Which Type of Allergy Medication Is Right for You?

Dr. Menachof, MD, has specialized in conditions around the head, throat, ear, nose, neck and face for over 20 years, and was the first to bring sublingual allergy drops to Colorado in 2005. He has been recognized as a Fellow by multiple academies, named one of America’s Top Facial Plastic Surgeons continually since 2003 and is featured in multiple national publications.

Allergy season is rough for both indoor and outdoor allergies. The good news? There are many different allergy medicines to help you feel your best.

Depending on your symptoms and lifestyle, some allergy medicines may work better than others. Each person reacts differently to allergens–the irritants that trigger histamine reactions and cause symptoms such as post nasal drip and itching. The same happens with prescription and over-the-counter (OTC) allergy treatments. So, if you’re trying to choose between over-the-counter allergy medication or allergy drops, here’s where to start:

Short Term Vs. Long Term Relief

If you’re looking for short-term allergy relief on a budget, over-the-counter allergy medication is a great way for you to get relief. But, if you’re looking for a long-term solution and want to train your body to fight allergies better in the future, allergy drops are a great solution. There are pros and cons to both options, but we suggest meeting with an allergy specialist to determine what choice is best for you.

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Types of Prescription and OTC Allergy Medications

Treating allergies can be difficult (especially when you’ve tried it all). From researching ingredients in scent-free lotion to keeping a journal of your symptoms – it can feel overwhelming. But the truth is, you may need to try a different allergy medicine, or a combination of several, to find relief. Allergy medicine options include oral antihistamines, decongestants, combination drugs, corticosteroids, and other OTC allergy medications. While most OTC medicines can provide temporary relief, we also offer alternative options for long-term relief and allergy prevention with immunotherapy (allergy drops). Immunotherapy is a preventative approach to treating allergies by gradually increasing your tolerance to allergens (like dust mites) through allergy shots or allergy drops.

We’re here to make it easier for you to find the best allergy treatment (or combination) that works for you. Here are the differences among several types of allergy treatments, including prescription and OTC allergy medicines, how they work, and what issues they alleviate.

Antihistamines

Best for Treating Itching and Nasal Allergies

Antihistamines are a type of allergy medicine that help treat allergies by targeting and blocking histamine, which is the chemical substance your body releases when exposed to an allergen, such as pollen or pet dander. Most people use an antihistamine for basic allergies and all-day relief. In fact, your child’s pediatrician may even recommend an antihistamine for your child’s rash. Allergy medicines like antihistamine treatments can take the form of pills, liquid, nasal spray, or eye drops. Once antihistamine medications are in your bloodstream, they can quickly reduce other symptoms caused by allergens and prevent the release of histamines in the first place.
Taking allergy medicines like antihistamines before or during exposure to an allergen can help limit and even prevent your allergy issues. Antihistamine pills can offer 24-hour allergy relief and are most effective against sneezing, and itchy and runny noses, while nasal sprays like Nasacort Allergy spray are primarily designed to relieve congestion and pressure. Getting all-day relief is a priority for most.
It’s important to note that certain antihistamines, especially older drugs, can make you feel drowsy and cause dizziness, so you should be careful to avoid certain activities like driving after taking some antihistamines.

Symptoms Treated by Antihistamines

• Itchy eyes
• Watery eyes
• Nasal congestion
• Runny nose
• Sneezing
• Coughing
• Itchy skin

Examples of Antihistamines

Over-the-Counter

• Allegra (Fexofenadine, non-drowsy relief)
• Benadryl (Diphenhydramine, can cause drowsiness)
• Claritin 24-hour allergy (non-drowsy relief, active ingredients include loratadine)
• Zyrtec (Cetirizine HCl is an active ingredient)

Prescription

• Clarinex (Desloratadine)
• Astelin (Azelastine, nasal spray)
• Optivar (Azelastine ophthalmic, eye drops)

Side Effects of Antihistamines

Older antihistamines may cause drowsiness or dizziness. Most newer OTC allergy medications are second or third-generation antihistamines, which often contain cetirizine hydrochloride. This medication is non-sedating and safe to take before most activities. Second generation antihistamines are a great option if you’re looking for a non-drowsy allergy medication with all-day relief. Antihistamines can, however, cause dryness as a side effect, especially after prolonged use.

Decongestants

Best for Treating for Nasal and Sinus Congestion or Pressure

The use of decongestants is popular for treating nasal and sinus congestion due to pet allergies and seasonal allergies. You may want to consider them if nasal obstruction or respiratory problems like difficulty breathing are your worst symptoms. Decongestants work by decreasing the inflammation and fluid production in your nose that is often triggered by allergens. This allows the nose to drain more effectively, air to flow freely, and any swelling of the nasal passages to go down, giving you symptom relief.

OTC allergy medicine like decongestants can come in pill (most common), liquid, or nasal spray form. Nasal sprays and eye drops can stop working or make pesky allergy symptoms worse if overused, so it is important to use them sparingly (no more than a few days at a time) when treating common allergies.

Symptoms Treated Best by Decongestants

• Nasal congestion
• Headache
• Facial pressure
• Clogged sinuses
• Frequent sinus infections
• Ear congestion or pressure

Examples of Decongestants

• Afrin (Oxymetazoline, nasal spray)
• Sudafed (Pseudoephedrine, pill or liquid)
• Neo-Synephrine (Phenylephrine is an active ingredient)
• Certain Visine eye drops

Side Effects of Decongestants

Decongestants can raise blood pressure, especially with prolonged use, so they are not usually recommended for people with high blood pressure or glaucoma. Certain decongestant treatments may also cause insomnia or irritability and can restrict urinary flow.

Combination Allergy Drugs

The Best of Both Antihistamines and Decongestants

Certain OTC allergy medications like Allegra Allergy contain both an antihistamine and decongestant to relieve multiple symptoms at once. These combination drugs can be an effective treatment for people who experience nasal congestion or trouble breathing in addition to other common allergies like hay fever, itchy skin, scratchy throat, hives, or itchy eyes.

Examples of Combination Over the Counter Allergy Medications

• Allegra – D
• Clarinex – D
• Claritin – D
• Dymista

Side Effects of Combination Medications

Due to the fact that OTC allergy combination medications typically include both antihistamines and decongestants, patients can experience side effects associated with either treatment. While these combination medications are non-drowsy and drowsiness is unlikely, it can still occur, as can insomnia or irritability and an increase in blood pressure.

Our Top Choices For Over-the-Counter Allergy Medications

Allegra

The Allegra Adult 24-Hour Allergy Relief is our top pick for fast-acting allergy medicine. It works within one hour and since it’s non-drowsy, you can take it at any time of the day. If you have itchy eyes or a runny nose, this medicine is perfect for you.

Pros:

• It works fast.
• It works for indoor and outdoor allergies.
• It’s non-drowsy (so you can take it whenever you need to).

Cons:

• The pills are quite large.
• It doesn’t work for everyone in the same way.
• The pills leave a bitter taste in your mouth.

Zyrtec

If you’re looking for an all-around winner for postnasal drip, itchy eyes, watery nose, sneezing, and more, the Zyrtec Prescription-Strength Allergy Medicine Tablets are for you. These tablets work fast and give you long-lasting 24-hour relief.

Pros:

• Works particularly great for indoor allergies.
• Works best when retaken the next day.
• Easy to swallow.

Cons:

• Isn’t non-drowsy for everyone.
• May cause grogginess for some.
• More expensive than other over-the-counter meds.

Nasacort Nasal Spray

If you want another option besides liquid medicines and pills, Nasacort is your friend. Nasacort helps with sneezing, runny and itchy nose, and nasal allergy congestion. You only need one to two sprays per nostril once daily (depending on your age). This nasal spray acts fast and is safe for kids ages 2 and up.

Pros:

• Easy to use for kids (doesn’t have to be swallowed)
• Scent-free.
• 120 sprays per bottle.

Cons:

• Can drip from your nose after spraying.
• Doesn’t always last a full 24 hours.
• Sometimes it has an aftertaste after spraying.

Immunotherapy

Best Treatment to Manage Allergies Long Term

Immunotherapy is a great allergy relief option for anyone who suffers from severe symptoms, especially for those with year-round allergies. It works by exposing you to gradually increasing levels of an allergen to help your immune system slowly build a tolerance to it. This helps relieve a wide range of allergy symptoms and even prevents new allergies from developing.

Allergy shots (delivered under the skin) are a form of immunotherapy that require frequent office visits to be administered by a clinical immunologist. Daily allergy drops are a revolutionary form of immunotherapy that can be taken under the tongue from home to relieve your allergies long-term. They treat symptoms without the bitter taste of liquid allergy medication. Both forms of immunotherapy can be prescribed by a doctor after specific allergies like outdoor allergies are determined by an allergy test. This is a long-term approach to allergy relief and management, with most patients using these methods for a period of three to five years.

Symptoms Treated by Shots or Drops

• Severe nasal congestion
• Runny nose
• Itchy, watery eyes
• Sore throat
• Wheezing
• Itchy skin or hives

Examples of Immunotherapy

• Allergy Shots
• Allergy Drops
• Allergy Tablets

Side Effects of Immunotherapy

Immunotherapy is well tolerated, and most people do well with it. The rare side effects of allergy shots include redness, inflammation or irritation at the site of injection, with occasional allergic reaction to the allergy shot. There are no reported side effects or issues from the use of allergy drops. If you are interested in taking the easiest route to a long-term solution with no side effects, schedule an appointment with us to begin the process of allergy drop treatment.

Corticosteroids

Treats Inflammation and Swelling

Corticosteroids can reduce inflammation that is associated with allergies. These medications primarily treat and prevent allergic reactions such as allergic rhinitis. They work quickly and limit the body’s histamine creation, preventing the allergic response that leads to problematic symptoms like nasal stuffiness, sneezing, an itchy or sore throat, or postnasal drip. Steroids can work well for treating hay fever, seasonal and year-round allergies.

Steroids are considered highly effective, but they must be taken regularly, even when no symptoms are experienced, to work well. Like many subscription or OTC allergy medications, it can take several weeks before the full relief from the medicine is felt.

Systemic steroids are available as pills or liquids for serious allergies and asthma but are also common as nasal sprays or inhalers. They can also be used as a topical cream for skin allergies to relieve hives and swelling. Many doctors recommend nasal steroid sprays to help with year-round allergies. Nasal steroids like Corticosteroid medications can take longer to kick in than antihistamines, but most healthcare providers consider them to be the most effective way to combat nasal allergies. Many, but not all, of these steroid treatments require a prescription.

Symptoms Treated by Corticosteroids

• Itchy eyes, mouth, nose or throat
• Runny nose
• Sneezing
• Tearing eyes
• Nasal congestion

Examples of Over the Counter Corticosteroids Include

• Flonase
• Nasonex
• Rhinocort
• Deltasone
• Beconase

Side Effects of Corticosteroids

Many potential side effects can occur if steroid treatments are used for an extended period of time. Side effects are typically mild, such as weight gain, fluid retention, and increased blood pressure, but certain patients may develop more serious complications, including diabetes, osteoporosis, and muscle weakness. Steroids that are ingested through nasal sprays or inhalers can cause side effects such as cough, hoarseness, and fungal infections of the mouth.

Mast Cell Stabilizers

Treats Mild to Moderate Inflammation in Allergy Sufferers

Mast cell stabilizers are often used alongside OTC allergy treatments to help alleviate mild to moderate inflammation. These allergy relief treatments work by preventing histamine from being released by the mast cells, which are the cells that produce and store histamine.
Mast cell stabilizers are available as redness reliever eye drops for itchy eyes, also called allergic conjunctivitis, and as nasal sprays for nasal allergies. As with many drugs, it may take several weeks to start working at its best.

Examples of Mast Cell Stabilizers

• Opticrom (Cromolyn sodium is an active ingredient)
• Alomide (Lodoxamide-tromethamine is an active ingredient)
• Alocril (Nedocromil is an active ingredient)
• Alamast (Pemirolast is an active ingredient)

Side Effects of Mast Cell Stabilizers

Side effects are not common, but in some cases, patients experience throat irritation, coughing, or skin rashes. Mast cell stabilizers taken as eye drops can occasionally cause burning, stinging, or blurred vision.

Leukotriene Modifiers

Treats Asthma and Nasal Allergies

Leukotriene modifiers can be prescribed along with other medications to help reduce your allergies. These drugs are primarily used to treat asthma, allergic asthma, and nasal issues. They work by blocking the leukotrienes, a type of chemical produced by the body in response to allergens. Leukotriene modifiers can be taken as pills, chewable tablets, and oral powder.

Examples of Leukotriene Modifiers

The only leukotriene modifier that the FDA has approved is Singulair (monteleukast).

Side Effects of Leukotriene Modifiers

Side effects of leukotriene modifiers are rare but can include:

• Stomach pain or stomach upset
• Heartburn
• Fever
• Stuffy noses
• Cough
• Rash
• Headache
• Irritability

Key Takeaways:

• Over-the-counter allergy medicines like Allegra, Zyrtec, and Nasacort are recommended as the first-choice treatment for people with unresolved allergy symptoms — but they take time to work and are more of a short-term solution.
• When considering which allergy medication is right for you, you need to prioritize your symptoms, how quickly you need relief, side effects, and how much you want to spend.
• Immunotherapy drops, also known as allergy drops, should be considered if you want to build up your body’s tolerance to allergies, reduce symptoms, and need long-term allergy relief.

Work With an Expert to Find Relief Faster

Deciding which allergy treatment option is right for you can be difficult. In addition to simply finding short-term relief, you want to prevent those symptoms in the future. Whether you’re looking for an asthma clinic for severe symptoms, an internal medicine physician, a board-certified allergist, or primary care physician, it’s important for you to discuss all of your options with a specialist. Working with a healthcare professional to discuss your problems and determine your best course of action will help you find the right medication and get allergy relief from symptoms faster. Schedule a consultation with Advanced ENT & Allergy Center to get to the root of your allergies and find the right treatment for your lifestyle.

What is the Best Allergy Medicine for Kids?

Zyrtec 24 Hr Children’s Allergy Syrup

This medicine is our #1 pick for your kids. If your child is dealing with allergies like sneezing, runny nose, itchy or watery eyes, etc. you need something to act fast. Children’s Zyrtec is recommended for children 2 years old. According to parents, this medicine even has a kid-approved flavor.

Pros:

• Dye – and sugar-free.
• Comes with a symptom-tracking app.
• Can be used for kids as young as 2 years old.

Cons:

• May cause itchiness.
• Might not work well for children with extreme allergies.
• Causes drowsiness in some children.

What is the Best Non-Drowsy Allergy Medicine?

Claritin’s 24-Hour Allergy Reditabs

Claritins’s Reditabs work fast and can relieve you of symptoms from over 200 types of allergens. These powerful tablets are reportedly the number one doctor-recommended, non-drowsy oral allergy brand. Because they are non-drowsy, you can conveniently take them at any time. The best part is, they dissolve in your mouth so you don’t even need water.

Pros:

• They melt-in-your-mouth.
• Are the #1 doctor-recommended non-drowsy option.
• Relieve symptoms from over 200 allergens.

Cons:

• They are pricier than other brands.
• Tablets may fall apart easily.
• Don’t always last a full 24 hours.

What Are the Best Eye Drops for Allergies?

Alcon Naphcon Eye Drops

Itchy and red eyes are not only annoying, but they can also be painful. That’s why we highly recommend Alcon Naphcon-A Allergy Relief Eye Drops. This formula has a redness reliever and an antihistamine ingredient which work together to bring you fast relief.

Pros:

• Non-oral solution for itchy, red eyes.
• Travel-size makes it easy to bring with you.
• Provides quick relief.

Cons:

• If used excessively, it can cause dryness.
• Only relieves eyes.
• Sometimes it’s difficult to put in eyedrops by yourself.

Schedule a consultation with Advanced ENT & Allergy Center to get to the root of your allergies and find the right treatment for your lifestyle.

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