Antihistamines, oral decongestants, combination antihistamines/decongestants, corticosteroid nasal sprays, skin creams, oral corticosteroids, eye drops, mast cell stabilizers, leukotriene inhibitors, biologics, and emergency epinephrine shots may all be used to treat allergies or allergic reactions.
Antihistamines work by blocking histamine, a chemical released by the immune system in response to allergens. Some, such as diphenhydramine (Allermax) and chlorpheniramine (Aller-Chlor) can cause drowsiness while others, such as cetirizine (Zyrtec, Zyrtec Allergy), desloratadine (Clarinex), fexofenadine (Allegra, Allegra Allergy), levocetirizine (Xyzal, Xyzal Allergy), or loratadine (Alavert, Claritin) are unlikely to cause drowsiness.
Antihistamine nasal sprays, such as azelastine (Astelin, Astepro), and olopatadine (Patanase) help relieve sneezing, itchy or runny nose, sinus congestion, and postnasal drip.
Antihistamine eye drops, available both over-the-counter and by prescription, can provide relief for itchy, red, and swollen eyes and examples include ketotifen (Alaway, Zaditor), olopatadine (Pataday, Patanol, Pazeo), and pheniramine with naphazoline (Visine, Opcon-A, among others).
Oral decongestants like phenylephrine and pseudoephedrine (Contact Cold) provide rapid, short-term relief from nasal and sinus congestion. However, they may bring about issues like insomnia, headaches, increased blood pressure, and irritability. It is advisable to steer clear of these medications if you have conditions such as high blood pressure, cardiovascular disease, glaucoma, or hyperthyroidism.
Combination oral decongestants with an antihistamine include:
Nasal decongestant sprays and drops such as oxymetazoline (Afrin) and tetrahydrozoline (Tyzine) provide relief from short-term nasal and sinus congestion but use beyond three consecutive days may lead to a cycle of recurring or worsening congestion.
Corticosteroid nasal sprays, such as budesonide (Rhinocort), fluticasone (Flonase Sensimist, Flonase Allergy Relief), mometasone (Nasonex), and triamcinolone (Nasacort Allergy 24 Hour) suppress allergy-related inflammation and alleviate congestion, sneezing, and a runny nose. Potential side effects include nasal irritation, nosebleeds, and an unpleasant taste.
Two aerosol alternative corticosteroid inhalers are beclomethasone (Qnasl), and ciclesonide (Zetonna) for those who find the sensation of liquid flowing down their throats or the taste of nasal sprays unpleasant.
Corticosteroid skin creams, such as betamethasone (Dermabet, Diprolene), desonide (Desonate, DesOwen), hydrocortisone (Locoid), mometasone (Elocon), and triamcinolone relieve allergic skin reactions such as itching, redness or scaling. Long-term use of prescription corticosteroid creams may cause skin thinning and affect hormones.
Oral corticosteroids, such as prednisolone (Flo-Pred), prednisone, or methylprednisolone (Medrol) may be prescribed short-term for severe allergic reactions. Cataracts, osteoporosis, stomach ulcers, increased blood sugar (glucose), high blood pressure, and delayed growth in children may occcur with long-term use.
Corticosteroid eye drops such as fluorometholone (Flarex, FML), loteprednol (Alrex, Lotemax), and prednisolone (Omnipred, Pred Forte) can help relieve persistent itchy, red, or watery eyes if other treatments are not helping to relieve eye symptoms. Their use should be monitored by a physician specializing in eye disorders because of the risk of infection, cataracts, and glaucoma.
Mast cell stabilizers are available as over-the-counter nasal sprays (Nasalcrom), and prescription eyedrops such as cromolyn (Crolom), lodoxamide (Alomide), and nedocromil (Alocril), and these work by preventing the release of histamine and other chemicals from mast cells which contribute to allergic reactions. They need to be used for several days before they produce an effect and are usually used when antihistamines are not working or are not well tolerated.
Leukotriene inhibitors are prescription medicines that work by preventing the release of symptom-causing leukotrienes from mast cells and eosinophils or by obstructing leukotriene receptors in airway tissues. Only montelukast (Singulair), is approved for treating hay fever.
Immunotherapy involves gradually desensitizing a person to allergens, particularly ones that are hard to avoid, such as dust mites, pollens, and molds. Depending on the allergen, it may be given as an injection or sublingual tablet. Available sublingual tablets include:
- Odactra for dust mites
- Ragwitek for short ragweed
- Oralair for sweet vernal, orchard, perennial rye, Timothy, and Kentucky bluegrass
- Grastek for Timothy grass.
Biological medications are injections that target specific immune system reactions and include dupilumab (Dupixent) and omalizumab (Xolair).
Emergency epinephrine shots (Adrenaclick, Auvi-Q, Epipen), administered by a self-injecting syringe and needle (known as an autoinjector), are used to treat sudden, life-threatening allergic reactions such as anaphylaxis. Epinephrine is short-acting and more injections are usually needed, so call 911 or get immediate emergency medical care.
The medications listed below are related to or used in the treatment of this condition.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.