Wednesday, April 20, 2011

Allergy Medications

Several types of medications are used to treat allergy symptoms. Discover which ones are right for you.

Allergy medications reduce your body's reaction to allergens or block symptom-causing chemicals such as histamine. Allergy medications are available as pills, liquids, nasal sprays, eyedrops, skin creams and shots (injections). Some allergy medications are available over-the-counter, while others are available by prescription only. Here's a summary of various types of allergy medications.


Corticosteroids help prevent and treat inflammation by blocking allergic reactions. Most corticosteroids require a prescription.

  • Oral corticosteroids (pills and liquids) are used to treat severe symptoms caused by all types of allergic reactions. Examples include prednisone (Prednisone Intensol) and prednisolone (Prelone, others). Because they can cause numerous short- and long-term side effects, oral corticosteroids are usually prescribed for short periods of time. Long-term use can cause cataracts, osteoporosis, muscle weakness and delayed growth in children.
  • Nasal corticosteroid sprays prevent and relieve allergy signs and symptoms such as nasal stuffiness, sneezing, and itchy, runny nose. Examples include fluticasone (Flonase), mometasone (Nasonex), budesonide (Rhinocort Aqua), flunisolide (Nasarel), triamcinolone (Nasacort AQ) and beclomethasone (Beconase AQ). Side effects can include unpleasant smell or taste, nasal irritation, and nosebleeds. These medications are much less likely to cause side effects than are oral corticosteroids.
  • Inhaled corticosteroids are used to relieve asthma symptoms triggered by allergens. Examples include flunisolide (Aerobid), triamcinolone (Azmacort), fluticasone (Flovent) and budesonide (Pulmacort). Side effects don't tend to be bothersome for most people, but can include an infection in the mouth, cough, hoarseness or headache.
  • Corticosteroid eyedrops are used to treat severe allergy signs and symptoms such as red, watery and itchy eyes caused by hay fever and allergic conjunctivitis. Examples include dexamethasone (Maxidex, others), fluorometholone (FML, others) and prednisolone (Pred Forte, others). These medications may cause blurred vision. Prolonged use may increase your risk of eye infections, glaucoma and cataracts.
  • Corticosteroid skin creams relieve the scaling and itching caused by eczema (atopic dermatitis). Some low-potency corticosteroid creams are available without a prescription, but you should always talk to your doctor before using any topical corticosteroid. Examples include hydrocortisone (Cortaid, others) and triamcinolone (Kenalog, others). Side effects can include skin irritation and discoloration.


Antihistamines block histamine, an inflammatory chemical released by your immune system during an allergic reaction.
  • Oral antihistamines (pills and liquids) reduce signs and symptoms such as swelling, runny nose, itchy, watery eyes, and hives (urticaria). Over-the-counter oral antihistamines include loratadine (Claritin), cetirizine (Zyrtec) and clemastine (Tavist). Fexofenadine (Allegra) is available by prescription. Some oral antihistamines may cause dry mouth and drowsiness. Older, "first generation" antihistamines such as diphenhydramine (Benadryl) and chlorpheniramine (Chlor-Trimeton) are more likely to cause drowsiness and slow your reaction time. These older, sedating antihistamines shouldn't be taken when driving or doing other potentially dangerous activities, and shouldn't be given to children or older adults.
  • Antihistamine nasal sprays help relieve sneezing, itchy or runny nose, sinus congestion, and postnasal drip. Prescription antihistamine nasal sprays include azelastine (Astelin, Astepro) and olopatadine (Patanase). Side effects of antihistamine nasal spray may include bitter taste, dizziness, drowsiness or fatigue, dry mouth, headache, nasal burning, nosebleed, nausea, runny nose, sore throat, and sneezing.
  • Antihistamine eyedrops are often combined with other medications such as mast cell stabilizers or decongestants. Antihistamine eyedrops can reduce itching, redness and swollen eyes. You may need to use these medications several times a day, as the effects may last only a few hours. Over-the-counter examples include ketotifen (Zaditor, Alaway, others), naphazoline (Visine-A, Opcon-A, others). Prescription examples include naphazoline (Albalon, others), emedastine (Emadine) and olopatadine (Patanol, others). Side effects of these medications can include red eyes, watering eyes, headache, and mild stinging or burning. Antihistamine eyedrops increase the risk of eye inflammation when you're wearing contact lenses.


Decongestants are used for quick, temporary relief of nasal and sinus congestion. You may need to avoid decongestants if you're pregnant, you're older, or you have high blood pressure.

Oral decongestants (pills and liquids) relieve nasal and sinus congestion caused by hay fever. Many decongestants are available over-the-counter. Examples include pseudoephedrine (Sudafed, others). A number of medications contain a decongestant such as pseudoephedrine combined with other medications. Claritin-D, for example, contains pseudoephedrine and an antihistamine. Oral decongestants can cause a number of side effects, including irritability, fast or irregular heartbeat, dizziness, insomnia, headaches, anxiety, tremors and increased blood pressure. Check with your doctor before using oral decongestants, as these medications are potentially dangerous if you take certain other medications or if you have high blood pressure (hypertension), heart disease or certain other health problems.
  • Nasal decongestant sprays relieve nasal and sinus congestion. Examples include phenylephrine (Neo-Synephrine, others) and oxymetazoline (Afrin, others). Nasal decongestants can cause dryness, burning or stinging inside the nose, runny nose and sneezing. Taking too much of a nasal decongestant can cause irritability, fast or irregular heartbeat, dizziness, insomnia, headaches, anxiety, tremors and increased blood pressure. Don't use a decongestant nasal spray for more than a week or so, or you may develop severe congestion as soon as you stop taking it (rebound congestion).
  • Decongestant eyedrops (or combined decongestant-antihistamine eyedrops) can temporarily ease symptoms such as red, itchy eyes. Available over-the-counter, examples include tetrahydrozoline (Visine, Clear Eyes, others). Side effects include persistent eye redness and damage to blood vessels in the eye when overused. Rarely, this medication causes a type of sudden (acute) glaucoma.

Other allergy medications

A few other medications work by blocking symptom-causing chemicals released during an allergic reaction.
  • Montelukast (Singulair) is a prescription medication that blocks symptom-causing chemicals called leukotrienes. This oral medication relieves allergy signs and symptoms including nasal congestion, runny nose and sneezing. Side effects can include upper respiratory infection in adults, and headache, ear infection and sore throat in children. The Food and Drug Administration (FDA) has warned that leukotriene-blocking medications could possibly cause psychological symptoms, such as irritability, anxiousness, insomnia, hallucinations, aggression, depression, suicidal thinking and suicidal behavior, in some people.
  • Cromolyn sodium (NasalCrom) is an over-the-counter nasal spray. It prevents the release of histamine and other symptom-causing chemicals during an allergic reaction. This medication works best when you take it before your symptoms start. Some people need to use the spray three or four times a day. Side effects may include nasal stinging or sneezing.
  • Mast cell stabilizer eyedrops prevent the release of symptom-causing chemicals such as histamine during an allergic reaction. These prescription medications reduce allergy symptoms such as red, itchy eyes. Examples include cromolyn sodium (Crolom), lodoxamide (Alomide), pemirolast (Alamast) and nedocromil (Alocril). These medications don't usually cause noticeable side effects.


Immunotherapy injections (allergy shots) may relieve hay fever symptoms or allergic asthma that doesn't improve with medications, or you aren't able to take allergy medications without side effects. Over a period of three to five years, you receive regular injections containing allergen extracts. The goal is to desensitize you to specific allergens and decrease or eliminate your need for medications. Immunotherapy may be especially effective if you're allergic to cat dander, dust mites, or pollen produced by trees, grass and weeds. In children with allergic rhinitis, immunotherapy may help prevent the development of asthma. Rarely, immunotherapy injections can cause a severe allergic reaction (anaphylaxis).

Emergency epinephrine shots

An epinephrine shot stops a severe allergic reaction. These self-injecting syringe and needle (autoinjector) devices include Twinject, EpiPen and EpiPen Jr. You may need to carry an autoinjector if you're likely to have a severe allergic reaction to a certain food, such as peanuts, or you're allergic to bee or wasp venom. A severe allergic reaction can cause anaphylactic shock — a sudden, life-threatening reaction. Epinephrine is a form of adrenaline that can help slow the reaction while you seek emergency treatment.
If you do carry an emergency epinephrine shot, be sure to replace it by the expiration date or it may not work correctly.

Work with your doctor

Work with your doctor to help you avoid problems and choose the most effective allergy medications. Even over-the-counter allergy medications have side effects, and some allergy medications can cause problems when combined with certain other medications.
It's especially important to talk to your doctor about taking allergy medications if:
  • You're pregnant or breast-feeding.
  • You have a chronic health condition such as diabetes, glaucoma or high blood pressure.
  • You're taking any other medications, including herbal supplements.
  • You're treating allergies in a child. Children need different doses of medication or different medications from those that adults use. Some medications, such as corticosteroids, can cause side effects in children.
  • You're treating allergies in an older adult. Some allergy medications can cause confusion, urinary symptoms or other side effects in older adults.
Keep track of your symptoms, when you use your medications, and how much you use — that way you and your doctor can figure out what works best. You may need to try a few different medications to determine which ones are most effective and have the least bothersome side effects for you.



A13 said...

Excellent Information HBM,
It's getting the allergy season here too, the "dry" season they call it, and we all get some kind of allergy this time of year.
Thanks again

Honk Bonk Man said...

Yes, it is really bad in my area. Lots trees and shrubs blooming. The rain made things even worse.

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