Table of Contents
- How antihistamines help allergies
- What to know about decongestants
- The scoop on corticosteroids
- How mast cell stabilizers work
- Using leukotriene inhibitors
- What are anticholinergics?
- What medication should I try first?
If you live with allergies, it can be hard to figure out which medication might be right for you.
There are inhalers, nasal sprays, eye drops, pills and liquids. Some need a prescription and others don’t. And some decongestants are available over the counter (OTC) but you must show identification to buy them.
Here are some of the different medications to consider — and what they do.
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How antihistamines help allergies
Antihistamines block a substance in your body called histamine, says Alyssa M. Wozniak, PharmD. She’s a clinical assistant professor and director of interprofessional education at the School of Pharmacy at D’Youville University in Buffalo, New York.
“Histamine is released when your body detects a harmful situation, such as an infection. It causes blood vessels and skin to swell and expand to protect your body,” she says.
In people who have allergies, histamine is released in response to harmless triggers. Those might include pollen, grass, animals or indoor dust. The reaction can cause:
- Itchiness
- Watery eyes
- Runny or stuffy nose
- Sneezing
- Rashes
Many antihistamines are available OTC, Wozniak says. Examples include fexofenadine (Allegra), loratadine (Claritin) and diphenhydramine (Benadryl).
“They can cause drowsiness, but it depends on the specific medicine,” Wozniak explains. For example, she says, Benadryl may cause more sleepiness than Claritin.
Other antihistamines, such as desloratadine, are available only by prescription.
There are also some antihistamine nasal sprays on the market. Azelastine is available OTC, but there’s also a stronger prescription version (Astelin). Azelastine nasal spray helps with seasonal or year-round allergy symptoms. Olopatadine (Pataday) is an OTC eye drop that blocks histamines. There’s also a prescription olopatadine nasal spray (Patanase) that’s similar to azelastine.
Recommended reading: Super easy ways to save on your allergy medication.
What to know about decongestants
When you’re exposed to an allergen, your blood vessels can expand and swell, says Tara F. Carr, MD. She’s a board-certified allergist and associate professor of medicine at the University of Arizona College of Medicine in Tucson. Decongestants can reduce some of the swelling in your nose and sinus cavities.
They can work very well. But, she says, they’re not a long-term strategy. These medications are best for patients with short-term symptoms such as a stuffy nose. They include oral phenylephrine (Sudafed PE) and nasal oxymetazoline (Afrin).
Decongestants are often combined with other allergy medications, such as antihistamines. When they’re used in a nasal spray form, such as Afrin, they should not be used for longer than 3 days. “Your nose can get used to them, and the effect may wear off. That can lead to worsening nasal congestion later,” Wozniak says.
Decongestants narrow blood vessels, which in turn can raise blood pressure. So while they may be available OTC, you should still talk to your doctor about whether they’re right for you.
Recommended reading: Allergies can cause hives, but you can calm the itch.
The scoop on corticosteroids
Steroids, sometimes called corticosteroids, often come in nasal spray form, says Wozniak. They can prevent and ease stuffiness, sneezing, and a runny nose. Options include fluticasone (Flonase) and mometasone (Nasonex).
These medicines reduce swelling in the mucous membranes to relieve a stuffy or runny nose. Wozniak says you should start to feel better within 12 hours. And the full effects should kick in after a few days. Possible side effects may include nasal irritation and a bad taste in your mouth.
“An advantage of these medications is their effect on nasal congestion and the fact that many are available over the counter,” she says.
The most common options are triamcinolone (Nasacort) and budesonide (Rhinocort), says Dr. Carr. But Beconase, Omnaris and Zetonna are also options.