Definition (1)
- Allergies and asthma: They often occur together
Symptoms (1)
- Anaphylaxis
Treatments and drugs (3)
- Allergy medications: Know your options
- Prednisone and other corticosteroids: Balance the risks and benefits
- Allergy shots: Hope for long-term allergy relief
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Allergy medications: Know your options
Several types of medications are used to treat allergy symptoms. Discover which ones are right for you.
By Mayo Clinic staffAllergy medications reduce your body's reaction to allergens or block symptom-causing chemicals such as histamine. Allergy medications are available as pills, liquids, 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 various types of allergy medications.
Corticosteroids
Corticosteroids help prevent and treat inflammation by blocking allergic reactions. Most corticosteroids require a prescription.
- 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 and delayed growth in children.
- Nasal corticosteroid sprays prevent and relieve allergy signs and symptoms such as nasal stuffiness, sneezing, and itchy, runny nose. Examples include fluticasone (Flonase), mometasone (Nasonex), budesonide (Rhinocort Aqua), flunisolide (Nasarel), triamcinolone (Nasacort AQ) and beclomethasone (Beconase AQ). Side effects can include unpleasant smell or taste, nasal irritation, and nosebleeds. These medications are much less likely to cause side effects than are oral corticosteroids.
- Inhaled corticosteroids are used to relieve asthma symptoms triggered by allergens. Examples include flunisolide (Aerobid), triamcinolone (Azmacort), fluticasone (Flovent) and budesonide (Pulmacort). Side effects don't tend to be bothersome for most people, but can include an infection in the mouth, cough, hoarseness or headache.
- Corticosteroid eyedrops are used to treat severe allergy signs and symptoms such as red, watery and itchy eyes caused by hay fever and allergic conjunctivitis. Examples include dexamethasone (Maxidex, others), fluorometholone (FML, others) and prednisolone (Pred Forte, others). These medications may cause blurred vision. Prolonged use may increase your risk of eye infections, glaucoma and cataracts.
- Corticosteroid skin creams relieve the scaling and itching caused by eczema (atopic dermatitis). Some low-potency corticosteroid creams are available without a prescription, but you should always talk to your doctor before using any topical corticosteroid. Examples include hydrocortisone (Cortaid, others) and triamcinolone (Kenalog, others). Side effects can include skin irritation and discoloration.
Antihistamines
Antihistamines block histamine, an inflammatory chemical released by your immune system during an allergic reaction.
- Oral antihistamines (pills and liquids) reduce signs and symptoms such as swelling, runny nose, itchy, watery eyes, and hives (urticaria). Over-the-counter oral antihistamines include loratadine (Claritin), cetirizine (Zyrtec) and clemastine (Tavist). Fexofenadine (Allegra) is available by prescription. Some oral antihistamines may cause dry mouth and drowsiness. Older, "first generation" antihistamines such as diphenhydramine (Benadryl) and chlorpheniramine (Chlor-Trimeton) are more likely to cause drowsiness and slow your reaction time. These older, sedating antihistamines shouldn't be taken when driving or doing other potentially dangerous activities, and shouldn't be given to children or older adults.
- 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 spray 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 reduce itching, redness and swollen eyes. You may need to use these medications several times a day, as the effects may last only a few hours. Over-the-counter examples include ketotifen (Zaditor, Alaway, others), naphazoline (Visine-A, Opcon-A, others). Prescription examples include naphazoline (Albalon, others), emedastine (Emadine) and olopatadine (Patanol, others). Side effects of these medications can include red eyes, watering eyes, headache, and mild stinging or burning. Antihistamine eyedrops increase the risk of eye inflammation when you're wearing contact lenses.
Decongestants
Decongestants are used for quick, temporary relief of nasal and sinus congestion. You may need to avoid decongestants if you're pregnant, you're older, or you have high blood pressure.
- Oral decongestants (pills and liquids) relieve nasal and sinus congestion caused by hay fever. Many decongestants are available over-the-counter. Examples include 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. Check with your doctor before using oral decongestants, as these medications are potentially dangerous if you take certain other medications or if you have high blood pressure (hypertension), heart disease or certain other health problems.
- Nasal decongestant sprays 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, Clear Eyes, others). Side effects include persistent eye redness and damage to blood vessels in the eye when overused. Rarely, this medication causes a type of sudden (acute) glaucoma.
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References
- deShazo R, et al. Pharmacotherapy of allergic rhinitis. http://www.uptodate.com/home/index.html. Accessed June 9, 2009.
- Inhaled corticosteroids. New York City Asthma Initiative. http://www.nyc.gov/html/doh/downloads/pdf/asthma/inhaled.pdf. Accessed June 9, 2009.
- Eye allergies. American College of Allergy, Asthma and Immunology. http://www.acaai.org/public/eyeALLERGY/eyeBrochure.htm. Accessed June 9, 2009.
- Orban NT, et al. Allergic and Non-Allergic Rhinitis. In: Adkinson NF: Middleton's Allergy: Principles and Practice. 7th ed. Philadelphia, Pa.: Mosby; 2008. http://www.mdconsult.com/das/book/body/142683441-4/0/1806/59.html?tocnode=56310309&fromURL=59.html#4-u1.0-B978-0-323-05659-5..00055-3--s0380_1872. Accessed June 9, 2009.
- Krouse JH. Allergic rhinitis — Current pharmacotherapy. Otolaryngologic Clinics of North America. 2008;41:347.
- Updated information on leukotriene inhibitors: Montelukast (marketed as Singulair), zafirlukast (marketed as Accolate), and zileuton (marketed as Zyflo and Zyflo CR). U.S. Food and Drug Administration. Accessed June 12, 2009.
- deShazo R, et al. Immunotherapy and immunologic treatments for allergic rhinitis. http://www.uptodate.com/home/index.html. Accessed June 9, 2009.
