What is Allergy?
Allergic rhinitis, or “allergies”, affects 1 in 6 adults and is the 5th most common chronic disease in US. It causes cold-like symptoms such as runny nose, sneezing, sinus congestion and itchy eyes. While a cold is caused by a virus, allergies are caused when you are exposed to an allergen such as pollen, dust, mold, or pet dander. One can experience allergy symptoms intermittently (seasonal) or chronically (perennial). Intermittent symptoms may be dependent on the geographical location, climate conditions, or exposure to pet dander at a friend’s house. On the other hand, chronic allergies are due to constant exposure to the allergens.
Allergic rhinitis costs $2 – $5 billion in direct health expenditures annually and can cause decreased quality of life and productivity if suffering from chronic symptoms.
Ways to Treat Allergies Non-Pharmacologically
Since allergic rhinitis is an inflammatory response to an allergen, avoiding those allergens helps reduce symptoms or frequencies of experiencing allergies. To find out what specific allergens you’re susceptible to, you can visit a doctor’s office for an IgE-mediated skin prick test or blood test. In addition, frequent vacuuming of carpets, drapes, and upholstery in the house
Nasal irrigation (rinsing out sinuses) with warm saline water rinses out allergens and mucus inside your sinuses and help reduce allergy symptoms and swelling. Neti Pot, available OTC, is a small pot that
Medications to Treat Allergies
Over the Counter Medications
There are a variety of medications available over the counter depending on your symptoms. Oral antihistamines such as Benadryl, Claritin, Zyrtec, and Allegra are widely used and they can ease symptoms of runny nose, sneezing, and itchy throat due to post nasal drip, but they are less effective for nasal congestion. Benadryl is most sedating and therefore should be avoided if it affects your daily activities. Second generation antihistamines such as Zyrtec, Claritin, and Allegra cause less sedation and cognitive impairment.
If your symptoms include sinus congestion, a combination product such as Claritin-D, Zyrtec-D, or Allegra-D can alleviate sinus congestion/pressure as well as runny nose and sneezing. These products are available behind the pharmacy counter as one of the ingredients is pseudoephedrine, which is regulated by DEA for a potential to abuse. You do not need a prescription to purchase, but requires an ID and there is limit to how much and how often you can purchase at one time. Pseudoephedrine can increase blood pressure and therefore should be avoided if you are taking a medication for high blood pressure.
Intranasal glucocorticoids such as Flonase, Nasacort and Rhinocort are the most potent drugs available for the relief of allergy symptoms, seasonal or perennial, and are equally effective in relieving nasal congestion as well as eye symptoms. They provide benefits with reduced side effects compared oral medications. Their most frequent side effect is local irritation in the nasal passage. These agents all achieve up to 70% overall symptom relief with some variation in the time period for onset of benefit. Make sure to shake the spray well before using, and they need to be primed (spray in the air) if using it for the first time or haven’t been used for more than 2 weeks.
Prescription Medications
Written By: Eddie Chang and Ellie Sung
References
- Cahill KN, Boyce JA. Urticaria, Angioedema, and Allergic Rhinitis. In: Jameson J, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J. eds. Harrison’s Principles of Internal Medicine, 20e New York, NY: McGraw-Hill.
- Seidman MD,
Gurel RK, Lin SY et al. Clinical Practice Guideline: Allergic Rhinitis. Otolaryngology-Head and Neck Surgery. 2015;152(1S): S1-S43. - Krinsky DL, Berardi RR, Ferreri SP, eds. Handbook of Nonprescription Drugs. 18th ed. Washington DC. APhA; 2015:172-208.
