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.

Antihistamines

Antihistamines block histamine, a symptom-causing chemical released by your immune system during an allergic reaction.

Pills and liquids

Oral antihistamines, available as over-the-counter and prescription drugs, ease 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, they shouldn't be taken when driving or doing other potentially dangerous activities.

Antihistamines that tend to cause drowsiness include:

  • Diphenhydramine (Benadryl)
  • Chlorpheniramine

These antihistamines are much less likely to cause drowsiness:

  • Cetirizine (Zyrtec)
  • Desloratadine (Clarinex)
  • Fexofenadine (Allegra)
  • Levocetirizine (Xyzal)
  • Loratadine (Alavert, Claritin)

Nasal sprays

Antihistamine nasal sprays help relieve sneezing, itchy or runny nose, sinus congestion, and postnasal drip. Side effects of antihistamine nasal sprays may include a bitter taste, drowsiness or fatigue. Prescription antihistamine nasal sprays include:

  • Azelastine (Astelin, Astepro)
  • Olopatadine (Patanase)

Eyedrops

Antihistamine eyedrops, available as over-the-counter or prescription medicines, can ease itchy, red, swollen eyes. These drops may have a combination of antihistamines and other medicines.

Side effects may 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, Zaditor)
  • Olopatadine (Pataday, Patanol)
  • Pheniramine (Visine-A, Opcon-A, others)

Decongestants

Decongestants are used for quick, temporary relief of nasal and sinus congestion. They can cause insomnia, headache, increased blood pressure and irritability. They are not recommended for women who are pregnant 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 (Sudafed, Afrinol, others), are available as over-the-counter drugs.

A number of oral allergy medications contain a decongestant combined with 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 they are used for a short period of time. Repeated use of these drugs for more than three consecutive days may result in a cycle of recurring or worsening congestion. Examples include:

  • Oxymetazoline (Afrin, Dristan, others)
  • Tetrahydrozoline (Tyzine)

Corticosteroids

Corticosteroids relieve symptoms by suppressing allergy-related inflammation. Most of these medications require a prescription.

Nasal sprays

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 Aqua)
  • Fluticasone furoate (Veramyst)
  • Fluticasone propionate (Flonase)
  • Mometasone (Nasonex)
  • Triamcinolone (Nasacort Allergy 24 Hour)

Inhalers

Inhaled corticosteroids are often used every day 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)
  • Fluticasone (Advair Diskus, Flovent Diskus, others)
  • Mometasone (Asmanex Twisthaler)

Eyedrops

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)
  • Rimexolone (Vexol)

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 (Flo-Pred, Prelone, others)
  • Prednisone (Prednisone Intensol, Rayos)

Skin creams

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 are usually used when antihistamines are not working or not well-tolerated.

Nasal spray

Generic over-the-counter nasal sprays are sold as cromolyn.

Eyedrops

Prescription eyedrops include the following:

  • Cromolyn (Crolom)
  • Lodoxamide (Alomide)
  • Pemirolast (Alamast)
  • Nedocromil (Alocril)
Jul. 12, 2014 See more In-depth