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Allergy medications: Know your options
Several types of medications are used to treat allergy symptoms. Here's more information.By Mayo Clinic staff
Allergy medications are available as pills, liquids, inhalers, nasal sprays, eyedrops, skin creams and shots (injections). Some allergy medications are available over-the-counter, while others are available by prescription only. Here's a summary of the various types of allergy medications and why they're used.
Corticosteroids help prevent the release of symptom-causing chemicals during an allergic reaction. Most corticosteroid medications require a prescription.
- Nasal corticosteroid sprays prevent and relieve signs and symptoms of allergies such as allergic rhinitis (hay fever). These medications can help with nasal stuffiness, sneezing, and itchy, runny nose. Examples include fluticasone (Flonase), mometasone (Nasonex), budesonide (Rhinocort Aqua), triamcinolone (Nasacort AQ) and beclomethasone (Beconase AQ), fluticasone (Veramyst) and ciclesonide (Omnaris). Side effects can include unpleasant smell or taste, nasal irritation and nosebleeds.
- Inhaled corticosteroids are used to relieve symptoms triggered by airborne allergy-triggering substances (allergens). These medications are generally taken on a daily basis as part of asthma treatment. Examples include fluticasone (Flovent Diskus, Flovent HFA), budesonide (Pulmicort Flexhaler), mometasone (Asmanex Twisthaler), beclomethasone (Qvar) and ciclesonide (Alvesco). Side effects are generally minor and can include mouth and throat irritation and oral yeast infections.
- Corticosteroid eyedrops are used to treat severe eye irritation caused by hay fever and allergic conjunctivitis. Examples include dexamethasone (Maxidex, others), fluorometholone (FML) and prednisolone (Pred Forte, Pred Mild). These medications may cause blurred vision. Prolonged use may increase your risk of eye infections, glaucoma and cataracts.
- Corticosteroid skin creams relieve allergic skin reactions such as scaling and itching. Some low-potency corticosteroid creams are available without a prescription, but talk to your doctor before using a topical corticosteroid for more than a few weeks. Examples include hydrocortisone (Cortaid, others) and triamcinolone (Kenalog, others). Side effects can include skin irritation and discoloration. Long-term use, especially of stronger prescription corticosteroids, thins the top layer of the skin, resulting in easy bruising where the cream has been applied. Corticosteroids are available in liquid form that can be useful for skin conditions involving the scalp.
- Oral corticosteroids (pills and liquids) are used to treat severe symptoms caused by all types of allergic reactions. Examples include prednisone (Prednisone Intensol) and prednisolone (Prelone, others). Because they can cause numerous short- and long-term side effects, oral corticosteroids are usually prescribed for short periods of time. Long-term use can cause cataracts, osteoporosis, muscle weakness, stomach ulcers and delayed growth in children. Oral corticosteroids can also worsen hypertension. In some situations, corticosteroids may be given as a shot (injection) rather than pills.
Antihistamines block histamine, a symptom-causing chemical released by your immune system during an allergic reaction.
- Oral antihistamines (pills and liquids) ease symptoms such as swelling, runny nose, itchy or watery eyes, and hives (urticaria). Over-the-counter oral antihistamines include loratadine (Claritin) and cetirizine (Zyrtec). Desloratadine (Clarinex) and levocetirizine (Xyzal) are available by prescription. Fexofenadine (Allegra) is available both over-the-counter and by prescription. Some oral antihistamines may cause dry mouth and drowsiness. Older antihistamines such as diphenhydramine (Benadryl), chlorpheniramine (Chlor-Trimeton) and clemastine (Tavist) are more likely to cause drowsiness and slow your reaction time. These sedating antihistamines shouldn't be taken when driving or doing other potentially dangerous activities.
- Antihistamine nasal sprays help relieve sneezing, itchy or runny nose, sinus congestion, and postnasal drip. Prescription antihistamine nasal sprays include azelastine (Astelin, Astepro) and olopatadine (Patanase). Side effects of antihistamine nasal sprays may include bitter taste, dizziness, drowsiness or fatigue, dry mouth, headache, nasal burning, nosebleed, nausea, runny nose, sore throat, and sneezing.
- Antihistamine eyedrops are often combined with other medications such as mast cell stabilizers or decongestants. Antihistamine eyedrops can ease symptoms such as itching, redness and swollen eyes. You may need to use these medications several times a day, because the effects may last only a few hours. Over-the-counter examples include ketotifen (Zaditor, Alaway, others) and pheniramine (Visine-A, Opcon-A, others). Prescription examples include emedastine (Emadine) and olopatadine (Patanol, others). Side effects of these medications can include red eyes, watery eyes, mild stinging or burning and headache. Antihistamine eyedrops increase the risk of eye inflammation when you're wearing contact lenses.
Decongestants are used for quick, temporary relief of nasal and sinus congestion. You may need to avoid decongestants if you're pregnant, if you're an older adult or if you have high blood pressure. Check with your doctor to see which medications are safe for you.
- Oral decongestants (pills and liquids) relieve nasal and sinus congestion caused by hay fever. Many decongestants are available over-the-counter. A common example is pseudoephedrine (Sudafed, others). A number of medications contain a decongestant such as pseudoephedrine combined with other medications. Claritin-D, for example, contains pseudoephedrine and an antihistamine. Oral decongestants can cause a number of side effects, including irritability, fast or irregular heartbeat, dizziness, insomnia, headaches, anxiety, tremors, and increased blood pressure.
- Nasal decongestant sprays and drops relieve nasal and sinus congestion. Examples include phenylephrine (Neo-Synephrine, others) and oxymetazoline (Afrin, others). Nasal decongestants can cause dryness, burning or stinging inside the nose, runny nose, and sneezing. Taking too much of a nasal decongestant can cause irritability, fast or irregular heartbeat, dizziness, insomnia, headaches, anxiety, tremors, and increased blood pressure. Don't use a decongestant nasal spray for more than a week or so, or you may develop severe congestion as soon as you stop taking it (rebound congestion).
- Decongestant eyedrops (or combined decongestant-antihistamine eyedrops) can temporarily ease symptoms such as red, itchy eyes. Available over-the-counter, examples include tetrahydrozoline (Visine others) and naphazoline (Clear Eyes, others). Side effects include persistent eye redness and damage to blood vessels in the eye when overused. In rare cases, decongestant eyedrops can cause a type of sudden (acute) glaucoma.
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