How Medications Can Manage Your Allergies 

If you suffer from allergies, you’re likely interested in learning more about the medication options that can help you manage the uncomfortable symptoms. Let’s take a closer look at understanding allergies and the effects medications can have on curbing the symptoms. 

What are Allergies?  

Allergies occur when your body reacts to certain substances. If you have allergies, your body’s immune system produces antibodies that classify the allergen as harmful to you even though it isn’t. Common allergens include dust, pollen, mold, pet dander, and even certain foods (however, there are many more). 

Allergy Symptoms 

Allergy symptoms can be intermittent (occasionally) or chronic (regularly). Intermittent symptoms can occur when exposed to allergens, while chronic symptoms can occur due to seasonal changes. 

Allergy symptoms are often confused with common cold symptoms as they are very similar. Check out this comparison to see how allergy symptoms differ from a common cold. 

Many Types of Treatment Options 

If you suffer from allergies then the good news is that there are solutions that may work for you. There are numerous non-drug treatment options and medications and therapies such as intranasal steroids, antihistamines, decongestants, eye drops, leukotriene receptor antagonists, and immunotherapy. Treatment should be based on symptom severity and target specific patient symptoms. 

Non-Drug Treatment Options 

Ventilation systems, nasal irrigation, and wetting agents are non-drug treatment options to relieve allergy symptoms. These non-drug treatment options are safe for children and pregnant women. Ventilation systems help reduce allergens however can be costly. Nasal irrigations can be administered using a neti pot and saline mixtures. Wetting agents provide moisture to the nasal passages providing some relief for runny noses. Common wetting agents include Ocean and Little Remedies. 

Intranasal Steroids 

Intranasal steroids are the first-line agents used for chronic, moderate-severe allergy symptoms. Intranasal steroids target nasal symptoms such as sneezing, itching, and runny nose by decreasing inflammation. Both adults and pediatric patients can use them. Common intranasal steroids include Rhinocort Allergy, Flonase Allergy Relief, and Nasacort Allergy 24HR. Intranasal steroids require at least a week of use before symptomatic relief. Common side effects include nose bleed, headache, and dry nose. It is important to note that the same steroids used to treat allergies and asthma have different brand names, and delivery systems. Therefore, doses can’t be used interchangeably. 

Antihistamines 

Oral antihistamines are used to treat mild-moderate allergies. They are categorized into first-generation oral antihistamines and second-generation oral antihistamines. Both classifications can relieve itching, sneezing, and runny nose. However, these agents have little effect on nasal congestion. First-generation oral antihistamines can easily cross the blood-brain barrier. Therefore, they can cause heavy sedation, while second-generation oral antihistamines minimally cross the blood-brain barrier and cause less sedation and cognitive impairment. The most sedating second-generation oral antihistamines include Zyrtec and Xyzal, and the least sedating second-generation oral antihistamines include Allegra and Claritin. Zyrtec and Claritin are preferred treatments in pregnancy and while breastfeeding. Common side effects include sedation, cognitive impairment, dry mouth, blurred vision, constipation, urinary retention, and photosensitivity. 

*Most sedating second-generation oral antihistamines 

Decongestants 

Decongestants work by causing vasoconstriction (the narrowing of blood vessels) and reducing sinus and nasal congestion. They are divided into two categories: systemic oral decongestants and intranasal decongestants. 

Systemic Oral Decongestants 

Systemic oral decongestants should not be used in children under four years of age and should be used with caution in patients with heart disease, high blood pressure, glaucoma, and benign prostatic hyperplasia (BPH). Common side effects include increased blood pressure, tachycardia, heart palpitations, insomnia, and decreased appetite. Systemic oral decongestants take around 15-60 minutes to have an effect. 

Pseudoephedrine is a common non-prescription behind-the-counter systemic oral decongestant that is highly regulated as it is easily converted to methamphetamine. Pseudoephedrine is the active ingredient in Sudafed, Nexafed, and Zephrex-D. Under federal law, the maximum amount allowed for purchase is 3.6 grams daily and 9 grams in a 30-day period, so be aware of this when buying this particular medication. To purchase products containing pseudoephedrine, a government-issued photo ID is required. 

Intranasal Decongestants 

Intranasal decongestants should be used with caution in patients with cardiovascular disease, high blood pressure, thyroid disease, diabetes, and BPH. They have a fast onset of around 5-10 minutes. Common side effects include rebound congestion, nasal stinging, dry nose, and sneezing. 

Oxymetazoline is the active ingredient in intranasal decongestants such as Afrin and Vicks Sinex. Products containing oxymetazoline should not be used for more than three days as prolonged use will cause rebound congestion. 

*Should not be used for more than 3 days 

Eye Drops 

Eye drops can help relieve itchiness, dry eyes, and redness. Eye drops used to relieve dry eyes are often called artificial tears. They contain lubricants and should be administered multiple times a day as needed.

Oxymetazoline is the active ingredient in intranasal decongestants such as Afrin and Vicks Sinex. Products containing oxymetazoline should not be used for more than three days as prolonged use will cause rebound congestion. 

Oral Leukotriene Receptor Antagonist 

Singulair (montelukast) is an oral leukotriene modifying agent commonly used to treat allergies and asthma in children. Montelukast is only available with prescriptions and should be reserved for individuals who do not find symptomatic relief with other allergy medications.

Immunotherapy 

Immunotherapy is a preventative treatment for allergies that slowly increases exposure to the allergen, causing the immune system to become less sensitive to it over time. Long-term immunotherapy can relieve symptoms even after stopping treatment. Immunotherapy is recommended for a minimum of three years. Immunotherapy can be administered through injections or sublingual (direct absorption) treatments. 

All injections and the first sublingual treatments must be administered in a medical office. However, patients can take the following sublingual doses at home if it’s tolerated. The FDA has approved four sublingual immunotherapy treatments with specifically targeted allergens. It is recommended that patients have an epinephrine auto-injector (commonly known by the brand name EpiPen) while on this type of immunotherapy so there is a fast solution if there is an allergic reaction. 

Discuss Treatment Options with Your Doctor 

Many options are available to you if you’re seeking ways to manage your allergies. Your condition, medical history, and severity of your allergies will all play a role in which solutions are best for you. Speak with your doctor to learn more about which options are best for you.