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Allergy Medications Compared

Medically reviewed by Carmen Pope, BPharm. Last updated on Feb 19, 2024.

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.

Drugs used to treat Allergies

The medications listed below are related to or used in the treatment of this condition.

Drug name Rating Reviews Activity ? Rx/OTC Pregnancy CSA Alcohol
loratadine 4.8 13 reviews for loratadine to treat Allergies Rx/OTC B N
Generic name:
loratadine systemic
Drug class:
antihistamines
For consumers:
dosage, interactions, side effects
For professionals:
AHFS DI Monograph, Prescribing Information
hydroxyzine 7.4 62 reviews for hydroxyzine to treat Allergies Rx N N X
Generic name:
hydroxyzine systemic
Brand name:
Vistaril
Drug class:
miscellaneous anxiolytics, sedatives and hypnotics, antihistamines
For consumers:
dosage, interactions, side effects
For professionals:
AHFS DI Monograph, Prescribing Information
levocetirizine 4.9 220 reviews for levocetirizine to treat Allergies Rx/OTC B N X
Generic name:
levocetirizine systemic
Brand name:
Xyzal
Drug class:
antihistamines
For consumers:
dosage, interactions, side effects
For professionals:
AHFS DI Monograph, Prescribing Information
Xyzal 4.6 182 reviews for Xyzal to treat Allergies Rx B N X
Generic name:
levocetirizine systemic
Drug class:
antihistamines
For consumers:
dosage, interactions, side effects
For professionals:
Prescribing Information
cetirizine 8.4 5 reviews for cetirizine to treat Allergies Rx/OTC B N X
Generic name:
cetirizine systemic
Brand name:
Zyrtec
Drug class:
antihistamines
For consumers:
dosage, interactions, side effects
For professionals:
AHFS DI Monograph, Prescribing Information
Zyrtec 8.0 4 reviews for Zyrtec to treat Allergies Rx/OTC B N X
Generic name:
cetirizine systemic
Drug class:
antihistamines
For consumers:
dosage, interactions, side effects
For professionals:
Prescribing Information
montelukast 10 2 reviews for montelukast to treat Allergies Rx B N
Generic name:
montelukast systemic
Drug class:
leukotriene modifiers
For consumers:
dosage, interactions, side effects
For professionals:
AHFS DI Monograph, Prescribing Information
fluticasone 7.0 2 reviews for fluticasone to treat Allergies Rx/OTC C N
Generic name:
fluticasone nasal
Brand names:
Flonase Allergy Relief, Flonase Sensimist
Drug class:
nasal steroids
For consumers:
dosage, interactions, side effects
For professionals:
AHFS DI Monograph, Prescribing Information
fexofenadine 7.0 2 reviews for fexofenadine to treat Allergies Rx/OTC C N
Generic name:
fexofenadine systemic
Brand names:
Allegra, Allegra Allergy, Allegra Hives, Allegra ODT, Aller-Ease
Drug class:
antihistamines
For consumers:
dosage, interactions, side effects
For professionals:
AHFS DI Monograph, Prescribing Information
Allegra Rate Add review Rx/OTC C N
Generic name:
fexofenadine systemic
Drug class:
antihistamines
For consumers:
dosage, interactions, side effects
For professionals:
Prescribing Information
Vistaril 6.7 3 reviews for Vistaril to treat Allergies Rx N N X
Generic name:
hydroxyzine systemic
Drug class:
miscellaneous anxiolytics, sedatives and hypnotics, antihistamines
For consumers:
dosage, interactions, side effects
For professionals:
Prescribing Information
Benadryl Rate Add review Rx/OTC B N X
Generic name:
diphenhydramine systemic
Drug class:
miscellaneous anxiolytics, sedatives and hypnotics, antihistamines, anticholinergic antiemetics, anticholinergic antiparkinson agents
For consumers:
dosage, interactions, side effects
For professionals:
Prescribing Information
doxylamine Rate Add review Rx/OTC B N X
Generic name:
doxylamine systemic
Drug class:
miscellaneous anxiolytics, sedatives and hypnotics
For consumers:
dosage, interactions, side effects
For professionals:
AHFS DI Monograph
corticotropin 1.0 1 review for corticotropin to treat Allergies Rx C N
Generic name:
corticotropin systemic
Brand names:
Acthar, H.P. Acthar Gel
Drug class:
corticotropin
For consumers:
dosage, interactions, side effects
For professionals:
AHFS DI Monograph
prednisone 9.0 1 review for prednisone to treat Allergies Rx C N
Generic name:
prednisone systemic
Drug class:
glucocorticoids
For consumers:
dosage, interactions, side effects
For professionals:
AHFS DI Monograph, Prescribing Information
azelastine 10 1 review for azelastine to treat Allergies Rx/OTC C N X
Generic name:
azelastine nasal
Drug class:
nasal antihistamines and decongestants
For consumers:
dosage, interactions, side effects
For professionals:
Prescribing Information
chlorpheniramine / ibuprofen / phenylephrine Rate Add review OTC N X
Generic name:
chlorpheniramine / ibuprofen / phenylephrine systemic
Brand names:
Advil Allergy and Congestion Relief, Advil Multi-Symptom Cold & Flu
Drug class:
upper respiratory combinations
For consumers:
interactions, side effects
Acthar 1.0 1 review for Acthar to treat Allergies Rx C N
Generic name:
corticotropin systemic
Drug class:
corticotropin
For consumers:
dosage, interactions, side effects
Allegra Allergy Rate Add review OTC C N
Generic name:
fexofenadine systemic
Drug class:
antihistamines
For consumers:
dosage, interactions, side effects
For professionals:
Prescribing Information
dexbrompheniramine 9.0 1 review for dexbrompheniramine to treat Allergies OTC C N X
Generic name:
dexbrompheniramine systemic
Brand name:
Ala-Hist IR
Drug class:
antihistamines
For consumers:
interactions, side effects
diphenhydramine Rate Add review Rx/OTC B N X
Generic name:
diphenhydramine systemic
Brand names:
Benadryl, Benadryl Allergy, Allermax
Drug class:
miscellaneous anxiolytics, sedatives and hypnotics, antihistamines, anticholinergic antiemetics, anticholinergic antiparkinson agents
For consumers:
dosage, interactions, side effects
For professionals:
AHFS DI Monograph, Prescribing Information
Flonase Allergy Relief Rate Add review OTC C N
Generic name:
fluticasone nasal
Drug class:
nasal steroids
For consumers:
dosage, interactions, side effects
Flonase Sensimist Rate Add review OTC C N
Generic name:
fluticasone nasal
Drug class:
nasal steroids
For consumers:
dosage, interactions, side effects
Ala-Hist IR Rate Add review OTC C N X
Generic name:
dexbrompheniramine systemic
Drug class:
antihistamines
For consumers:
interactions, side effects
Benadryl Allergy Rate Add review Rx/OTC B N X
Generic name:
diphenhydramine systemic
Drug class:
miscellaneous anxiolytics, sedatives and hypnotics, antihistamines, anticholinergic antiemetics, anticholinergic antiparkinson agents
For consumers:
dosage, interactions, side effects
For professionals:
Prescribing Information

Frequently asked questions

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Topics under Allergies

Alternative treatments for Allergies

The following products are considered to be alternative treatments or natural remedies for Allergies. Their efficacy may not have been scientifically tested to the same degree as the drugs listed in the table above. However, there may be historical, cultural or anecdotal evidence linking their use to the treatment of Allergies.

Legend

Rating For ratings, users were asked how effective they found the medicine while considering positive/adverse effects and ease of use (1 = not effective, 10 = most effective).
Activity Activity is based on recent site visitor activity relative to other medications in the list.
Rx Prescription only.
OTC Over-the-counter.
Rx/OTC Prescription or Over-the-counter.
Off-label This medication may not be approved by the FDA for the treatment of this condition.
EUA An Emergency Use Authorization (EUA) allows the FDA to authorize unapproved medical products or unapproved uses of approved medical products to be used in a declared public health emergency when there are no adequate, approved, and available alternatives.
Expanded Access Expanded Access is a potential pathway for a patient with a serious or immediately life-threatening disease or condition to gain access to an investigational medical product (drug, biologic, or medical device) for treatment outside of clinical trials when no comparable or satisfactory alternative therapy options are available.
Pregnancy Category
A Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).
B Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.
C Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.
D There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.
X Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use in pregnant women clearly outweigh potential benefits.
N FDA has not classified the drug.
Controlled Substances Act (CSA) Schedule
M The drug has multiple schedules. The schedule may depend on the exact dosage form or strength of the medication.
U CSA Schedule is unknown.
N Is not subject to the Controlled Substances Act.
1 Has a high potential for abuse. Has no currently accepted medical use in treatment in the United States. There is a lack of accepted safety for use under medical supervision.
2 Has a high potential for abuse. Has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions. Abuse may lead to severe psychological or physical dependence.
3 Has a potential for abuse less than those in schedules 1 and 2. Has a currently accepted medical use in treatment in the United States. Abuse may lead to moderate or low physical dependence or high psychological dependence.
4 Has a low potential for abuse relative to those in schedule 3. It has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 3.
5 Has a low potential for abuse relative to those in schedule 4. Has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 4.
Alcohol
X Interacts with Alcohol.

Further information

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