Remedies for Seasonal Allergies

26
May

Remedies for Seasonal Allergies

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
  • Singulair
  • 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

 

  1. Lexicomp
  2. LactMed database.
  3. 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

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