4 of the best eye drops for allergies

Key takeaways

• Dual-action antihistamine and mast-cell stabilizer eye drops, such as olopatadine and ketotifen, are proven to provide rapid itch relief and help prevent allergic symptoms from returning.
• Over-the-counter and prescription options are available. Preservative-free and once-daily formulations may be preferred for people with dry eye, frequent use, or contact lens wear.
• Choosing the best eye drop depends on your symptoms, how often you need relief, and whether you have coexisting dry eye or use contact lenses.

Overview

Springtime often brings better weather and new beginnings, but it can also mark the start of allergy season. Seasonal allergies can cause uncomfortable symptoms like a runny nose and itchy skin, and they can particularly affect your eyes in a condition called allergic conjunctivitis.

Eye drops can be a good option to treat allergic conjunctivitis, and there are several different options available. Let’s take a look at what the evidence says about the best eye drops for allergies.

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What eye drops can treat allergies?

The best eye drops for allergies are usually those that provide fast relief from itching, prevent symptoms from coming back, and are safe to use with minimal side effects. Typically, the gold-standard options will combine two medication types:

• Antihistamines: Antihistamines block the production of histamine, which is the substance that causes uncomfortable allergy symptoms. Eye drops containing antihistamines can provide fast-acting relief from itching.
• Mast cell stabilizers: Mast cell stabilizers can prevent the release of chemicals that cause allergic reactions, lowering the risk of your symptoms coming back.

Here are some of the most common options, each with its own benefits:

Olopatadine eye drops

Olopatadine (Pataday) eye drops are a dual-action antihistamine and mast cell stabilizer. They’re available in different strengths. Lower strengths are available over the counter (OTC), whereas the stronger drops are available on prescription.

OTC olopatadine may be given twice per day, but stronger options only need to be given once daily, which may be more convenient for you. The drops provide fast relief from symptoms and prevent them from coming back.

Like any medication, they can cause some side effects, including:

• blurred vision
• burning or stinging in the eyes
• dry eyes
• abnormal sensation in the eyes
• headache

Olopatadine can be used in adults and children older than 3 years. This means they’re a good option for people of different ages.

Ketotifen eye drops

Ketotifen eye drops are also a combination of antihistamines and mast cell stabilizers. These are only available OTC, making them very accessible, and they’re approved for use in adults and children aged 3 and older.

They offer up to 12 hours of relief from itchy eyes and get to work in minutes, according to the drug’s packaging. You need to take them twice per day.

Alcaftadine eye drops

Alcaftadine (Lastacaft) eye drops are a stronger option for allergy relief. They’re available both OTC and on prescription. They also contain an antihistamine and a mast cell stabilizer, and they’re taken once per day. They can be used in adults and children older than 2 years.

One of the main benefits of alcaftadine is that it works for slightly longer than other options, with its effects lasting up to 16 hours. It also gets to work quickly.

The most common side effects of alcaftadine include eye irritation or redness after applying the drops.

Bepotastine eye drops

Bepotastine (Bepreve) is a newer, prescription-only option for adults and children older than 2 years. It’s usually given twice per day, but it may also still be effective if only given once.

Some research suggests that bepostasine may also work for 16 hours, and it may get to work within minutes. Its most common side effects include mild, temporary eye irritation.

Compared to some other eye drops, it may be just as effective while also being safer, with fewer side effects. It may also be able to treat non-ocular symptoms of allergies, such as sneezing or a runny nose.

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Other eye drops for allergies

While combination antihistamines and mast cell activators are considered the gold standard for allergic conjunctivitis, they may not be right for everyone. There are several other eye drops available on the market:

• Antihistamine-only drops: These are effective for fast relief, but they don’t offer the prevention of dual drops, and they may not last as long. One example is azelastine (Optivar). This is only available by prescription, while the nasal spray version is available OTC.
• Mast cell stabilizers: These are better for prevention but may not provide fast relief. They may need days to weeks of consistent use to have their full effect. Examples include nedocromil (Alocril) and cromolyn sodium (Crolom). They’re available on prescription.
• Artificial tears: These OTC drops provide fast but temporary relief by washing away allergens and soothing redness, itchiness, and irritation in your eyes. They don’t typically treat the underlying condition.
• Steroid eye drops: These are typically used for very severe allergies, but they’re not suitable for long-term use. Examples include loteprednol (Alrex) and dexamethasone (Maxidex).

How to choose what eye drops to use

To help you decide which eye drops are right for you, consider reaching out to a doctor or a pharmacist for guidance. Many options are only available on prescription, so you will need a doctor’s diagnosis. However, here are some ways to decide which drops may be right for you:

• Longest relief: Some eye drops, such as bepotastine and alcaftadine, can last up to 16 hours.
• Most convenient: It may be more convenient for you to pick an eye drop that only needs to be given once per day, like stronger forms of olopatadine.
• Affordability: Aim to pick a medication with generic option, as these tend to be more affordable. OTC options may also be slightly cheaper than prescription if they work for you.

From our editors

How do you prepare for seasonal allergies?

“When I buy antihistamines at the end of April, I buy enough to cover me until the end of August, as well as an extra 10 pills to divide into my hiking and climbing rucksacks, toiletry kit, and car – just in case!”

— Alex Marceau

“I always have some sort of allergy nose spray in the house to help with congestion, especially before bed.”

— Mandy French

Summary

Eye drops are usually a good option to treat itchy, watery eyes caused by seasonal allergies, but there are so many available that it can be difficult to know which are best.

Combination antihistamine/mast cell stabilizer eye drops are generally best for fast, long-acting relief without many severe side effects. Some of these may even be available OTC.

You can speak with a doctor or pharmacist to help you decide which option may be right for you.

Download the free Optum Perks Discount Card to save up to 80% on many prescription medications. Plus, you can now get them delivered to your home in as little as 3 days. Search for your medication here.

Disclaimer: While Optum Perks strives for factual, comprehensive, and current information, this article is not a substitute for a licensed healthcare professional’s expertise. Always consult a doctor before taking or discontinuing any medication. Drug information is subject to change and may not cover all uses, directions, precautions, warnings, interactions, reactions, or adverse effects. The lack of a warning does not guarantee a drug’s safety, effectiveness, or appropriateness for all patients or specific uses.