In case you’re scuffling with allergy signs, you could assume you’ll be able to resolve them with an over-the-counter (OTC) treatment. And that could be true. Many pharmaceutical-grade allergy medications as soon as obtainable solely by prescription at the moment are as straightforward to purchase as aspirin. However, that improvement forces you to grow to be a physician within the drugstore aisle as you attempt to determine which product is best for you. “Individuals usually make the wrong choice about which medicine to take, and so they wind up being undertreated. They struggle a mixture of drugs, however, do not get a reduction,” says Dr Ahmad Sedaghat, an ear, nostril, and throat specialist at Harvard-affiliated Massachusetts Eye and Ear Infirmary.
What causes allergic reactions?
Earlier than selecting a medicine, it helps to know what’s inflicting your allergic reactions. Usually, it is a matter of inhaling an innocent substance, akin to pollen or one other allergen, which the immune system mistakenly perceives as a harmful invader.
The immune system then “releases the hounds” and generates substances designed to battle the assumed invader. Considered one of these substances is histamine, which stimulates nerves within the nostril to set off sneezing. Histamine additionally causes the nasal passages to fill with fluid and cells that may battle invaders. The outcome: infected mucous membranes and the manufacturing of mucus (a lot of it). This situation, known as allergic rhinitis, is marked by a stuffy or runny nostril, watery or itchy eyes, sneezing, coughing, and typically a sore throat.
Methods to battle again
There are two significant ways in which OTC medication enable you to handle allergic reactions. One is by blocking the consequences of histamine when alarm bells sound. To do that, you should utilise a medicine known as an antihistamine, akin to diphenhydramine (Benadryl) or loratadine (Claritin).
One other method, says Dr Sedaghat, is by suppressing the immune system response earlier than it even releases histamine. That is executed with corticosteroid nasal sprays. OTC variations embrace budesonide (Rhinocort), fluticasone propionate (Flonase), and triamcinolone (Nasacort). Generally, a mixture of an antihistamine and a corticosteroid nasal spray is the most straightforward therapy.
In case you’re experiencing what looks like your first response to an allergen from pollen, grasses, or weeds — perhaps from a very potent pollen season — or when you’re experiencing a remoted response to a day of yard work, Dr Sedaghat recommends attempting an antihistamine for fast reduction.
However watch out: first-generation OTC antihistamines akin to chlorpheniramine (Chlor-Trimeton) and diphenhydramine could cause drowsiness and confusion in some individuals, which may additionally result in falls. As an alternative, Dr Sedaghat suggests taking a second-generation OTC antihistamine that is much less more likely to trigger drowsiness, akin to fexofenadine (Allegra), loratadine, or cetirizine (Zyrtec). In contrast with first-generation antihistamines, the second-generation ones aren’t any stronger. However, they’re costlier.
Antihistamine eye drops, akin to ketotifen (Zaditor), obtainable over-the-counter, can be utilised for watery eyes.
If an antihistamine is not resolving your signs, or if you already know you may have an allergic response in a specific season (tree pollens are bothersome within the spring, grasses generally is a drawback in early summertime, and ragweed is an offender in late summertime and fall), you could need to up your sport through the use of a corticosteroid nasal spray. “Face to face, the corticosteroid nasal sprays work higher than the oral antihistamines for congestion and stuffy nostril,” Dr Sedaghat says.
The drawback is that these sprays take time — often not less than two to 4 weeks — for his or her full impact. That may be powerful whenever you’re dealing with signs. In case you anticipate seasonal allergy signs, you may want to start out utilising the corticosteroid nasal spray earlier than symptoms usually start.
However nasal corticosteroids even have uncomfortable side effects: they’ll trigger bloody noses; they’ll worsen glaucoma; and in uncommon instances, they’ll trigger a gap within the septum, the wall that separates the appropriate and left the aspect of the nostril.
What about decongestants?
Over-the-counter decongestants, akin to pseudoephedrine (Sudafed) or phenylephrine (Neo-Synephrine, Sudafed PE), slender the blood vessels, which can assist scale back irritation in your nasal passages and supply reduction. However, older adults could be extra delicate to the consequences of those drugs, so it is necessary to verify along with your physician earlier than utilising them.
What’s the issue? For one, decongestants can enhance your blood strain. Decongestants are additionally stimulants, which may improve your coronary heart price or trigger nervousness or insomnia. The medication isn’t beneficial for individuals with coronary heart illness, hypertension, diabetes, or angina.
Utilising over-the-counter decongestant nasal sprays for greater than two or three days can backfire, resulting in better swelling than you skilled initially.
When to see a physician
Dr Sedaghat recommends attempting out OTC treatments to deal with allergy signs for a month. In case you nonetheless have symptoms, or when you’re involved about uncomfortable side effects, it might be time to seek the advice of your primary care doctor; an allergist; or an ear, nostril, and throat specialist.
“All of those drugs could be tweaked by way of how a lot you are taking and the way usually,” Dr Sedaghat says. However bear in mind, it takes a professional to understand how a lot and which sort of drug might be secure on your specific well being situation and the way it will work together along with your different drugs.
Another choice: transferring to prescription allergy medication. Prescription antihistamine sprays, akin to azelastine (Astelin) and olopatadine (Patanase), could assist forestall the signs of sneezing and a runny nostril whereas minimising drowsiness.
Docs may also add one other sort of prescription medicine to your routine, known as a leukotriene inhibitor. This medication — akin to montelukast (Singulair), zafirlukast (Accolate), and zileuton (Zyflo) — block inflammatory chemical compounds known as leukotrienes.
Generally, it takes trial and error to seek out one of the best mixture of medicines to alleviate your signs. And if nothing is controlling them, there are nonetheless extra choices, together with allergy photographs that may change how your immune system responds to allergens (a remedy that takes months to kick in and years to keep up).
However, Dr Sedaghat recommends attempting other conservative remedies first. “We’ve got nice success with the usual method of antihistamines and corticosteroid nasal sprays,” he says. “For many individuals, that is all it takes to breathe simpler and eradicate the signs of allergic rhinitis.”