first place.

Leukotriene Modifiers block chemicals other than histamine that contribute to allergy symptoms.

Immunotherapy gradually desensitizes your immune system to specific allergens over time.

Common Types

Oral Antihistamines

Second-Generation (Non-Drowsy)

• Cetirizine (Zyrtec) - Fast-acting; lasts 24 hours
• Loratadine (Claritin) - Non-drowsy; once daily
• Fexofenadine (Allegra) - Truly non-sedating; avoid with fruit juice
• Levocetirizine (Xyzal) - Active form of cetirizine

First-Generation (Sedating)

• Diphenhydramine (Benadryl) - Fast relief but causes drowsiness
• Chlorpheniramine (Chlor-Trimeton) - Available in many combination products
• Clemastine (Tavist) - Long-acting first-generation option

Nasal Corticosteroid Sprays

• Fluticasone (Flonase) - Available over-the-counter
• Triamcinolone (Nasacort) - OTC; scent-free
• Budesonide (Rhinocort) - OTC; gentle on nasal passages
• Mometasone (Nasonex) - Prescription; low systemic absorption
• Fluticasone/azelastine (Dymista) - Combination prescription spray

Antihistamine Nasal Sprays

• Azelastine (Astelin, Astepro) - Fast-acting nasal relief
• Olopatadine (Patanase) - Prescription antihistamine spray

Decongestants

• Pseudoephedrine (Sudafed) - Oral; sold behind pharmacy counter
• Phenylephrine - Oral; less effective than pseudoephedrine
• Oxymetazoline (Afrin) - Nasal spray; limit to 3 days

Eye Drops

• Ketotifen (Zaditor) - OTC antihistamine drop
• Olopatadine (Pataday) - Once-daily OTC option
• Artificial tears - Help wash away allergens

Leukotriene Modifiers

• Montelukast (Singulair) - Prescription; also used for asthma

Immunotherapy

• Allergy shots - Injections at doctor’s office over months to years
• Sublingual tablets - Dissolve under tongue at home (grass, ragweed, dust mites)

What to Expect

Antihistamines: Relief begins within 1-3 hours for most oral antihistamines. Non-drowsy versions are best for daytime use, while sedating types may help with nighttime symptoms and sleep.

Nasal Corticosteroids: These work best with consistent daily use. Some relief may be noticed within 12 hours, but full effectiveness typically takes several days to two weeks of regular use.

Decongestants: Provide quick relief within 15-30 minutes but are meant for short-term use. Nasal decongestant sprays should not be used for more than 3 consecutive days to avoid rebound congestion.

Immunotherapy: This is a long-term commitment, typically requiring 3-5 years of treatment, but can provide lasting relief even after treatment ends.

Potential Side Effects

Antihistamines (Second-Generation)

• Mild drowsiness (especially cetirizine)
• Dry mouth
• Headache

Antihistamines (First-Generation)

• Significant drowsiness
• Dry mouth, eyes, and nose
• Urinary retention
• Confusion in older adults

Nasal Corticosteroids

• Nasal irritation or dryness
• Nosebleeds
• Headache
• Unpleasant taste

Decongestants

• Increased heart rate
• Elevated blood pressure
• Insomnia
• Restlessness
• Rebound congestion (nasal sprays)

Montelukast

• Headache
• Stomach pain
• Behavioral/mood changes (rare but FDA-warned)

Important Precautions

Drug Interactions:

• First-generation antihistamines increase sedation with alcohol and other sedatives
• Fexofenadine absorption is reduced by fruit juices
• Decongestants may interact with certain antidepressants (MAOIs)

Who Should Be Cautious:

• People with high blood pressure should avoid decongestants
• Those with glaucoma should use antihistamines carefully
• Prostate enlargement can worsen with first-generation antihistamines
• Pregnant women should consult their doctor before using allergy medications

Special Considerations:

• Sedating antihistamines impair driving
• Nasal decongestant sprays can cause dependency if overused
• Some allergy medications require adjustments for kidney or liver problems

Tips for Safe Use

1. Start nasal steroids before allergy season for best prevention.
2. Use non-drowsy antihistamines during the day; save sedating types for bedtime if needed.
3. Limit nasal decongestant sprays to 3 days to prevent rebound congestion.
4. Aim nasal sprays away from the septum to reduce irritation.
5. Be consistent with nasal corticosteroids—they work best with daily use.
6. Avoid alcohol when taking sedating antihistamines.
7. Check ingredient lists in combination cold/allergy products to avoid doubling up.
8. Try environmental controls alongside medication: air filters, allergen-proof bedding, and keeping windows closed.

When to Talk to Your Doctor

Contact your healthcare provider if you experience:

• Symptoms not controlled by over-the-counter medications
• Side effects that interfere with daily activities
• Need to use decongestants frequently
• Symptoms that worsen or change
• Interest in allergy testing to identify triggers
• Consideration of immunotherapy for long-term relief
• Signs of severe allergic reaction (difficulty breathing, swelling)

Also discuss allergies with your doctor if you have heart disease, high blood pressure, glaucoma, or prostate problems, as these conditions affect which medications are safe for you.

Key Takeaways

• Multiple medication types are available for allergies, allowing personalized treatment approaches.
• Nasal corticosteroids are most effective for nasal symptoms and work best with consistent daily use.
• Second-generation antihistamines offer effective relief with minimal drowsiness for most people.
• Immunotherapy offers long-term benefits for those with significant allergies who want lasting relief beyond daily medication.

Allergies are highly manageable with today’s medications. If over-the-counter options aren’t providing adequate relief, work with your healthcare provider to develop a more comprehensive treatment plan.