Changing seasons mean an increased release of pollens from trees, flowers and plants. Indoor allergens, like dust and pet dander, can cause issues all year long. Unfortunately, many people who love spending time outdoors during the most beautiful weeks of the year, and those who love being around their furry friends, experience allergy symptoms. And so, they want to know which over-the-counter (OTC) allergy medications will provide the best relief.
Fortunately, there are many different OTC allergy medications that can help. The best seasonal allergy medicine for you depends on your symptoms and the type of relief you seek.
Why Do Allergies Occur?
Normally, the immune system attacks invaders that are harmful to the body, such as viruses, bacteria and even some cancerous cells. However, allergic reactions occur when the immune system reacts to something that is not generally harmful to the body, like food, medication, pollen or pet dander.
Histamines play a role in many bodily functions. For example, they help to create stomach acid and keep us awake. When the immune system signals that it has identified a foreign substance or allergy trigger, histamines are released to help the body eliminate the allergen. Histamine release can cause unpleasant symptoms, including itchy or watery eyes, itchy nose, sneezing, runny or stuffy nose, rashes and hives.
Antihistamines and Other OTC Allergy Medications
Generally, OTC allergy medications are available as tablets, nasal sprays, eye drops and creams.
Oral Antihistamines for Daily Allergy Relief
There are three different categories (or generations) of oral antihistamines: first-generation, second-generation and third-generation.
First-generation antihistamines cross the blood-brain barrier and enter the central nervous system, making them likely to cause drowsiness. Because drowsiness is one of the main side effects of first-generation antihistamines, they are not ideal medications for daily use, and it's best to take them for short-term relief of allergy symptoms. First-generation antihistamines can also cause hyperactivity in children.
Second- and third-generation antihistamines are newer than first-generation antihistamines and do not enter the central nervous system as readily as their earlier counterparts. Therefore, they are less likely to cause drowsiness and are more suitable for daily use. Most second- and third-generation antihistamines have a longer duration of action than first-generation medications, so they can be taken once or twice a day depending on the formulation to provide lasting relief.
First-Generation Antihistamines
There's a variety of first-generation antihistamines available today that are used to ease allergy symptoms. The following are two of the most popular:
- Diphenhydramine (Benadryl) is the most commonly known first-generation antihistamine — and can be taken every four to six hours. It's best to take Benadryl only for short-term relief of allergy symptoms.
- Chlorpheniramine is another rapid-acting first-generation antihistamine. The regular formulation can be taken every four to six hours; an advanced chlorpheniramine formulation provides 12-hour relief.
Second- and Third-Generation Antihistamines
Among the many second- and third-generation antihistamines available, the following are the most common:
- Loratadine (Claritin) provides non-drowsy relief of allergy symptoms. It's effective against various allergens and suitable for long-term use. For many, Claritin typically begins working within three hours.
- Cetirizine (Zyrtec) provides 24-hour relief and is particularly effective for seasonal allergies. It addresses symptoms like sneezing and itching. Zyrtec does not cause drowsiness in most people. It's more likely to make you sleepy than Claritin or Allegra, especially in those 60 and older.
- Fexofenadine (Allegra) is fast-acting and long-lasting. It has minimal side effects, making it suitable for daily use. Allegra is particularly effective against nasal allergy symptoms. Fruit juices can interfere with absorption, so don't drink juice one to two hours before or after taking this medicine.
- Levocetirizine (Xyzal) is another third-generation antihistamine that provides 24-hour relief of allergy symptoms.
Seeing as some first-generation antihistamines can cause hyperactivity in children, they should only take products specially formulated for kids, like Children's Benadryl Allergy Relief. Or, they can take a second-generation antihistamine made for children, such as Zyrtec 24-Hour Children's Allergy Relief Syrup or Claritin Children's Allergy Relief Chewable Tablets.
Oral Decongestants and Sinus Relief
When you develop nasal allergy symptoms, the blood vessels around the sinuses swell, causing more congestion to form, which helps the body trap and get rid of allergens. Decongestants reduce swelling, alleviating excess congestion better than an antihistamine alone. You probably do not need a daily decongestant, but they're helpful when allergy symptoms flare up.
- Sudafed products contain the active ingredient pseudoephedrine, while Sudafed PE contains the active ingredient phenylephrine. Both are common ingredients in decongestant products.
Other sinus relief medications, like Mucinex Fast-Max Severe Congestion Relief Caplets, contain a decongestant, a pain reliever for sinus discomfort and an expectorant, which thins secretions, making them easier to excrete.
If you have congestion and an itchy or runny nose, you can take an antihistamine with a decongestant, such as Claritin-D, Zyrtec-D or Allegra-D.
Keep in mind that, in most locations, you'll need to purchase any decongestant products containing pseudoephedrine at a pharmacy counter. The U.S. Food and Drug Administration (FDA) has strict regulations surrounding the purchase of cold medicine products containing pseudoephedrine. The FDA requires retailers to limit their purchase quantities, obtain a photo ID with purchase, and keep records of pseudoephedrine purchases for at least two years.
When taking combination OTC remedies, be aware of the individual medications in the products you take; many contain the same active ingredients.
Allergy Nasal Sprays
Here are some examples of nasal spray products for allergies:
- Fluticasone (Flonase), triamcinolone (Nasacort), mometasone (Nasonex) and budesonide (Rhinocort) are OTC steroid nasal sprays. They reduce sinus inflammation and swelling in the nasal passages, relieving allergy symptoms.
- Steroid nasal sprays work mostly in the nasal passages, and the body absorbs very little of the medication, so there's no need to worry you'll be getting large doses of steroids.
- Steroid nasal sprays work best when taken daily to prevent symptoms. They can take up to two weeks before they become fully effective, so if you don't take them year-round, start taking them a few weeks before your allergy symptoms typically start.
- Azelastine (Astepro) is an antihistamine nasal spray that also reduces nasal allergy symptoms by blocking histamines in the sinuses.
- Cromolyn (NasalCrom) is a mast cell stabilizer nasal spray. Instead of taking a nasal spray once symptoms begin, you can use NasalCrom year-round to prevent allergy symptoms before they start.
Relief for Itchy Eyes
You may be tempted to rub and scratch your itchy, watery eyes, but don't do it! This can actually worsen eye irritation.
- Ketotifen (Zaditor Eye Itch Relief or Alaway Eye Itch Relief or Visine Eye Allergy Relief Multi-Action Eye Drops) contain antihistamines formulated specifically to quickly relieve allergic eye symptoms. Zaditor and Alaway last 12 hours, while Visine can be used up to four times a day.
Topical Creams for Skin Reactions
Topical creams can be used to alleviate itching and swelling of skin caused by conditions like like poison ivy, oak or sumac, insect bites, and allergic reactions to soaps or detergents. The following are some common examples:
- The antihistamine diphenhydramine (Benadryl) is also available in topical form. Two popular products are Benadryl Extra Strength Itch Stopping Cream and Gel.
- Hydrocortisone cream (also sold under the brand name Cortizone-10 Anti-Itch Cream) is a steroid that will also relieve itching.
Non-Medication Solutions for Allergies
Avoidance of allergy triggers is key to preventing allergy symptoms. If you experience seasonal allergies, stay indoors when pollen counts are high, and keep windows and doors closed. Consider air purifiers or HVAC filters that trap allergens in the air and prevent them from circulating through your home.
Saline nasal sprays can moisten the sinuses and loosen dried nasal congestion. Neti pots irrigate the sinuses with a gentle salt solution, help to relieve nasal pressure and congestion.
When OTC Remedies Don't Cut It
If your allergy symptoms become unpredictable, are not controlled by OTC allergy medications, start impacting your daily life or are causing you to become sick with secondary infections, you may need to see an allergy specialist.
Seek prompt medical advice if you develop a sudden, widespread allergic reaction like hives.
In severe cases, histamine release can lead to life-threatening anaphylaxis. Antihistamines will not treat anaphylaxis. Anaphylaxis is a medical emergency that requires treatment with the drug epinephrine. Get immediate medical care if you experience any signs of anaphylaxis, including swelling of the mouth or lips and difficulty breathing.
Feeling Better
Your local pharmacists are available to answer any questions you might have about allergies and specific medications. They can help guide you in searching for the right products — and ultimately, help you feel better. The wide array of OTC allergy medications available provides options for all your different allergy needs and symptoms. So, whatever the season, you don't have to let allergies slow you down.
These articles are intended for informational purposes only and are not a substitute for professional medical advice, diagnosis, or treatment and are not intended to treat or cure any disease. Never disregard professional medical advice or delay in seeking it because of something you have read in these articles. Advances in medicine may cause this information to become outdated, invalid, or subject to debate. Professional opinions and interpretations of scientific literature may vary. Consult your healthcare professional before making changes to your diet, exercise or medication regimen.