Medications for allergies

Antihistamines help runny nose, sneezing and itchiness, but do not help congestion. They work by stopping the action of histamine, a major substance involved in the allergic reaction. Commonly used antihistamines, such as Benadryl®, Chlor-Trimeton®, Naldecon®, Actifed® and Tavist®, can cause drowsiness.

Some of the newer antihistamines, such as Claritin®, Allegra®, Zyrtec® and Clarinex®, do not cause drowsiness. These antihistamines are not necessarily more potent, but they are easier to tolerate and take on a regular, round-the-clock schedule. Astelin® is an antihistamine nasal spray that delivers the antihistamine to the nose where it is needed most.

Decongestants are used to relieve nasal congestion or stuffiness. Pseudoephedrine (Sudafed®) and phenylephrine are available over-the-counter. Decongestants frequently are added to the antihistamines. Side effects of decongestants include insomnia, shakiness, urinary hesitancy and increasing blood pressure in people prone to hypertension.

Decongestant nasal sprays, such as Afrin®, immediately help relieve nasal stuffiness but, after only a few days of regular use, are highly addicting. They start causing more congestion that seems to respond only to more nasal decongestant sprays.

Nasal corticosteroid sprays, such as fluticasone (Flonase®), mometasone (Nasonex®), triamcinolone (Nasacort®) and budesonide (Rhinocort Aqua®), are very effective and safe for people whose symptoms are not relieved by antihistamines alone. They work by preventing and decreasing inflammation in the nose, which eases allergy symptoms. They take several days of use to obtain maximum benefit, and should be used daily to maintain symptom control.

These sprays are not like over-the-counter nasal sprays that people can get addicted to. They are not the kind of steroids that athletes or body builders use. Common side effects include nasal irritation, sneezing or headaches.

Cromolyn sodium is available as a nasal spray (Nasalcrom®). It works by preventing cells from releasing the substances that cause the allergic reaction. It can treat seasonal or chronic allergies. It requires use several times per day and may take several weeks to provide relief. It is a very safe drug with no significant side effects.

Leukotriene modifiers have been shown to relieve the symptoms of seasonal allergies. Leukotrienes originally were approved to treat asthma by blocking bronchial constriction and mucus production, leading to decreased asthma symptoms. Montelukast (Singulair®) is the only leukotriene modifier to be approved for both asthma and allergic diseases.

Several types of allergy medications are available in the form of eye drops to relieve allergy symptoms in the eyes.

• Crolom®, Alomide® and Optivar® are anti-inflammatory eye drops that can be used on a daily basis during allergy season to relieve pain, inflammation and itching.
• Livostin®, Patanol®, Optivar® and Pataday® are antihistamine eye drops. They prevent the release of histamine from cells and relieve itching.
• OcuClear®, Visine LR®, Allerest® and Murine Plus® are decongestant eye drops. They constrict swollen blood vessels and decrease fluid pressure in the eye. They are available over-the-counter. They can cause rebound redness with regular use.
• Opcon-A® or Naphcon-A® are combination antihistamine and decongestant eye drops. They provide quick relief for itchy, red eyes and are available over-the-counter. With regular use, decongestant eye drops may become addicting and eventually increase eye symptoms.