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Updated January 31, 2009

Updated January 31, 2009

What Over-the-Counter Medications Can I Use for Treating My Allergies?

There are numerous over-the-counter (OTC) medications available for the treatment of allergy symptoms. Some of these, like oral decongestants such as Sudafed (pseudoephedrine) and sedating antihistamines like Benadryl (diphenhydramine), have been available for many years. Others, such as Claritin (loratadine) and Zyrtec-D (cetirizine/pseudoephedrine), have only recently become available OTC without a prescription.

Antihistamines

The older antihistamines, such as Benadryl and Chlor-Trimeton (chlorphenirimine), are considered too sedating for routine use. These medications can cause mental and physical impairment; you might even be charged with a DUI (driving under the influence) in many states if you drive an automobile while taking these medications.

Two newer antihistamines, Claritin and Zyrtec (cetirizine), are now available OTC without a prescription. These medications cause much less sedation, and no impairment of mental or physical tasks, when taken at recommended dosages. They are generally considered to be safe, even when taken for long periods of time, when used as directed on the package labeling.

Learn more about antihistamines for the treatment of allergies.

Decongestants

Decongestants are available in both pill form (such as Sudafed) and nasal forms (such as Afrin nasal spray). Both do a fairly good job at treating nasal congestion. While some people use Sudafed on a regular basis, side effects are common. Side effects of oral decongestants include insomnia, high blood pressure, anxiety, headaches, and urinary retention. People with these symptoms should check with their doctor prior to using oral decongestants.

Nasal decongestant sprays, such as Afrin (oxymetazoline), should only be used for short periods of time, usually for no more than 3 days. Overuse of Afrin can lead to a medical condition called rhinitis medicamentosa, characterized by symptoms of worsening nasal congestion that are less responsive or unresponsive to additional Afrin use. This condition requires evaluation and treatment by a physician.

Antihistamine/Decongestant Combinations

The combination of antihistamines and decongestants is nothing new. These medications, such as Actifed (chlorpheniramine/phenylephrine) and Dimetapp (brompheniramine/phenylephrine), have been on the market for years. In recent years, the combination of a newer antihistamine along with a decongestant has become available by prescription, and more recently OTC. These include Claritin-D (loratadine/pseudoephedrine) and Zyrtec-D. While some people take these medications on a routine basis, I usually recommend them only for short periods of time due to the side effects they cause as a result of the decongestant component (see above under “Decongestants”).

Other Nasal Sprays

At the present time, there are only 2 types of medicated nasal sprays available OTC for the treatment of nasal symptoms: Nasal decongestants (see “Decongestants” above) and Nasalcrom (cromolyn).

Nasalcrom is a relatively good medication for preventing allergic rhinitis symptoms, but must be used on a regular basis in order to work. This medicine works by preventing the release of allergic chemicals such as histamine from mast cells, but does nothing to block the effects of the allergic chemicals once released (unlike an antihistamine). NasalCrom is relatively safe, can be used for long periods of time and is OK for adults and children as young as 2 years of age.

Non-medicated nasal sprays include nasal saline sprays and irrigation. Nasal saline can be helpful for the temporary relief of nasal congestion, as well as the possible treatment and prevention of chronic sinus infections. Since nasal saline does not contain any active drug, it is safe for all ages and does not have any side effects. Find out more about nasal saline irrigation.

What Over the Counter Medications Should I Avoid?

Most OTC allergy medications are relatively safe for short-term use. People with chronic underlying medical conditions such as high blood pressure, heart disease, glaucoma, diabetes and any other chronic condition requiring the regular care of a physician should check with their doctor prior to taking any OTC product. In addition, any OTC medication should be used only as directed on the package that the product comes in, and all warnings on such labels should be followed.

The use of an OTC medication should never be used as a substitute for the regular care of a physician, and any chronic or long-term use of an OTC medication should only be done so as directed by a physician.

Are Over the Counter Medications as Good as Prescription Types?

Since Zyrtec and Claritin are now available without a prescription, these OTC antihistamines are likely to be just as effective as any prescription antihistamine. The same would also apply to OTC antihistamine/decongestant combinations such as Zyrtec-D and Claritin-D.

NasalCrom is not as effective as prescription nasal steroids or nasal antihistamines, although it works reasonably well and is a safe OTC alternative to prescription nasal sprays.

Find out more about medications for the treatment of allergic rhinitis.

Source:

Dykewicz MS, Fineman S, editors. Diagnosis and Management of Rhinitis: Complete Guidelines of the Joint Task Force on Practice Parameters in Allergy, Asthma and Immunology.

DISCLAIMER: The information contained in this site is for educational purposes only, and should not be used as a substitute for personal care by a licensed physician. Please see your physician for diagnosis and treatment of any concerning symptoms or medical condition.

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