Which Type of Allergy Medication Is Right for You?

Dr. Menachof, MD, has specialized in conditions around the head, throat, ear, nose, neck and face for over 20 years, and was the first to bring sublingual allergy drops to Colorado in 2005. He has been recognized as a Fellow by multiple academies, named one of America’s Top Facial Plastic Surgeons continually since 2003 and is featured in multiple national publications.

There are many different ways to treat allergies, and some treatments work better than others depending on your symptoms and lifestyle. Each person reacts differently to allergens–the irritants that trigger histamine reactions and cause symptoms like stuffy nose and itching. The same is true for allergy medications as well. 

It may take some trials with different medications, or a combination of several, to find the ideal relief from all of your allergy symptoms. Allergy treatment options include antihistamines, decongestants, combination drugs, corticosteroids, and other medications. Immunotherapy is also a long-term approach to allergy treatment, which gradually increases your tolerance to allergens through allergy shots or allergy drops

Below we explain the differences between several types of allergy medicine, how they work, and which allergy symptoms they alleviate most effectively.

Antihistamines

Best for Treating Itching and Nasal Allergy Symptoms

Antihistamines work by targeting and blocking histamine, which is the chemical substance your body releases when exposed to an allergen, such as pollen or pet dander. Antihistamine treatments can take the form of pills, liquid, nasal spray, or eye drops. Once antihistamine medications are in your bloodstream, they can quickly reduce symptoms caused by allergens and prevent the release of histamines in the first place.

Taking antihistamines before or during exposure to an allergen can help limit and even prevent allergy symptoms. Antihistamine pills are most effective against itching, sneezing and runny nose, while nasal sprays are primarily designed to relieve congestion and pressure. It’s important to note that certain antihistamine, especially older drugs, can cause drowsiness and dizziness, so you should be careful to avoid certain activities like driving after taking some antihistamines.

Symptoms Treated by Antihistamines

Examples of Antihistamines

Over-the-Counter

  • Allegra (fexofenadine)
  • Benadryl (diphenhydramine, can cause drowsiness)
  • Claritin (loratadine)
  • Zyrtec (cetirizine)

Prescription

  • Clarinex  (desloratadine)
  • Astelin (azelastine, nasal spray)
  • Optivar (azelastine ophthalmic, eye drops)

Side Effects of Antihistamines

Older antihistamines, especially over-the-counter drugs, may cause drowsiness or dizziness. However, newer second and third generation antihistamines are non-sedating, meaning they do not cause drowsiness and are safe to take before most activities. Antihistamines can also cause dryness as a side effect, especially after prolonged use. 

Decongestants 

Best for Treating for Nasal and Sinus Congestion or Pressure

Decongestants primarily target congestion and nasal-related allergy symptoms, and they can work well for fast relief. If nasal obstruction or trouble breathing is your worst allergy symptom, this may be the best option for you. Decongestants work by decreasing the inflammation and fluid production in your nose that are often triggered by allergens. This allows the nose to drain more effectively, air to flow freely, and any swelling of the nasal passages to go down, relieving symptoms. 

Allergy medications that are decongestants can come in pill, liquid or nasal spray form. The most common form of decongestant are pills, which many people use to combat seasonal allergies especially. Nasal sprays and eye drops can both stop being effective or make symptoms worse if overused, so it is important to use them sporadically (no more than a few days at a time) to treat symptoms.  

Symptoms Treated Best by Decongestants

Examples of Decongestants

  • Afrin (oxymetazoline, nasal spray)
  • Sudafed (pseudoephedrine, pill or liquid)
  • Neo-Synephrine (phenylephrine)
  • Certain Visine eye drops

Side Effects of Decongestants

Decongestants can raise blood pressure, especially with prolonged use, so they are not usually recommended for people with high blood pressure or glaucoma. Certain decongestant treatments may also cause insomnia or irritability and can restrict urinary flow.

Combination Allergy Drugs

The Best of Both Antihistamines and Decongestants

Choosing Allergy MedicationCertain allergy medications contain both an antihistamine and decongestant to relieve multiple allergy symptoms at once. These combination drugs can be an effective treatment for people who experience nasal congestion or trouble breathing in addition to other allergy symptoms like hives or itchy eyes

Examples of Combination Allergy Medications

  • Allegra – D 
  • Clarinex – D
  • Claritin – D
  • Dymista

Side Effects of Combination Medications

Since combination allergy meds include elements of both antihistamines and decongestants, it is possible for patients using these drugs to experience side effects associated with either treatment type. While drowsiness is unlikely it can still occur, as can insomnia or irritability and blood pressure increase.

Corticosteroids

Treats Inflammation and Swelling

Corticosteroids can reduce inflammation that is associated with allergies. These medications primarily treat and prevent nasal stuffiness, sneezing, and an itchy, runny nose caused by allergic reactions. They work quickly and limit the body’s histamine creation preventing the allergic response that leads to problematic symptoms like a stuffy nose or sore throat. Steroids can work well both for seasonal and year-round allergy symptoms.

Steroids are considered highly effective at relieving allergy symptoms, but they must be taken regularly, even when no symptoms are experienced, to work well. Like many allergy medication types, it can take several weeks before the full relief from the medicine is felt.

Systemic steroids are available as pills or liquids for serious allergies and asthma, but are also common as nasal sprays or inhalers. They can also be used as a topical cream for skin allergies to relieve hives and swelling. Many doctors recommend nasal steroid sprays to help with year-round allergies. Corticosteroid medications can take longer to kick in than antihistamines, but most healthcare providers consider them to be the most effective way to combat nasal allergies. Many, but not all, of these steroid treatments require a prescription.

Symptoms Treated by Corticosteroids

Examples of Corticosteroids Include

  • Flonase
  • Nasonex
  • Rhinocort
  • Deltasone
  • Beconase

Side Effects of Corticosteroids

There are many potential side effects that can occur if steroid treatments are used for an extended period of time. Side effects are typically mild, such as weight gain, fluid retention, and increased blood pressure but certain patients may develop more serious complications including diabetes, osteoporosis, and muscle weakness. Steroids that are ingested through nasal sprays or inhalers can cause side effects such as cough, hoarseness, and fungal infections of the mouth. 

Mast Cell Stabilizers

Treats Mild to Moderate Inflammation in Allergy Sufferers

Mast cell stabilizers are often used alongside other allergy treatments to help alleviate mild to moderate inflammation. These treatments work by preventing histamine from being released by the mast cells, which are the cells that produce and store histamine. 

Mast cell stabilizers are available as eye drops for itchy eyes, also called allergic conjunctivitis, and as nasal sprays for nasal allergy symptoms. As with many drugs, it may take several weeks to start working at its best.

Examples of Mast Cell Stabilizers

  • Opticrom (Cromolyn sodium)
  • Alomide (Lodoxamide-tromethamine)
  • Alocril (Nedocromil)
  • Alamast (Pemirolast)

Side Effects of Mast Cell Stabilizers

Side effects are not common, but in some cases patients experience throat irritation, coughing, or skin rashes. Mast cell stabilizers taken as eye drops can occasionally cause burning, stinging, or blurred vision.

Leukotriene Modifiers

 Treats Asthma and Nasal Allergy Symptoms

Leukotriene modifiers can be prescribed along with other allergy medications to help reduce allergy symptoms. These drugs are primarily used to treat asthma and nasal allergy symptoms. They work by blocking the leukotrienes, a type of chemical produced by the body in response to allergens. Leukotriene modifiers can be taken as pills, chewable tablets, and oral powder. 

Examples of Leukotriene Modifiers

The only leukotriene modifiers that the FDA has approved is Singulair (monteleukast).

Side Effects of Leukotriene Modifiers

Side effects of leukotriene modifiers are rare but can include:

  • Stomach pain or stomach upset
  • Heartburn
  • Fever
  • Stuffy nose
  • Cough
  • Rash
  • Headache
  • Irritability

Immunotherapy

Best Treatment to Manage Allergies Long Term

Immunotherapy is a great option for anyone who suffers from severe allergy symptoms, especially for those with year-round allergies. Immunotherapy works by exposing you to gradually increasing levels of an allergen to help your immune system slowly build a tolerance, relieving allergy symptoms and even preventing new allergies from developing. 

Allergy shots are one form of immunotherapy that require frequent office visits to be administered by a doctor. Allergy drops are a revolutionary form of immunotherapy that can be taken under the tongue from home each day to relieve allergy symptoms long term. Both allergy shots and allergy drops can be prescribed by a doctor after specific allergies are determined by an allergy test. This is a long term approach to allergy relief and management, with most patients taking allergy shots or drops for a period of three to five years.

Symptoms Treated by Allergy Shots or Drops

Examples of Immunotherapy

  • Allergy Shots
  • Allergy Drops
  • Allergy Tablets

Side Effects of Immunotherapy

The rare side effects that occur with allergy shots include redness, inflammation or irritation at the site of injection, with occasional allergic reaction to the allergy shot. There are no reported side effects or issues from the use of allergy drops. 

Work With an Expert to Find Relief Faster

Deciding which allergy treatment option is right for you can be difficult. It’s important to understand your exact type and severity of allergies and discuss all of your options with a specialist. Working with an expert to discuss your symptoms and determine your best course of action will help you find the right medication and get relief from allergy symptoms faster. Schedule a consultation with Advanced ENT & Allergy Center to get to the root of your allergies and find the right treatment for your lifestyle. 

Schedule an Appointment with an Expert