It’s that time of the year, folks. Springtime. The weather is warming up. The birds are singing. The trees and flowers are blooming. It is one of my favorite times of the year. Except for one thing…..allergies. Itchy eyes, runny nose, sneezing, sinus congestion……maybe I don’t like Spring that much after all. Sure, I do. These things are treatable. Let’s talk about the what the best OTC treatment for seasonal allergies is.
To be clear, there isn’t just one best OTC treatment for seasonal allergies. There is only a best treatment for you. It depends on how severe your allergies are and how often they occur. This is also different than an allergic reaction to food or medication that I wrote about in an earlier article. There are several categories of medications to cover and we will cover them one at a time.
Antihistamines
Antihistamines are usually the first type of OTC medications that most people try when their allergies are bothering them. Like with our smart phones, there are different “generations” of antihistamines.
First generation antihistamines include diphenhydramine (Benadryl), pheniramine, and chlorpheniramine. You will find these ingredients available alone, or in combination products. The first generation medications are effective but they have some drawbacks. They might tend to make you sleepy. They also must be taken several times each day to get the most benefit. I would recommend Benadryl for hives or an allergic reaction, but not for seasonal allergies. In fact, Benadryl makes you so sleepy that most OTC sleep aids contain diphenhydramine, the active ingredient in Benadryl.
Second generation antihistamines are the best OTC treatment for seasonal allergies for a lot of people who have symptoms that are easy to treat. This class includes familiar names like Claritin, Zyrtec, and Allegra. These medications work really well for most people. They won’t make you sleepy. They can be taken once daily. In a lot of cases, this will be all you need to feel better.
These second generation antihistamines are all available as a single ingredient or in combination with a decongestant, or the “D” formulation. If you have sinus congestion with your allergies, you can consider the “D” version. Otherwise, just stick with the regular version. Claritin D, Zyrtec D, and Allegra D must all be purchased behind the pharmacy counter. To see why, just refer back to this article.
I don’t really have a preference among these three products. You will need to pick one and see how well it works. Different ones work better for different people. If you have been taking one product for a while, and the effectiveness seems to be decreasing, just switch to another one. A simple switch will sometimes make a big difference. You can often go back to your preferred product later, after some time off of it.
There are third generation antihistamines, but they are not available over the counter. The names include Xyzal and Clarinex. I am not convinced they are any better than the second generation products. Don’t spend a lot of money to get them.
Nasal Decongestants
A lot of customers I run into have a wrong impression of what nasal decongestants are for. They think it cures anything to do with the nose. I mean, it has “nasal” in the name, right? They will tell me “My nose just won’t stop running. Every time this happens I know I need my Sudafed.” This is simply not accurate. Runny noses are best dealt with by using antihistamines. Antihistamines will dry up your runny nose. Some of these customers will still purchase the Sudafed, even after I explain this to them. Oh well, I tried.
For young pharmacists out there, know that some people have their minds made up before they come to the store. They may ask you a question about what to buy. What they want is a confirmation of what their idea is. If you don’t agree, they often don’t take your advice. Don’t take it personally.
Nasal decongestants are for sinus pressure. That feeling of tightness under your eyes, or in your ears. If you bend over it feels like your head might just explode. Your voice sounds funny, or stuffy. This is why you would use a nasal decongestant. Psuedoephedrine is the best nasal decongestant. Phenylephrine is also used over the counter. As I mentioned before, all of the second generation antihistamines are available in combination with a decongestant if needed. For a more thorough breakdown of nasal decongestants refer back to this previous article.
Products containing pseudoephedrine must be purchased at the pharmacy counter. You must have a valid id to purchase them and you must be at least 18 years old. To find out why, read this.
Steroid Nasal Sprays
In my opinion, this is the best OTC treatment for seasonal allergies. Flonase, Nasacort, and Rhinocort were only available with a prescription until recently. The FDA finally decided that they were safe enough to allow purchase without supervision from a doctor. You should always let your doctor know about medications you are taking over the counter.
Steroid nasal sprays can help with all types of allergy symptoms including runny nose, itchy eyes, sneezing, and sinus congestion. They don’t work as quickly as some of the other products we have discussed so far. Max effectiveness starts on about day three of treatment. Therefore, you should not use them for a temporary problem. Steroid nasal sprays are most effective when used every day throughout your allergy season.
Steroid nasal sprays are dosed just once daily. Two sprays in each nostril every morning should do the trick. It is important to know that you want the spray to absorb in your sinuses, where it will work the best. A slow deep inhalation is what you want. Don’t sniff so hard that it goes straight into your lungs! The package directions will tell you to avoid sneezing after inhalation. Let me know if you figure out how to avoid sneezing.
Don’t let the word “steroid” scare you. This is different than anabolic steroids. You shouldn’t fear, or hope for, excessive muscle growth or roid rage. And don’t try to blame losing your temper on your Flonase. That excuse won’t fly. Not for Helpful Pharmacist readers anyway.
Which steroid nasal spray is the best? There are some subtle differences. I will write a full review of them in my next article so stay tuned.
Eye Drops
Even after using all of the products we have already talked about, you sometimes still need something more for your red, itchy eyes. There are a few options here. Antihistamines are available in eye drops. Ketotifen seems to be the most effective antihistamine ingredient in a drop. You will find it in Zaditor, Alaway, or other store branded products. Zaditor was a prescription eye drop for a long time.
Sometimes antihistamine drops will tend to dry your eyes out even more. If this is the case, you can find drops just for redness or lubricant eye drops for dry eyes. I prefer a combination redness reliever and lubricant such as Visine Totality. Any of these eye drops are fine to use in combination with the other products mentioned in this article.
That wraps it up for today. I hope you enjoyed learning about the best OTC treatment for seasonal allergies. There are other options available for allergies if these items still don’t control your symptoms. Your next step would probably be to go see an allergist. They can test to see the exact source of your allergies. They can then create a serum to help you. Unfortunately, that means giving yourself allergy shots but that may be what it takes to make you feel better.
Until next time….
HP
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