A leukotriene inhibitor is a prescription medication that blocks symptom-causing chemicals called leukotrienes. This oral medication relieves allergy signs and symptoms including nasal congestion, runny nose and sneezing. Only one type of this drug, montelukast (Singulair), is approved for treating hay fever.
In some people, leukotriene inhibitors may cause psychological symptoms such as irritability, anxiousness, insomnia, hallucinations, aggression, depression, and suicidal thinking or behavior.
Immunotherapy is carefully timed and gradually increased exposure to allergens, particularly those that are difficult to avoid, such as pollens, dust mites and molds. The goal is to train the body's immune system not to react to these allergens. Immunotherapy may be used when other treatments aren't effective or tolerated. It may help prevent the development of asthma in some people.
Immunotherapy may be administered as a series of shots, usually one or two times a week for three to six months. This is followed by a series of less frequent maintenance shots that usually continue for three to five years.
Side effects may include irritation at the injection site and allergy symptoms such as sneezing, congestion or hives. Rarely, allergy shots can cause anaphylaxis, a sudden life-threatening reaction that causes swelling in the throat, difficulty breathing and other signs and symptoms.
Sublingual immunotherapy (SLIT)
With this type of immunotherapy, you place an allergen-based tablet under your tongue (sublingual) and allow it to be absorbed. This daily treatment has been shown to reduce runny nose, congestion, eye irritation and other symptoms associated with hay fever. It also improves asthma symptoms and may prevent the development of asthma. SLIT tablets contain extracts from pollens of different types of grass, including the following:
- Short ragweed (Ragwitek)
- Sweet vernal, orchard, perennial rye, Timothy and Kentucky blue grass (Oralair)
- Timothy grass (Grastek)
Emergency epinephrine shots
Epinephrine shots are used to treat anaphylaxis, a sudden, life-threatening reaction. The drug is administered with a self-injecting syringe and needle device (autoinjector). You may need to carry two autoinjectors and wear an alert bracelet if you're likely to have a severe allergic reaction to a certain food, such as peanuts, or if you're allergic to bee or wasp venom.
A second injection is often needed. Therefore, it's important to call 911 or get immediate emergency medical care.
Your doctor or a member of the clinical staff will train you on how to use an epinephrine autoinjector. It is important to get the type that your doctor prescribed, as the method for injection may be slightly different for each brand. Also, be sure to replace your emergency epinephrine before the expiration date. Examples of these medications include:
Get your doctor's advice
Work with your doctor to choose the most effective allergy medications and avoid problems. Even over-the-counter allergy medications have side effects, and some allergy medications can cause problems when combined with other medications.
It's especially important to talk to your doctor about taking allergy medications in the following circumstances:
- You're pregnant or breast-feeding.
- You have a chronic health condition, such as diabetes, glaucoma, osteoporosis or high blood pressure.
- You're taking any other medications, including herbal supplements.
- You're treating allergies in a child. Children need different doses of medication or different medications than adults.
- You're treating allergies in an older adult. Some allergy medications can cause confusion, urinary symptoms or other side effects in older adults.
- You're already taking an allergy medication that isn't working. Bring the medication with you in its original bottle or package when you see your doctor.
Keep track of what symptoms you experience, when you use your medications and how much you use. This will help your doctor figure out what works best. You may need to try a few different medications to determine which ones are most effective and have the least bothersome side effects for you.
July 12, 2014
See more In-depth
- DeShazo RD, et al. Pharmacotherapy of allergic rhinitis. http://www.uptodate.com/home. Accessed March 12, 2014.
- Overview of allergy and atopy. The Merck Manuals: Merck Manual for Health Care Professionals. 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 12, 2014.
- Weston WL, et al. Treatment of atopic dermatitis (eczema). http://www.uptodate.com/home. Accessed March 12, 2014.
- Goldstein GB, et al. General principles of dermatologic therapy and topical corticosteroid use. http://www.uptodate.com/home. Accessed March 12, 2014.
- Saag KG, et al. Major side effects of inhaled glucocorticoids. http://www.uptodate.com/home. Accessed March 12, 2014.
- Asthma care quick reference: Diagnosing and managing asthma. National Heart, Lung, and Blood Institute. https://http://www.nhlbi.nih.gov/guidelines/asthma/asthma_quickref.htm. Accessed March 12, 2014.
- Hamrah P, et al. Allergic conjunctivitis: Management. http://www.uptodate.com/home. Accessed March 12, 2014.
- Saag KG, et al. Major side effects of systemic glucocorticoids. http://www.uptodate.com/home. Accessed March 12, 2014.
- Schatz M. Recognition and management of allergic disease during pregnancy. http://www.uptodate.com/home. Accessed March 13, 2014.
- Allergy shots: Tips to remember. American Academy of Allergy, Asthma & Immunology. https://http://www.aaaai.org/conditions-and-treatments/library/at-a-glance/allergy-shots.aspx. Accessed March 13, 2014.
- Casale TB, et al. Immunotherapy: What lies beyond. The Journal of Allergy and Clinical Immunology. 2014;133:612.
- FDA briefing document: Biologics license application (BLA) for Ragwitek™ [standardized allergen extract, short ragweed (Ambrosia artemisiifolia)] sublingual tablet for oral use. Allergenic Products Advisory Committee (APAC) Meeting, Food and Drug Administration, Jan. 28, 2014. http://www.fda.gov/downloads/advisorycommittees/committeesmeetingmaterials/bloodvaccinesandotherbiologics/allergenicproductsadvisorycommittee/ucm382841.pdf. Accessed March 13, 2014.
- FDA briefing document: Biologic license application (BLA) for sweet vernal, orchard, perennial rye, Timothy, and Kentucky blue grass mixed pollens allergen extract tablet for sublingual use. Allergenic Products Advisory Committee (APAC) Meeting, Food and Drug Administration, Dec. 11, 2013. http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/BloodVaccinesandOtherBiologics/AllergenicProductsAdvisoryCommittee/UCM377852.pdf. Accessed March 13, 2014.
- FDA briefing document: Biologic license application (BLA) for Timothy grass pollen allergen extract tablet for sublingual use. Allergenic Products Advisory Committee (APAC) Meeting, Food and Drug Administration, Dec. 12, 2013. http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/BloodVaccinesandOtherBiologics/AllergenicProductsAdvisoryCommittee/UCM378092.pdf. Accessed March 13, 2014.
- Simons FER, et al. Anaphylaxis: Rapid recognition and treatment. http://www.uptodate.com/home. Accessed March 25, 2014.
- Make sure you receive the epinephrine autoinjector you were prescribed. American Academy of Allergy, Asthma & Immunology. http://www.aaaai.org/conditions-and-treatments/library/allergy-library/epinephrine-autoinjector.aspx. Accessed March 13, 2014.
- Li JT (expert opinion). Mayo Clinic, Rochester, Minn. March 24, 2014.
- Anderson CF (expert opinion). Mayo Clinic, Rochester, Minn. March 25, 2014.