When looking for relief for seasonal allergies there are a lot of choices for medication and treatment. See my recommendations below.
The Best Over-the-Counter Allergy Medicine For:
A Stuffy/Runny Nose:
Step 1: Try Nasacort or Flonase, nasal steroid sprays
- For adults: Do 1-2 squirts in each nostril once daily. For kids 2-6 years old: do 1 squirt in each nostril once daily.
- Expect that it may take 1-2 weeks for it to start working.
- Most people tolerate these nasal sprays without side effects. But possible side effects are bloody nose, sore throat and headache.
- Pregnant and Breastfeeding women can use these, as they have not been shown to hurt the baby. (1)
- If these do not work for you or you have side effects, you can try Step 2 or 3 alone or in combination with Step 1. In addition, your physician can give you a script for a different nasal steroid that may work better for you.
Step 2: Try Claritin (Loratadine) or Zyrtec (Cetirizine)
- Try one or the other of these medicine, not both at the same time.
- You can take 1-4 tabs once a day of either medicine. Start with one tab, and if that does not help, increase the number of tabs one at a time until you get relief. However, the more tabs you take, the greater risk of side effects.
- The generics work just as well as the brand names.
- Most common side effects include: headache, drowsiness (mostly Cetirizine).
- If you take either of these continuously for over a year, they tend to lose their effectiveness.
- Loratadine is safe to take while pregnant or breastfeeding. Cetirizine is also safe in pregnancy, but may cause drowsiness in the infant if taken daily while breastfeeding (2).
- If your child has allergies, your doctor can prescribe him/her one of these medicines in liquid form.
- Benadryl is as effective as these medicines, but Benadryl tends to make you drowsy.
Step 3: Try Allegra (Fexofenadine)
- This is more expensive, but more effective than Claritin and Zyrtec
- You can start with the short acting 60mg pill twice a day, and then progress to the stronger long-acting 180mg pill once a day if needed
- Most common side effect: Headache
- This is safe to take when pregnant or breastfeeding (1, 2)
- Do not use with Claritin or Zyrtec
Step 4: See your Physician about other options available by prescription:
- Zyrtec, Claritin, or Allegra, each combined with a decongestant in a combo pill
- A different Nasal Steroid
- Antihistamine Nasal Sprays
- Steroid shot: these used to be given more frequently in years past, but are now falling out of favor with expert Allergists because of their long term side effects.
Step 5: Talk with your doctor about Allergy Testing and Allergy Shots or Allergy Drops
- Most people who have not found relief from medications can have their allergy cured by allergy shots in the arm or drops under the tongue.
- Children with asthma are much more likely to grow out of their asthma if they get allergy shots for the allergy triggers of their asthma.
Itchy Red Eyes:
Step 1: Cold compresses (e.g. ice packs) applied over the eyes as frequently as needed.
- Only helps when the eyes get really inflamed, red, and sore
Step 2: Try Over-the-Counter Antihistamine Allergy Eye drops like Zaditor or Alaway
- These can be ordered on-line if you cannot find them at your drug store
- Contact lens wearers should not put these in their eyes while wearing contact lenses; wait 10 minutes after putting in the eye drops before putting in your contact lenses (1).
- Most people tolerate these eye drops fine without any issues. However, the most common side effect is a feeling of burning in the eyes.
- Use the eye drops twice a day.
- These eye drops are more effective than taking Claritin, Zyrtec, or Allegra alone.
Step 3: In addition to using the eye drops, take Claritin (Loratadine), Zyrec (Cetirizine), or Allegra
- Sometimes Claritin, Zyrtec, and Allegra, although they stop the itching, can dry out the eyes and make them redder, which is why I recommend trying the eye drops by themselves first.
Step 4: See your doctor about prescription antihistamine eye drops like Pataday or Patanol.
Step 5: Use Over-the-Counter allergy eye drops that have an antihistamine and a vasoconstrictor in them, like Opcon-A, Visine-A, or Naphcon-A.
- These work well, but if used continuously for more than 2 weeks, once the drops’ effect wears off, the eyes become redder than before (3).
Step 6: Ask your doctor about Allergy Testing and Allergy Shots or Allergy drops.
- Most people who have not found relief from medications can have their allergy cured by allergy shots or drops under the tongue.
David Beckstead, MD
Canyon View Family Medicine
- LactMed database.
- Hamra P, Dana R. Allergic conjunctivitis: Management. UpToDate. http://www.uptodate.com.xlib1.intermountain.net/contents/allergic-conjunctivitis-management?source=preview&search=%2Fcontents%2Fsearch&anchor=H20575032#H20575032