Allergy Medicine can be quite helpful for control of allergy symptoms. This blog will review the over the counter options to start. As mentioned in the last blog, nasal saline rinses or sprays, artificial tears and moisturizing eyedrops represent a great first step.
A variety of antihistamines are also available. These can be taken orally in liquid or pill form. Some over-the-counter eye drops also contain antihistamines. Antihistamines can help reduce itching, sneezing, runny nose, post nasal drip and to a mild degree, nasal congestion. Different antihistamines contain active ingredients with different effects. The antihistamines are grouped in 2 general categories. The first generation antihistamines include diphenhydramine (aka Benadryl®, chlorpheniramine (Chlor-Triemton®), brompheniramine, doxylamine, and others. The first generation antihistamines cause drowsiness and should be avoided with driving.
The second generation antihistamines include loratadine (such as Claritin® or Alavert®), cetirizine (Zyrtec ® or Allertek®), or fexofenadine (such as Allegra®). In general these agents are less sedating although cetirizine can be associated with sedation in 10% of individuals. The most common side effect associated with the second generation antihistamines include eye, mouth, and skin dryness.
The antihistamine/decongestant combinations (the above antihistamines in combination with phenylephrine or pseudoephedrine) can produce more significant relief of nasal congestion than with antihistamines alone. The use of the antihistamine/decongestant combinations however should be limited to short term use only, as prolonged use can lead to rebound increased nasal congestion. These medications also can be associated with significant side effects including headache, irritability, insomnia, and heart palpitations and are not advised in patients with certain underlying medical conditions such as high blood pressure.
Many people have symptoms not controlled with over the counter medications. These individuals will require evaluation by an Allergist for consideration of additional treatments. The next blog will talk about prescription medications for hay fever.