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 are available over-the-counter; others are available by prescription only. Here's a summary of the types of allergy medications and why they're used.
Antihistamines block histamine, a symptom-causing chemical released by your immune system during an allergic reaction.
Pills and liquids
Oral antihistamines, available over-the-counter and by prescription, ease a runny nose, itchy or watery eyes, hives, swelling, and other signs or symptoms of allergies. Because some of these drugs can cause drowsiness and fatigue, take them with caution when you need to drive or do other activities that require alertness.
Antihistamines that tend to cause drowsiness include:
These antihistamines are much less likely to cause drowsiness:
- Cetirizine (Zyrtec Allergy)
- Desloratadine (Clarinex)
- Fexofenadine (Allegra Allergy)
- Levocetirizine (Xyzal)
- Loratadine (Alavert, Claritin)
Antihistamine nasal sprays help relieve sneezing, itchy or runny nose, sinus congestion, and postnasal drip. Side effects of antihistamine nasal sprays might include a bitter taste, drowsiness or fatigue. Prescription antihistamine nasal sprays include:
- Azelastine (Astelin, Astepro)
- Olopatadine (Patanase)
Antihistamine eyedrops, available over-the-counter or by prescription, can ease itchy, red, swollen eyes. These drops might have a combination of antihistamines and other medicines.
Side effects might include headache and dry eyes. If antihistamine drops sting or burn, try keeping them in the refrigerator or using refrigerated artificial-tear drops before you use the medicated drops. Examples include:
- Azelastine (Optivar)
- Emedastine (Emadine)
- Ketotifen (Alaway)
- Olopatadine (Pataday, Patanol, Pazeo)
- Pheniramine (Visine-A, Opcon-A, others)
Decongestants are used for quick, temporary relief of nasal and sinus congestion. They can cause insomnia, headache, increased blood pressure and irritability. They're not recommended for pregnant women or for people with high blood pressure, cardiovascular disease, glaucoma or hyperthyroidism.
Pills and liquids
Oral decongestants relieve nasal and sinus congestion caused by hay fever (allergic rhinitis). Many decongestants, such as pseudoephedrine (Afrinol, Sudafed, others), are available over-the-counter.
A number of oral allergy medications contain a decongestant and an antihistamine. Examples include:
- Cetirizine and pseudoephedrine (Zyrtec-D)
- Desloratadine and pseudoephedrine (Clarinex-D)
- Fexofenadine and pseudoephedrine (Allegra-D)
- Loratadine and pseudoephedrine (Claritin-D)
Nasal sprays and drops
Nasal decongestant sprays and drops relieve nasal and sinus congestion if used only for a short time. Repeated use of these drugs for more than three consecutive days can result in a cycle of recurring or worsening congestion. Examples include:
- Oxymetazoline (Afrin, Dristan, others)
- Tetrahydrozoline (Tyzine)
Corticosteroids relieve symptoms by suppressing allergy-related inflammation.
Corticosteroid sprays prevent and relieve stuffiness, sneezing and runny nose. Side effects can include an unpleasant smell or taste, nasal irritation, and nosebleeds. Examples include:
- Budesonide (Rhinocort)
- Fluticasone furoate (Flonase Sensimist, Veramyst)
- Fluticasone propionate (Flonase Allergy Relief)
- Mometasone (Nasonex)
- Triamcinolone (Nasacort Allergy 24 Hour)
For people who are bothered by the feeling of liquid running down their throats or the taste of the above, there are two aerosol formulas:
- Beclomethasone (Qnasl)
- Ciclesonide (Zetonna)
Inhaled corticosteroids are often used daily as part of treatment for asthma caused or complicated by reactions to airborne allergy triggers (allergens). Side effects are generally minor and can include mouth and throat irritation and oral yeast infections.
Some inhalers combine corticosteroids with other asthma medications. Prescription inhalers include:
- Beclomethasone (Qvar)
- Budesonide (Pulmicort Flexhaler)
- Ciclesonide (Alvesco, Zetonna)
- Fluticasone (Advair Diskus, Flovent Diskus, others)
- Mometasone (Asmanex Twisthaler)
Corticosteroid eyedrops are used to relieve persistent itchy, red or watery eyes when other interventions aren't effective. A physician specializing in eye disorders (ophthalmologist) usually monitors the use of these drops because of the risk of vision impairment, cataracts, glaucoma and infection. Examples include:
- Fluorometholone (Flarex, FML)
- Loteprednol (Alrex, Lotemax)
- Prednisolone (Omnipred, Pred Forte, others)
Pills and liquids
Oral corticosteroids are used to treat severe symptoms caused by all types of allergic reactions. Long-term use can cause cataracts, osteoporosis, muscle weakness, stomach ulcers, increased blood sugar (glucose) and delayed growth in children. Oral corticosteroids can also worsen hypertension.
Prescription oral corticosteroids include:
- Prednisolone (Prelone)
- Prednisone (Prednisone Intensol, Rayos)
- Methylprednisolone (Medrol)
Corticosteroid creams relieve allergic skin reactions such as itching, redness, scaling or other irritations. Some low-potency corticosteroid creams are available without a prescription, but talk to your doctor before using these drugs for more than a few weeks.
Side effects can include skin discoloration and irritation. Long-term use, especially of stronger prescription corticosteroids, can cause thinning of the skin and disruption of normal hormone levels. Examples include:
- Betamethasone (Dermabet, Diprolene, others)
- Desonide (Desonate, DesOwen)
- Hydrocortisone (Cortaid, Micort-HC, others)
- Mometasone (Elocon)
Mast cell stabilizers
Mast cell stabilizers block the release of immune system chemicals that contribute to allergic reactions. These drugs are generally safe but usually need to be used for several days to reach full effect. They're usually used when antihistamines are not working or not well-tolerated.
Generic over-the-counter nasal sprays are sold as cromolyn.
Prescription eyedrops include the following:
June 06, 2017
- Cromolyn (Crolom)
- Lodoxamide (Alomide)
- Pemirolast (Alamast)
- Nedocromil (Alocril)
See more In-depth
- AAAAI allergy and asthma drug guide. American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/conditions-and-treatments/drug-guide. Accessed March 1, 2017.
- DeShazo RD, et al. Pharmacotherapy of allergic rhinitis. http://www.uptodate.com/home. Accessed March 1, 2017.
- Allergy meds could affect your driving. U.S. Food and Drug Administration. https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm354117.htm. Accessed March 1, 2017.
- Ciprandi G, et al. Allergic rhinitis: The eligible candidate to mite immunotherapy in the real world. Allergy, Asthma & Clinical Immunology. 2017;13:11.
- Overview of allergy and atopic disorders. Merck Manual Professional Version. http://www.merckmanuals.com/professional/immunology_allergic_disorders/allergic_autoimmune_and_other_hypersensitivity_disorders/overview_of_allergy_and_atopy.html?qt=allergy medication&alt=sh - v6515259. Accessed March 3, 2017.
- Weston WL, et al. Treatment of atopic dermatitis (eczema). http://www.uptodate.com/home. Accessed March 3, 2017.
- Hamrah P, et al. Allergic conjuctivitis: Management. http://www.uptodate.com/home. Accessed March 3, 2017.