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Health Education

Are you using the best seasonal allergy medicine?

Jenni Miller By | Updated on April 16, 2020
Medically reviewed by Kristi C. Torres, Pharm.D.

Springtime can be a glorious season for those who enjoy warmer weather and more sunshine, but it’s a mixed bag for people with seasonal allergies. It’s not just in your head (or sinuses)—allergy season is longer and more relentless than ever. Thanks to global warming, pollen counts are rising almost as quickly as the temperature. 

If hay fever (aka allergic rhinitis) is making you miserable, you’ll be reaching for an over-the-counter medication soon enough, but before you do, check out our guide to the best seasonal allergy medicine.

RELATED: Allergy vs. coronavirus symptoms: Which do I have?

Seasonal allergies: Causes, symptoms, treatment

On the most basic level, allergies occur when your body attacks a foreign substance—that can range from foods to pet dander and dust to pollen.

The length, severity, and cycle of your allergies depends on where you live and what you’re allergic to in particular. For example, allergy-prone North Texans are used to dealing with a wicked ragweed season in the fall, but as temperatures rise, that season has become nearly year-round, according to one local doctor. If trees make you sneeze, your allergy season could begin in February if you’re down south; you’ll be sitting pretty until May or June if you live in the Northern U.S. The American Academy of Allergy, Asthma & Immunology offers an interactive map from the National Allergy Bureau that offers information on local allergen levels.

However, self-diagnosing is not what the doctor ordered. An Australian study observed nearly 300 people who believed they had hay fever based upon their symptoms. Researchers were surprised to find that only 17% of the group selected the correct OTC medication to treat their symptoms, and the bulk of them actually had another condition instead of hay fever. Most selected their medications without consulting a pharmacist while experiencing moderate to severe symptoms. Spending more on drugs that may not treat the condition can result in more missed days at work as well as general discomfort. 60% of people in the survey said that their symptoms had an impact on at least one aspect of their life.

Before you go tackling your symptoms on your own, it’s best to see an allergist for testing; that can head off more serious allergies that can cause deadly complications (such as anaphylaxis) or conditions that can coexist with allergies, like asthma. It can also be hard to differentiate between seasonal allergies, a garden-variety cold, or the flu. Then there’s the question of whether you’re experiencing a sinus headache or a full-blown migraine. These are all great reasons to consult your allergist, doctor, pharmacist, or even telehealth professional—especially since there’s a glut of anti-allergy treatments on the market.

Which allergy medicine works the best?

So, which allergy medicine is best? That’s a great question, and it depends on what kind of allergies you have and what your system can tolerate. You have plenty of options, so let’s break them down by type.

Antihistamines

Oral antihistamines are a classic way to battle your symptoms, but they can cause drowsiness. An allergic reaction causes the immune system to release histamines to battle the foreign body, triggering inflammation that presents as allergy symptoms; antihistamines can reduce or block histamines before they can set off the immune system’s response.

Benadryl (diphenhydramine) is one of the original antihistamines out there, and while it’s still very effective, its sedating side effects can make it an unreasonable choice for daytime use. There are some non-drowsy antihistamine options on the market, like Claritin (loratadine), Zyrtec Allergy (cetirizine), Xyzal (levocetirizine dihydrochloride), and Allegra (fexofenadine) to battle symptoms. These non-drowsy options are called second- and third-generation antihistamines. Some antihistamines are available as nasal sprays, such as Astepro (azelastine), but most sprays are steroids. Common side effects include headaches, nausea, anxiety, dry mouth, and fatigue. These antihistamines are safe to use daily. 

There are also antihistamines that pack a pseudoephedrine punch to ward off sinus congestion, like Claritin-D, Allegra-D, and Zyrtec-D. However, pseudoephedrine can increase blood pressure and cause cardiovascular problems, not to mention triggering anxiety, dizziness, and generally feeling “speedy.” They’re also dangerous to combine with alcohol

Decongestants

Decongestants tackle inflammation and swelling in the tender tissues affected by allergies, which causes nasal congestion, itchy or watery eyes, or a congested chest. One of the most popular decongestants is Sudafed, but its main active ingredient is pseudoephedrine, which plenty of users can’t tolerate. Robitussin Cough+Chest Congestion is an alternative decongestant for people who have high blood pressure or otherwise can’t tolerate pseudoephedrine. Mucinex (guaifenesin) is a popular choice to loosen up mucus in the chest and make coughing more productive.

Afrin and Neo-Synephrine nasal allergy sprays are effective but generally not favored by healthcare providers; continuous use can cause what’s known as rebound congestion. If you’re debating between Afrin and Flonase (fluticasone propionate), a corticosteroid, this will help you weigh the pros and cons. Decongestants can be useful for stuffiness and mucous build-up and are often used in conjunction with antihistamines. However, the aforementioned side effects make these a tricky option. They’re also not recommended for pregnant people in the first trimester.

Eye drops

If dry, itchy eyes are your main allergy symptom, eye drops may be the best solution. There are two varieties available: antihistamine and decongestant eye drops. Some popular ones include: Visine, Clear Eyes, Refresh Optive, Lastacaft, Acular, and Elestat. Talk to your pharmacist or healthcare provider about which one might be right for you.

Nasal steroids

If you have seasonal or year-round allergies, corticosteroid sprays could be the answer. Flonase, Nasacort Allergy 24hr (triamcinolone), Nasonex (mometasone), and Rhinocort (budesonide) are a few of the more popular sprays, and while they’re thought to be more effective than antihistamines or decongestants, they don’t work as quickly, and you have to take them regularly. They also come with a slew of possible side effects, like osteoporosis, high blood pressure, memory and mood issues, and weight gain. Long-term users can face even more serious side effects, such as decreased immunity, heart disease, and thinning of the skin. Still, nasal steroids are thought to be more effective in general than other options for ongoing allergies.

Allergy shots

Subcutaneous allergen immunotherapy, otherwise known as allergy shots, takes dedication but it can really pay off in the end. People with seasonal allergies can benefit as much as those who are allergic to food, pet dander, or insect stings. The allergist will inject a small amount of the allergen in question under the skin once a week for the first seven months or so. After that, treatments will taper off to once every two weeks, and eventually once every four weeks, for anywhere from three to five years or longer. Sublingual immunotherapy (SLIT) is a needle-free way to develop immunity to allergens, but the newer technology can only treat one allergen at a time, whereas SCIT can treat several.

If you don’t have insurance or you’re underinsured, allergy shots can be prohibitively expensive, and they require a real commitment to continuing the treatment over the duration of several years. However, as per the American College of Allergy, Asthma, & Immunology, these shots are “the only treatment that changes the immune system.”

How to get rid of seasonal allergies fast

Even with the appropriate prescription, some individuals may not find complete relief from their seasonal allergy symptoms. Thankfully, there are several tips to keep in mind to help offset your runny nose and itchy eyes:

  • Stay indoors on windy days when pollens are more likely to be airborne.
  • Wear a mask when doing yard work or any time you are outside and exposed to triggers.
  • Watch your local weather forecast to find out when pollen counts are low and play your outdoor activities on these days.
  • Invest in air purifiers for the rooms in your home, ideally with HEPA filters; there are also vacuums with HEPA filters built right in.
  • Investigate alternative therapies to treat your allergies, with guidance from your general practitioner. Some people have found allergy relief using nasal irrigation, getting acupuncture, or eating honey (if they’re not allergic, of course).

Relief is possible from seasonal allergies with the proper diagnosis, medication, and by planning outdoor activities ahead of time.

How to save on allergy medication

When you’ve been suffering from seasonal allergies day in and day out with no relief in sight, you’d more than likely pay any price for medication that works. Yet the cost of common antihistamines are often quite high, and even the popular option Claritin charts at nearly $1 per day. 

Here’s where visiting your family physician can be beneficial in more ways than one—not only will an appointment likely diagnose the cause of your symptoms and provide a clear course of treatment, but a prescription for steroids or antihistamines could be cheaper in the long run. Using insurance to cover the cost of your medication could result in a less expensive and more effective result.

However, prices at pharmacies can vary dramatically even within the same town, so it’s always recommended to use SingleCare to make sure you’re paying the lowest price possible!