ASK A PHARMACIST: SEASONAL ALLERGIES

Written By: Malissa Carroll, Web Content Specialist

Leaves are returning to trees, flowers are blooming, and the grass in your front yard probably needs mowing – spring has officially arrived! However, the arrival of warmer weather is not always welcomed for the millions of people who suffer with seasonal allergies. Sneezing, nasal congestion, and itchy, red eyes often send allergy sufferers on repeated visits to their local pharmacy in search of an over-the-counter treatment that will bring them some relief.

With so many options to choose from – Claritin, Zyrtec, Allegra, you name it – it can be difficult to determine which over-the-counter allergy medication might best meet your needs. Below, Deanna Tran, PharmD, BCACP, assistant professor in the Department of Pharmacy Practice and Science (PPS) at the School of Pharmacy, answers patients’ commonly asked questions about over-the-counter allergy medications and offers advice on how to choose the best treatment to address your unique needs.

How do over-the-counter allergy medications work?

The most common over-the-counter allergy medications are called anti-histamines. They block a chemical called histamines, which is released by your body during an allergic reaction. By blocking histamines, these medications are able to reduce the symptoms associated with allergies, such as sneezing, runny nose, congestion, and itchy eyes.

Although many people are most familiar with oral anti-histamines such as Claritin (loratadine), Allegra (fexofenadine), and Zyrtec (cetirizine), two of the most effective over-the-counter allergy medications are actually nasal sprays — Nasacort Allergy 24-HR (triamcinolone acetonide) and Flonase Allergy Relief (fluticasone propionate). These medications get right to the source by working directly in the nose to relieve nose- and eye-related allergy symptoms.

What is the difference between medications like Zyrtec and Zyrtec-D? How can patients tell which one might be best for them?

Zyrtec is an anti-histamine, also known as cetirizine. Zyrtec-D contains cetirizine as well as pseudoephedrine, a decongestant. Pseudoephedrine helps to relieve congestion, and would benefit any patients suffering from congestion in addition to other allergy symptoms. Pseudoephedrine products are found behind the pharmacy counter, and require a pharmacist to get the medication for you. I recommend purchasing the generic version if available, as it provides the same medication, but at a lower cost.

Who should NOT take an over-the-counter allergy medication?

Many individuals suffering from allergies could benefit from an over-the-counter medication. However, some individuals may not be able to take combination allergy products, such as Zyrtec-D, due to other medical conditions. I highly suggest asking your pharmacist for a recommendation before starting any allergy medication. Pharmacists can determine if your symptoms are due to allergies or some other underlying condition that needs additional medical attention, such as asthma or an infection. The pharmacist can recommend the best medication for you based on symptoms and other medical conditions, while keeping costs in mind. Children younger than 12 years old and women who are pregnant or lactating should not use an over-the-counter medication, but contact their primary care doctor for information about treatments that might work best for them.

Can over-the-counter allergy medications cause any side effects?

Side effects of common allergy medications taken by mouth (such as Claritin) are mild, and often stop when the medication is discontinued. Common side effects include dry mouth and throat, blurry vision, and constipation. Some patients also experience drowsiness with Zyrtec. I recommend taking Zyrtec at night if you are someone who does experience drowsiness. Nasacort and Flonase also have minor side effects, including nasal discomfort, bleeding, and/or sneezing.

Medications such as Benadryl (diphenhydramine) are not as effective and should not be used for seasonal allergies. Diphenhydramine is also associated with more side effects, such as severe drowsiness.

Can patients use a neti pot to help relieve their allergies?

Neti pots and saline nasal sprays, such as Ayr Saline Nasal Mist, may help wash away the mucus in your nose, but they do not address the underlying problem. Nasacort, Flonase, or a tablet allergy medication can address the underlying problem. If you choose to use a neti pot, make sure to use distilled, sterile, or boiled tap water to avoid infection.

What should be a patient’s next step if over-the-counter allergy medications do not relieve his or her symptoms?

If allergy symptoms do not improve after several days, a patient could ask a pharmacist for further advice, as there are over-the-counter medications that can be used in combination to help relieve allergy symptoms. If symptoms worsen while taking an over-the-counter medication or do not improve after 2-3 weeks, the patient should contact his/her primary care physician for evaluation and potentially a prescription medication for his/her allergies.

What other advice would you give to individuals suffering from allergies?

The best type of medicine may be no medicine! Try to avoid what triggers your allergies. Pollen counts are highest in the morning, so plan outdoor activities for later in the day or avoid it altogether. I would also suggest not opening your windows or hanging your clothes outside to dry. Washing your clothes and taking a shower after returning from an outdoor activity can also help reduce symptoms by washing away any pollen or other allergens that have accumulated on you or your clothing.