Which over-the-counter allergy medication works best? (2023)

To search for! hi good old manallergiesseason. Her eyes are watering, her nose is running and her whole face itches. Now you're at the pharmacy with an allergy medicine and you feel completely overwhelmed. Which of the many options is the best option for you?

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allergistMark Aronica, MD, to the rescue. It explains the differences between different types of over-the-counter allergy medications and how to decide which (or more) are right for you.

Antihistamines and Decongestants Explained

There are two categories of over-the-counter drugs commonly used for treatmentallergies: Antihistamines and decongestants.

dr Aronica explains what they are, what they do, how often you can take them, and more.

What is an antihistamine?

To understandantihistamines, it's good to know what histamine is. This important chemical plays a role in regulating many of your body's physiological functions. It is also involved in local immune responses.

"Histamine is stored in immune cells called mast cells," explains Dr. aronic. "When your body encounters something it's allergic to (known as an allergen), these mast cells are activated to release their contents, which causes allergy symptoms."

Histamine is the main chemical responsible for the itchiness associated with allergies. It can also make blood vessels more leaky (leaky), leading to a blockage. Therefore, antihistamines are drugs that block some of the effects of histamine.

Allergists recommend non-sedating, non-drowsy, long-acting antihistamines for daily use. While you might know them by their brand names, the generic versions address the same issues:

  • cetirizine(Zyrtec®, Aller-Tec®, Wall-Zyr®).
  • fexofenadina(Allegra®, Aller-ease®, Aller-Fex®, Wal-Fex®).
  • Loratadine(Claritin®, Alavart®, Allerclear®, Wal-itin®, Lodamed®).

Diphenhydramine, commonly known as Benadryl®, is also an antihistamine but is not recommended for everyday allergies. It has a short, strong sedative effect, which can affect your daily work and your ability to use machines (eg your car).

Zyrtec vs. Allegra vs. Claritin: what kind of antihistamine to take

With three types of antihistamines claiming to do the trick, which one should you choose? In a way, it's about figuring out which drug your body responds to best.

"They all block the same receptor," notes Dr. Aronica, "but some patients say a drug seems to work better for them. And in this case, that's the drug you should be using."

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The main difference between the three is their ability to put you to sleep. They are all labeled "non-drowsy" (non-sedative), but butcetirizine has the highest likelihood of drowsiness.

"Cetirizine (Zyrtec) has a slightly higher risk of sedation than the other two, followed by loratadine (Claritin)," explains Dr. aronic. "Fexofenadine (Allegra) is the only long-acting, non-sedating antihistamine approved for use in airline pilots because it is the least sedating of the three."

Another note here: although it tends to cause drowsiness, cetirizine also has the most rapid onset of action; in other words, it starts working faster.

What is a decongestant?

Decongestants do exactly what the name suggests: they aid in detoxification.To stay(Constipation) caused by allergies. "Decongestants narrow the blood vessels in the nose, which opens up the airways in some patients," explains Dr. aronic.

Pseudoephedrine, sold by itself as Sudafed®, is the most common decongestant, but pseudoephedrine also comes with an additional antihistamine. If there is a "-D" at the end of the drug's name, it stands for "decongestant", meaning it is an antihistamine/decongestant hybrid:

  • Cetirizina com pseudoefedrina (Zyrtec-D®).
  • Desloratadine with pseudoephedrine (Clarinex-D®).
  • Fexofenadine with Pseudoephedrine (Allegra-D®).
  • Loratadine with Pseudoephedrine (Claritin-D®).

Products containing pseudoephedrine are usually regulated by law. Many states require you to show your driver's license to purchase them.

How often can you take allergy medication?

good news forbad allergies: Antihistamines are good for daily use.

"Long-acting, non-sedating antihistamines can be used daily and are generally very safe for long-term use," says Dr. aronic. In a pinch, you can take two in one day, but if you often find that antihistamines aren't relieving your allergy symptoms, try a different type or ask your allergist for advice.

And don't take a decongestant every day.

"Decongestants can be used as needed to cover heavy days, but certainly not for more than 10 to 14 days at a time," cautions Dr. aronic. They have a caffeine-like effect on your body, so there is a risk of side effects such as increased heart rate and blood pressure.

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In other words, save the decongestants for your worst allergy days.

Can you take two types of allergy pills together?

There is no definite answer to this question as it differs depending on the type of allergy pill. dr Aronica reviews the pros and cons of allergy medication mixes.

  1. Find the antihistamine that works best for you."I usually encourage patients to find one that works and stick with it," says Dr. aronic. That said, if you're in a pinch on allergy day, it's generally safe to take a different antihistamine than what you were taking earlier in the day. And if your allergist recommends that taking two different antihistamines regularly is right for you, follow their advice.
  2. Take an antihistamine and a decongestant together as needed.On days when you are particularly hot, you can take your regular antihistamine with a Sudafed. "If you have additional issues within a few days, you can add a Sudafed to your antihistamine as needed," he says. (This will also save you some money, as antihistamine/decongestant combinations can be expensive.)
  3. Do not add a decongestant to medications that end in "-D".Remember that antihistamines ending in -D already contain a decongestant. Therefore, if you have taken any of these, you should not add a separate decongestant.
  4. Do not take more than one combination of allergy medications.If it ends in "-D", only take one a day, and again, no more than a week or two at a time.

What are the side effects of allergy medication?

We've already covered some of the possible side effects of allergy medication, but they bear repeating.

Of the three antihistamines, cetirizine (Zyrtec) is most likely to cause drowsiness (3% to 8% more than placebo in most studies), followed by loratadine (Claritin) (2% to 4%). If you want to be sure your allergy medication isn't interfering with your daily functions, take it at night before bed or take fexofenadine (Allegra) (1% to 3%), whichever makes you less drowsy.

And you shouldn't take decongestants (like Sudafed or other allergy medications that end in "-D") for more than a week or two at a time or you risk heart problems.

Don't forget the nasal spray

nasal spraysare one of the best and only ways to really tryprevents seasonal allergies, and you can use them along with your daily antihistamine. But nasal sprays work so well, you might not even need antihistamines or decongestants!

There are two classes of allergy nasal sprays: over-the-counter steroid nasal sprays, such as fluticasone and betamethasone, and prescription antihistamine nasal sprays, such as azelastine and olopatadine.

“Nose sprays really are the best medical therapies we have for treating allergic rhinitis,” says Dr. aronic. "I advise my patients to start using the nasal spray at least two to three weeks before allergy season starts."

To learn more about allergies with Dr. To learn more about Aronica, listen to the Health Essentials podcast episode,"How to Deal with Spring and Summer Allergies."New episodes of the Health Essentials podcast are released every Wednesday.

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