More about Allergy Medications

If you are in the Salt Lake City Utah area and you can schedule an allergy doctor appointment or contact us with any of your allergy related questions. There are many different types of allergy medicines available (both prescription and nonprescription) for those who suffer from allergy symptoms. Utah has a relatively high pollen count, so there are many Utahns who take prescription allergy medications, and over-the-counter drugs. None of these medications can “cure” allergies, but they can help treat the symptoms. Currently about 50% of those with allergies take prescription medication, while 35% of those with allergies take over-the-counter medicine for relief. However, each medication works differently for each individual, and it can be a challenge finding what works best for you. It is also necessary to compare the pros and cons of each medication, as many of them have mild side effects. When you visit your allergy doctor’s clinic, he or she will help you determine what type of medication is the most appropriate for you. Different categories of allergy medications are designed to treat different types of symptoms. There is not a one-size-fits all approach when it comes to allergy treatment. Your allergy doctor may need to recommend taking more than one medication, if you suffer from a wide range of symptoms. It is always best to take medication (even over-the-counter versions) under the supervision of an experienced allergist. When you visit your allergist’s clinic, he or she can run assessments and tests that will help determine what type of medications are best for you. The following are the five major kinds of allergy medications: Oral antihistamines Nasal antihistamines Decongestants Nasal sprays Eye drops Below is a guide to each of these categories, including definitions, the names of common medications, uses, side effects and detailed special features for some of the more common, or popular medications. ORAL ANTIHISTAMINES Oral antihistamines are the most common allergy medication, and some have been around for over 60 years. They relieve allergy symptoms by blocking histamine, the chemical released by your body’s immune system that causes various allergy symptoms. Antihistamines are either classified as H1 blockers or H2 blockers, depending on the type of cell receptors that they interact with. H1 receptors are associated with human tissue involving capillaries, whereas H2 receptors predominate in the lining of the stomach. Antihistamines do not offer long-term or permanent relief. They temporarily relieve symptoms like sneezing, itching, nasal drainage, and hives, but they do not relieve nasal congestion. Some original antihistamines have drawbacks that include being short-acting, lessened ability to concentrate, and drowsiness. By far, the most common side effect of this type of allergy medication is drowsiness. If you suffer from allergies you may think of histamine as something negative, since it is associated with allergic reactions. However, histamine is a necessary neurotransmitter, which helps nerve cells communicate with each other. An “antihistamine,” therefore, can block the normal way our brains function. In general, these side effects are not serious. The manufacturers of these types of medication, warn individuals who are currently taking these medications to avoid activities in which you need to remain alert, such as driving, operating machinery, or performing potentially dangerous activities. People who cannot avoid these types of activities are advised to take this type of medication only at night. It is interesting to note that driving under the influence (DUI) can also apply to medications. If your driving is effected by taking antihistamines- you can potentially be cited for DUI. Its important to use common sense, and pay attention to how any medication affects you personally.

Some of the older antihistamines include drugs such as:

◇ Benadryl (diphenhydramine)

◇ Chlor-Trimeton (chlorpheniramine)

◇ Atarax

◇ Dimetapp

◇ Periactin

◇ Phenergan

◇ Vistaril

◇ Tavist

Potential Side Effects

This type of allergy medication causes several side effects. Aside from the drowsiness and inability to concentrate mentioned above, side effects can include: increased anxiety, nausea, loss of libido, depression, fatigue, loss of appetite, difficulty with urination, tremors, dry mouth, gastritis, and dizziness. Although there are potential side effects, many doctors feel that allergy medications such as Benadryl should be included in every medicine chest. Since Benadryl works quickly, is considered generally safe, and is easily absorbed, it is a good idea to have around for emergency situations. Featured: Benadryl Benadryl is an antihistamine that can relieve allergy symptoms such as: itchy, watery eyes; sneezing; runny nose; coughing; red eyes; and redness from hives and rashes. Benadryl also relieves itching from a variety of conditions, such as: insect bites, sunburn, bee stings, poison ivy, and poison oak. Benadryl works by blocking the effects of histamine, a chemical that our body makes which can constrict air passages and cause inflammation. This type of allergy medication offers temporary relief from allergy symptoms; it doesn’t cure, it simply suppresses symptoms. Benadryl Dosage: Benadryl comes in the form of a tablet, capsule, and liquid. It is offered in a range of products, including:

◇ A non-drowsy formula that works up to 8 hours

◇ A non-drowsy formula that works up to 8 hours, with added decongestant

◇ A one-a-day formula

◇ A liquid formula for children as young as two years

◇ A cream or lotion for skin irritation

The usual adult dosage of Benadryl is 25 to 50 milligrams, 3 or 4 times daily. The sleep-aid dosage is 50 milligrams at bedtime. The usual child dosage of Benadryl is 12.5 to 25 milligrams, 3 to 4 times daily. A child should not take more than 300 milligrams a day. Side Effects of Benadryl: The most common possible side effects associated with Benadryl are as follows:

◇ Dry mouth, nose, and throat

◇ Disturbed coordination

◇ Upset stomach

◇ Chest congestion

◇ Sleepiness

◇ Excessive calm

Benadryl Special Warnings: People with glaucoma, peptic ulcer, urinary obstruction, enlarged prostate, asthma, chronic lung disease, an over-active thyroid, high blood pressure, or heart disease should use this allergy medication cautiously. Benadryl may cause excitability in young children. Do not give Benadryl to children younger than 6 years of age unless directed to do so by your doctor. People over 60 years of age are more likely to experience dizziness and low blood pressure. This allergy medication may cause drowsiness. Second Generation Oral Antihistamines The newer antihistamines, also known as second-generation antihistamines, are supposed to be less likely to cause the drowsiness associated with the original medications. They are sometimes referred to as “non-sedating.” Claritin has been recently made available over-the-counter, but most of the non-sedating antihistamines still require a prescription. In general, allergists will try to treat patients using these newer medications, but if they do not seem to work for an individual, doctors will often try the original, first generation antihistamines next. The newer, second generation antihistamines include: Zyrtec (cetirizine) Allegra (fexofenadine) Clarinex (desloratadine) Claritin (loratadine) Singulaire (montelukast) Featured: Zyrtec Zyrtec is a second-generation antihistamine that is less likely to cause drowsiness or impair motor abilities. Doctors prescribe this allergy medication to treat a wide variety of allergies such as: animal dander, mold, dust, hay fever, and skin conditions. Zyrtec works like other antihistamines, by blocking the effects of the biological chemical known as histamine, that can cause constricted air passages and inflammation. This type of allergy medication offers temporary relief from allergy symptoms and is very effective for some individuals. Zyrtec Dosage: Zyrtec comes in the form of a tablet or syrup to be taken by mouth. The usual dosage is just once a day, and may be taken on a regular basis, or just when the allergy season is most potent. Tablets are offered in 5 mg and 10 mg, while the syrup is labeled 5 mg/5mL. For adults 12 years and older, the typical starting dose is 5 or 10 mgs once per day. For children 6 to 11 years of age, the typical starting dose is 5 or 10 mgs per day, or one to two teaspoons of syrup. Zyrtec can be given to children as young as 6 months. Always check with your doctor for individual dosage instructions. Zyrtec Side Effects: The most common side effects associated with Zyrtec are as follows: Drowsiness Dry mouth Fatigue Abdominal pain (children) Coughing (children) Diarrhea (children) Headache (children) Nosebleed (children) Sleepiness (children) Sore throat (children) Wheezing (children) Zyrtec Special Warnings: Your dosage of Zyrtec may need to be reduced, if you have kidney or liver disease. Do not consume alcohol, sedatives, tranquilizers, sleeping pills, or muscle relaxants while taking Zyrtec. Combining Zyrtec with these substances can lead to serious drowsiness and reduced mental alertness. Even though it was designed to cause less drowsiness, this allergy medication can still cause moderate drowsiness in some individuals. Therefore you should not drive a motor vehicle or operate dangerous machinery until you know how your body reacts to Zyrtec. NASAL ANTIHISTAMINES This is a relatively new class of antihistamine, available only by prescription. This type of medication is sprayed directly into the nose. The nasal antihistamine is steroid free and can help patients have reduced symptoms for up to 12 hours. The first allergy medication of this type is known as Astelin (azelastine). The theory is that by spraying this drug directly into the nose, the concentration of the drug is increased where it is needed most. This may increase the patients’ relief from allergy symptoms. This type of drug does have some side effects, however. It can potentially cause headaches, drowsiness, and a bitter taste if the spray drips down from the nasal passages into the throat and mouth. It depends on what your doctor determines would be best for you, but even though oral antihistamines are the most popular choice for treating allergy symptoms, sometimes nasal antihistamines can be even more effective at reducing rhinitis symptoms such as sneezing, itchy, and runny nose. Featured: Astelin Astelin is administered as a nasal spray that focuses allergy medication where it is most needed. Doctors prescribe Astelin for allergy symptoms. Astelin is often used to treat hay fever symptoms, congested nasal passages, and post nasal drip. Again, like other antihistamines, Astelin works by blocking the effects of the biological chemical histamine, which causes allergy symptoms. This type of allergy medication offers temporary relief from allergy symptoms. No known allergy medications can “cure” allergies, but for some people these types of nasal sprays are very effective at suppressing unwanted symptoms Astelin Dosage Astelin is usually sprayed in each nostril two times a day. When you use this allergy medication for the first time, you have to first remove the child-resistant screw cap and install the included pump. You must then prime the pump until a mist is visible, before you administer the first dose. For adults 12 years and older, the typical dose is 2 sprays into each nostril twice a day. For children between 5 and 12 years of age, the usual dose is 1 spray in each nostril twice per day. In this age group, Astelin is not recommended for types of congestion other than hay fever symptoms. Astelin Side-Effects The most common side effects associated with Astelin are as follows:

◇ Bitter taste

◇ Drowsiness

◇ Loss of sensation

◇ Headache

◇ Nasal burning

◇ Sneezing

◇ Sore throat

Astelin Special Warnings:

Astelin can make some individuals drowsy. For those people with a kidney condition, their dosage of Astelin may have to be reduced. The effects of Astelin change when it is taken with other drugs, such as alcohol, Codeine, Phenobarbital, Restoril, Tagamet, Nizoral, Benadryl, and Claritin. Tell your doctor if you are pregnant, or if you become pregnant while using Astelin. If you are scheduled for surgery, tell your doctor you are using Astelin. This allergy medication may cause drowsiness. You should not drive a motor vehicle or operate dangerous machinery until you know how your body reacts to Astelin. Let your allergy doctor know if you experience any of these side effects.

DECONGESTANTS (oral & nasal)

Those of us who suffer from allergic reactions like sinusitis, know that there is a definite need for decongestants! Having runny noses, swollen sinuses, and post-nasal drip makes it extremely difficult to sleep and enjoy every day activities. Fortunately there are medications to treat these symptoms. Decongestants are available by prescription and over-the-counter, and they are sold in various forms including pills, liquid, sprays, and drops. This type of allergy medication is a stimulant. It works by constricting the blood vessels that enter the nose, which in turn reduces the fluid build-up that causes blocked sinuses. There are two major types of medication under the category of decongestants: psuedoephedrine and phenylephrine. Decongestants can be an effective way to treat congestion caused by allergies such as hay fever (pollen allergy), but they are also commonly used to treat viral nasal symptoms and sinusitis. This is why some decongestants say they are for cold and allergy. However, this type of allergy medication does not treat sneezing, itching, and nasal secretions. There are several types of decongestant allergy medications that are currently prescribed. One version of these drugs is called phenylpropanolamine. The FDA has banned this ingredient banned due to unacceptable side effects. If you have very old medicine, it is best to throw it out, unless you are sure it is safe. Also, most medications become less effective with time.

Some common decongestants are:

◇ Atrohist Plus

◇ Sudafed

◇ Triaminic

◇ Profen

◇ Poly-Histine

◇ Ornade

◇ Entex

◇ Dura-Vent

Decongestants are known to have side effects that you should be aware of. Unlike antihistamines, which cause drowsiness, this type of allergy, medication can cause insomnia. Since antihistamines and decongestants have side effects that counteract each other, it can be a good idea to take them together. Perhaps this is why many patients find the combined allergy medication, the ones that contain both antihistamine and decongestants, so effective and convenient to use. It is a good practice, therefore, to take this medicine several hours before going to bed. Other side effects of the decongestants include: nervousness, difficulty with urination, headaches, and elevated blood pressure. Patients are not advised to take decongestants if they have conditions such as: enlarged prostate, heart diseases, glaucoma, diabetes, or if they are taking certain types of antidepressants. There is an important caution about nasal decongestants. A “rebound effect” that can occur when nasal decongestants are used for more than two or three consecutive days. When the rebound effect occurs, your nasal congestion can actually become worse than it was before you started using the nasal decongestant. This condition is known as “rhinitis medicamentosa,” and we are cautioned not to over-use this type of allergy medication. Featured: Sudafed Sudafed is a decongestant that can provide relief from sinus congestion caused by allergic reaction, hay fever, irritated sinuses, and the common cold. Sudafed can also relieve ear congestion caused by infection. The drug pseudoephedrine works by shrinking blood vessels in the nose, lungs, and mucus membranes. Since blood flow to the nose and other areas is decreased, this allergy medication decreases congestion, allowing airways to open up. Range of Products Sudafed is offered in a wide range of products, including: Sudafed 12 Hour, Sudafed Sinus and Allergy, Sudafed Cold & Cough Liquid, Sudafed Sinus & Cold, Sudafed Nasal Decongestant, Sudafed 24 Hour Tablets, Sudafed Non-Drying Sinus, Sudafed Severe Cold Formula, Sudafed Sinus Headache, Sudafed Sinus Nighttime, Sudafed Nighttime Plus Pain Relief, Children’s Sudafed Cold & Cough, Children’s Sudafed Nasal Decongestant, and Children’s Sudafed Nasal Decongestant Chewables. Sudafed Dosage Because there is such a wide range of products, it is best to check the instructions included with the medication, or consult with your allergist.

Sudafed Side Effects:

◇ Dizziness

◇ Headache

◇ Pounding heartbeat

◇ Nausea

◇ Vomiting

◇ Difficulty with urination

◇ Sweating

◇ Nervousness

◇ Trouble sleeping

Special Warnings- Sudafed Nasal Decongestant It is necessary to contact your doctor if you have any of the following conditions: heart problems, kidney disease, liver disease, lung disease, seizures, enlarged prostate, glaucoma, diabetes, overactive thyroid, high blood pressure, or emphysema. Contact your doctor if you are pregnant or become pregnant while using Sudafed. Contact your doctor if you plan to use Sudafed while breast-feeding. Contact your doctor if you are taking any of the following medication: sleeping pills, MAO inhibitors, tranquilizers, high blood pressure medication, muscle relaxants, or medication for depression.

NASAL SPRAYS

Non-Steroid Nasal Spray The most common non-steroid nasal spray is called cromolyn sodium (brand name, Nasalcrom). It is a medication that is considered relatively safe, and is approved for use by pregnant women. Cromolyn works by interfering with the release of histamine, so it can work as a preventative agent for allergy symptoms. A common side effect of cromolyn is that it can cause mild nose irritation. For maximum benefit, patients should start taking this drug several weeks before allergy season begins. As with all medications, the beneficial effects of this drug are different for everyone. To help make nasal sprays work better, it is advisable to rinse your nose with a saline solution before using the spray. This cleans the nasal passages, removing mucous and helping the medicine contact the lining of the nose. Non-steroid nasal sprays are available by prescription and over-the-counter.

Aside from Nasalcrom, some other nasal sprays in this category include:

◇ Opticrom

◇ Tilade Steroid Nasal Spray

Steroid type nasal sprays appear to be more effective because they can counteract a greater variety of symptoms, including: congestion, postnasal drip, itching, and sneezing. Steroid nasal sprays decrease inflammation, opening the nasal passages so breathing through the nose is easier. These drugs also work by inhibiting histamine, cytokines, leukotrienes, basophils, and mast cells. They are not readily absorbed into the bloodstream, so they cause fewer side effects than oral steroids, but there are still some possible side effects. Nasal sprays of the steroid variety that are used for treating allergies include: Nasacort (trimcinolone acetonide) Nasonex (mometasone) Flonase (fluticasone) AeroBID (flunisolide) Pulmicort (budenoside) Beclovent (beclomethasone) Nasalide (flunisolide) Rhinocort (Budesonide) Side effects- Steroid Nasal Spray: The use of steroid allergy medication should be monitored closely. One possible side effect of repeated use of steroid nasal spray is damage to the nasal septum (the bone and cartilage that divides the nostrils. Other side effects may include: Hypertension Nasal ulcers Cataracts Glaucoma Osteoporosis Hyperlipidemia Mood disorders Headache Insomnia Weight gain Interference with bone growth (in children) EYE DROP ALLERGY MEDICATION Many people suffer from allergy symptoms that affect the eye, known as allergic conjunctivitis. Symptoms include swelling of the eye, redness, itchiness/irritation, and increased fluid production. Below are some common allergy medicine eye drops, separated by main categories. The first name is the brand name, which is followed by the generic name in parenthesis. If there is an “Rx” following the name, it is available only by prescription. Antihistamines: Used for the temporary relief of the signs and symptoms of allergic conjunctivitis. Optivar (Azelastine) (Rx) Emadine (Emadastine) (Rx) Antihistamine/decongestants: Used for relief of the symptoms of allergic conjunctivitis. This has a decongestant in addition to an antihistamine. The generic name for these drugs is Naphazoline/ Pheniramine. Naphcon A Opcon-A Visine-A Antihistamine/Mast cell Stabilizers: Used to treat the signs and symptoms of allergic conjunctivitis. Elestat (epinastine) Patanol (Olopatadine) Rx Corticosteroids: Used for the temporary relief of the signs and symptoms of seasonal allergic conjunctivitis. If used for longer than 14 days, an exam of the eye with magnification should be performed. The generic name is Loteprednol. Alrex (Rx) Lotemax Decongestants: Used to relieve redness associated with allergic eye conditions. Do not use for longer than three days without a physician’s advice. Use of this product can cause a “rebound”. The generic drug name is Naphazoline. Vasocon Albalon Many Generic versions Mast Cell Stabilizers: Used for relief of symptoms of allergic conjunctivitis, giant papillary conjunctivitis and vernal keratitis. Crolom (Cromolyn) (Rx) Generic Cromolyn (Rx) Zaditor (Ketotifen) (Rx) Alomide (Lodoxamine) (Rx) Non-steroidal anti-inflammatory drug: Used for the temporary relief of itching due to seasonal allergic rhinitis. Do not use if allergic to aspirin and other non-steroidal inflammatory drugs. If stored in refrigerator will sting less during application. Acular (Ketorolac) (Rx) What If I Am Pregnant? The truth is that since allergy medications cannot be ethically tested on pregnant women to see if they produce birth defects, it is simply not known what is entirely safe for use during pregnancy. In general most antihistamines are considered reasonably safe since they have been in use for so many years without reports of causing birth defects. Even so, that is not conclusive proof that they are 100% safe. On the other hand, if you are suffering from severe allergies that keep you up all night, or stressed out during the day- that is not necessarily a healthy alternative either. Your doctor can help you determine what your best options are for your individual situation. While there is no scientific proof, many women report that their allergy symptoms are naturally reduced during pregnancy. This could be due to the many hormonal changes that take place during pregnancy. What If I Am Breastfeeding? It is worth considering that small amounts of antihistamines, decongestants, or other ingredients may pass into the breast milk. If it can be avoided, it is not recommended to use these medications, since it may cause unusual excitement or irritability, in the nursing baby. Another consideration is that this medicine tends to decrease bodily secretions. It is possible that the flow of breast milk would be reduced in some women. 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