The majority of allergy medications are now available without a prescription. This is obviously a good thing if you are an allergy suffer, as you do not have to see your doctor to get a prescription for a simple treatment.
However, you should be careful. Over-the-counter medications can be tricky if you don’t know all of the benefits or risks of using them.
This is where I come in. I am going to educate you on the best over-the-counter medication for your spring allergies.
Benedryl (which has the generic name diphenhydramine) is the best known oral antihistamine. It has been around the longest and is the most widely used, but it shouldn’t be!
Benedryl may be beneficial for an acute allergic reaction to a food, but as a chronic medication it has too many drawbacks.
Benedryl is a short-acting antihistamine, so it’s protection is limited to a few hours. The other well-known adverse reaction is that it crosses into the brain, and makes users tired. Pharmaceutical companies have taken advantage of this drawback by adding diphenhydramine to pain medications, like Tylenol PM or Advil PM, in their nighttime formulas.
A Better Choice
A much better choice of oral antihistamines are the newer products: Claritin (loratidine ), Allegra (fenofexadine) and Zyrtec (cetirizine). These antihistamines act for a much longer period of time, varying from 24 hours to 3 days with just one pill.
These antihistamines tend to be much less sedating than the older antihistamines and with few drug interactions or side-effects.
Advantages of Oral Antihistamines
There are advantages to taking an oral antihistamine for allergic symptoms such as sneezing, runny nose and eye itching.
These medications can block each one of these reactions and are easy to administer. There is no difficult technique involved in taking these types of antihistamines, which include eye drops or nose sprays.
Therefore, you would probably think these antihistamines are the perfect anti-allergy medication. However, in reality they are good, but not great!
For the tougher allergy symptoms, such as severe nasal congestion, red eyes and throat itching, topical medications trump the oral antihistamines.
By administering the topical solution to the nose and/or eye, the tissue gets an immediate and deeper absorption of medicine to block the allergic reaction.
My patients continually talk about their confusion when choosing over-the-counter nasal sprays. Many are aware of Afrin but are afraid to use it. They have heard it is addictive – and they are right!
Afrin is not a good medication to use to treat nasal allergies on a long-term basis. It does not block allergic inflammation, and you can get a rebound effect where after you stop using it you become even more congested, hence the addictive quality to it.
Additionally, many patients are aware that nasal sprays can contain cortisone and have concerns around whether it is dangerous. Cortisone nasal sprays, such as Flonase (fluticasone) or Nasacort are steroid sprays that are available over-the-counter. They can work wonderfully in relieving symptoms within an hour and last for a full day.
These nasal sprays tend to be very safe, since they mainly work locally in the nasal tissue without significant absorption by the rest of the body. This avoids concern of a drug-drug interaction, which can happen with an oral antihistamine. However, like with all nasal sprays I tell my patients that technique is very important, so important that you are using them in the right way.
The Importance of Technique
When using nasal sprays, it is essential that you have the right technique. You should aim the spray to the side of the nose, not to the middle! If you aim to the middle of your nose you can irritate your nasal septum or, in the worst case scenario, perforate or make a hole in the septum. If you have been using a cortisone nasal spray for over a month, I would advise checking with your doctor to see if have been using the right technique.
Ophthalmic Eye Drops
Ophthalmic eye drops are an excellent way to relieve severe eye itching and redness. There are many different types, and of course some are good and some are bad.
The over-the-counter Visine is a bad choice. The decongestant in the Visine may “Get the Red Out” as they advertise in the commercials, but like Afrin it can be addicting and cause more long-term problems.
The only antihistamine eye drops available are older version type antihistamines and I do not recommend them!
There are many good prescription antihistamine eye drops such as Patanol, Pataday, Elestat and Optivar. Be sure to check with your doctor to see which one would be best for you. Also, check with your insurance coverage. Many of these eye drops can be very expensive, so make sure you are covered.
Why Do You Need An Allergist?
At this point you may be wondering: ” Who needs an allergist when all of these over-the-counter medications are available?” I thought about this question long and hard, and surprisingly there are still many allergy sufferers who need my help.
One important service I provide to my patients is allergy desensitization or immunotherapy. I have treated thousands of patients effectively with sublingual drops to environmental allergens, like tree and grass pollen, cats and dogs and dust and mold.
Sublingual allergy immunotherapy, is a natural way to get lasting protection against airborne allergens. The only key factor is that a patient has to build up high levels several months before the beginning of their allergy season.
The snow is finally melting here in New York, so we are all braced to go out an enjoy the warmth and green of spring. If allergies slow you down, consider these medications available at your local pharmacy. If they paralyze your golf game or jogging, consider sublingual allergy drops – beating allergies has never been easier!
You can read more about how I use sublingual drops to treat my patients in my book: Dr. Dean Mitchell’s Allergy and Asthma Solution.