Top Allergy Medicines: Which One Works Best?

Finding the best allergy medicine is key for handling symptoms like a runny nose or itchy eyes. These meds can come in many types, from pills to nasal sprays. Some you can buy at a store, others need a doctor’s prescription.¹

Allergy meds help by stopping histamine, which your body makes during an allergic reaction. This stops the feelings of itchiness, sneezing, and swelling. There are different kinds of meds, like antihistamines or corticosteroids.²

Key Takeaways

Allergy medications come in various forms, including pills, liquids, inhalers, nasal sprays, eyedrops, skin creams, and shots.
The main types of allergy treatments include antihistamines, decongestants, corticosteroids, mast cell stabilizers, leukotriene inhibitors, allergen immunotherapy, biological medications, and emergency epinephrine shots.
Allergy medications work by blocking histamine, a chemical released during an allergic reaction that causes symptoms.
Some allergy medications are available over-the-counter, while others require a prescription.
Finding the most effective allergy medication depends on the individual’s specific symptoms, preferences, and consultation with a healthcare provider.

Antihistamines: The Front-line Allergy Defense

Antihistamines are key in fighting allergy symptoms. They block the action of histamine. This chemical leads to symptoms like sneezing and watery eyes.³ You can get antihistamines over the counter or with a prescription, making them easy and effective to use.

Non-sedating Antihistamines

Non-sedating antihistamines are a better choice for the day. Medicines such as Zyrtec and Clarinex cause less sleepiness.³ You’ll feel better within hours of taking them.³

Sedating Antihistamines

On the other hand, sedating antihistamines like Benadryl can make you sleepy.³ They might be helpful at night but can make it hard to focus during the day.

Nasal Sprays: Targeting Nasal Symptoms

Nasal sprays play a vital role in treating allergies because they directly target nasal symptoms. These include sneezing, itchiness, a runny nose, and more.⁴

Antihistamine Nasal Sprays

Prescription antihistamine sprays like azelastine (Astelin) and olopatadine (Patanase) can help. They stop histamine, a chemical that causes allergy symptoms.²

Steroid Nasal Sprays

Other nasal sprays made with steroids, such as fluticasone (Flonase), are also key in treating allergies. They reduce swelling in the nose. This lowers reaction to allergens, easing stuffiness and a runny nose.²

You can use nasal sprays along with oral antihistamines for better allergy symptom control. This approach helps a lot if you have strong or ongoing nasal issues.²

Decongestants: Relieving Nasal Congestion

Decongestants are medicines that help you breathe better by making the blood vessels in your nose smaller. This reduces the swollen feeling and stuffiness in your nose and sinuses.⁴ They’re available in different types like pills, liquids, and sprays.⁴

Oral Decongestants

Things like pseudoephedrine (Sudafed) and phenylephrine (Sudafed PE) are oral decongestants. They’re used for a bit of time to ease up your congested nose and sinuses.⁴ You can find them at the store and they might also include antihistamines or painkillers. These help handle more than just the stuffy nose.⁴

Nasal Decongestant Sprays and Drops

Then there are sprays and drops for your nose. They have things like oxymetazoline (Afrin) and phenylephrine hydrochloride to clear up your nose.⁴ These work faster than things you swallow. But, using them for too long can make things worse, not better.⁴

A lot of allergy drugs mix decongestants with antihistamines. This helps with more symptoms at the same time.⁴ Always use these medicines like it says on the label. And if you’re taking them for a while, talk to your doctor first. This makes sure you’re using them the right way.⁴

Corticosteroids: Reducing Inflammation

Nasal Corticosteroid Sprays

Corticosteroids help fight inflammation, a big cause of allergy symptoms.² Using sprays like fluticasone (Flonase), budesonide (Rhinocort), and triamcinolone (Nasacort) treats and stops nasal congestion, sneezing, and a runny nose.²

Inhaled Corticosteroids

For asthma due to allergies, inhaled corticosteroids are part of daily treatment.²

Corticosteroid Eye Drops

For itchy, red, or watery eyes, you can use corticosteroid eye drops. Examples include fluorometholone (Flarex, FML) and loteprednol (Alrex, Lotemax). They help calm your eyes.²

Oral Corticosteroids

Prednisone and other oral corticosteroids treat severe allergy signs but can have more side effects over time.² In the short term, they might cause fluid retention, weight gain, and high blood sugar. With long or high doses, issues like bone thinning, mental health changes, and muscle loss might happen.⁵ Be careful because corticosteroids might not mix well with drugs that affect digestion and metabolism, such as Nizoral (ketoconazole) and Norvir or Kaletra (ritonavir).⁵

Mast Cell Stabilizers: Preventing Allergy Symptoms

Mast cell stabilizers are a special kind of allergy medicine. They stop the release of chemicals like histamine that lead to allergy symptoms.² Unlike antihistamines, these stabilizers keep the inflammatory messengers from starting, hence, avoiding symptoms.

Nasal Mast Cell Stabilizers

Nasal sprays with cromolyn, such as Nasalcrom, can help with sneezing, itching, and a runny nose.² They are easy on the body but might need a few days to work fully.

Eye Drop Mast Cell Stabilizers

For itchy, red eyes from allergies, special eye drops can offer relief. Prescriptions like cromolyn (Crolom), lodoxamide (Alomide), and nedocromil (Alocril) are made to help.⁶ They keep the eye membrane’s mast cells calm, stopping the harmful chemicals from causing trouble.

Mast cell stabilizers are not quick fixes like antihistamines. But, they are great for keeping allergy symptoms away for those looking to be ahead of their allergies.²⁶

Leukotriene Inhibitors: Blocking Symptom-Causing Chemicals

Leukotriene inhibitors are special medicines that block leukotrienes. These are chemicals your body makes during allergic reactions. They can make you have a stuffy or runny nose, and make you sneeze. Montelukast (Singulair) is a popular leukotriene inhibitor known for treating hay fever. It works by stopping leukotrienes from causing allergy symptoms like a stuffed-up nose, runny nose, and sneezing. However, for some people, these inhibitors might bring on things like feeling anxious or sad, having strange dreams, not sleeping well, or thinking about hurting themselves.

Zafirlukast (Accolate®) and Zileuton (Zyflo®) are also in the group of leukotriene modifiers⁷. While Montelukast and Zafirlukast block leukotriene receptors, Zileuton stops the body from making leukotrienes in the first place. These medicines can reduce allergy and asthma symptoms. Yet, they might damage the liver, so patients need to get regular blood tests. They could also cause symptoms like having a cold, diarrhea, feeling tired, or a headache, among others. Some rare but serious side effects include changes in mental health, hives, a hoarse voice, a fast heart, or difficulty breathing or swallowing.

Montelukast is the only one of these medicines approved to manage allergic rhinitis, or allergies,⁸. Studies show it works as well as loratadine (Claritin) for symptoms like a runny nose. But remember, these modifiers can’t be used by themselves to treat a sudden asthma attack. They need a few days to two weeks to show their full effects on allergies and asthma. Possible side effects include feeling like you have the flu, being nervous, headaches, upset stomach, got a little nauseous, or had a stuffed up nose. Montelukast also has a risk of serious mental health side effects, like thinking about hurting yourself. Plus, we don’t know if these medicines are safe or work well in very young children for asthma or year-round allergies.

which allergy medicine works best?

There isn’t one perfect allergy medicine for everyone. What works best varies from person to person. It depends on what allergies you have, your likes, and what you need.²

Factors to Consider

When choosing an allergy medicine, think about what symptoms you have and how bad they are. Also consider side effects, the cost, and if you can buy it without a doctor or you need a prescription.² For instance, people who want to stay awake might like fexofenadine (Allegra®). But if you need sleep, diphenhydramine (Benadryl) could be better.⁹

Personalized Treatment Approach

A treatment just for you is often the best way to beat allergies. Talking with a doctor can help find the right medicine. They can also suggest more than one medicine if needed. This way, you get relief without too many side effects.²

Taking a personalized approach really helps. It lets you find the best medicine for your allergies. You’ll get relief that fits your specific needs and symptoms.²

Allergen Immunotherapy: Retraining the Immune System

Allergen immunotherapy, or allergy shots, slowly exposes patients to their allergies.² This helps the immune system react less over time.²

Allergy Shots

Allergy shots are given as a series of small injections.¹⁰ They last for 3 to 5 years, containing enough allergen to spark a reaction but not cause big symptoms.¹⁰

The first phase lasts 3 to 6 months, with doses 1 to 3 times weekly. Then, it moves to a maintenance phase, once monthly for 3 to 5 years.¹⁰

People usually see their allergies get better in the first year of shots. The second year brings even more relief.¹⁰

After ending the shots, some might stay symptom-free. Others might need to continue with the shots. It depends on the person.¹⁰

Sublingual Immunotherapy (SLIT)

SLIT means putting a tablet under the tongue.² In the U.S., FDA-approved tablets are covered by insurance. But, drops aren’t FDA-approved and aren’t covered.¹¹

In Europe, allergy drops have been used for a long time. Now, more in the U.S. are using them, too.¹¹

These drops cover more air allergens. They are made just for you, based on your allergy tests.¹¹

While shots are a bit more effective, drops can also help. They are good for kids and adults with allergies, except those on beta blockers or with labile asthma.¹¹

Allergy drops start helping in 3 to 4 months. You might need to use them daily for 3 to 5 years.¹¹

SLIT is generally safe. Severe reactions are rare, and no one has died from it.¹¹

Common side effects are mouth and throat issues, plus stomach problems like nausea and vomiting. These are usually mild to moderate.¹¹

Immunotherapy works well for lessening allergy signs, like asthma, when basic treatments don’t cut it.²

Biological Medications: Targeting Specific Immune Reactions

Biological medications are a new kind of allergy treatment. They focus on certain reactions within the immune system.¹² For example, dupilumab (Dupixent) helps with allergic skin issues. Omalizumab (Xolair) is for asthma or severe hives.¹² These medicines are given via shots. They’re great when classic allergy meds don’t work.¹² Yet, they may cause redness, itching, or irritation where the shot goes in.¹³

These meds aim at precise immune system parts to manage diseases like psoriatic arthritis.¹³ They help with many health problems, including cancer, psoriasis, rheumatoid arthritis, and Crohn’s disease.¹³ Using these drugs might lead to several potential side effects. These include reactions where the shot was given, nausea, headaches, and more.¹³

In a study, out of every 1,000 people who tried a biological drug, 770 had side effects. This was a bit more than the placebo group, where 724 had side effects.¹³ 127 out of 1,000 people on biologics had a severe side effect, compared to 118 on placebos.¹³ To dodge infections while on biologics, good hygiene is key. This means frequent handwashing and steering clear of crowded areas.¹³ Also, some side effects can be managed. This includes using cold packs, antihistamines, and talking with your doctor.¹³ Always read the info pack that comes with your medication. It lists all possible side effects and how to manage them.¹³

Emergency Epinephrine Shots: Treating Anaphylaxis

Epinephrine auto-injectors, such as EpiPen, Adrenaclick, and Auvi-Q, help treat anaphylaxis. This is a severe and life-threatening allergic reaction.¹⁴ Epinephrine works by tightening blood vessels, boosting the heart, and opening airways.¹⁴ This fights the harm caused by the allergic reaction.

It’s crucial to always have two epinephrine auto-injectors in case you need a second dose. Also, make sure they are not expired.¹⁴ People who are at risk for anaphylaxis learn how to use these injectors in an emergency.¹⁴

Statistics on Anaphylaxis and Epinephrine Auto-Injectors
Anaphylaxis can lead to shock, a rapid drop in blood pressure, and respiratory distress, affecting those with allergies.¹⁴
Immediate administration of epinephrine autoinjectors like EpiPen is crucial in treating anaphylaxis.¹⁴
Symptoms of anaphylaxis include skin reactions, facial swelling, airway narrowing, rapid pulse, nausea, dizziness, and unconsciousness.¹⁴
Common triggers for anaphylaxis are medications, latex, peanuts, tree nuts, fish, shellfish, insect stings, and more.¹⁴
Untreated anaphylaxis can result in death within half an hour in severe cases.¹⁴
Antihistamines like diphenhydramine are insufficient for treating anaphylaxis; they provide relief but are ineffective in severe reactions.¹⁴

Epinephrine auto-injectors are vital for anaphylaxis, a dangerous reaction needing quick action.

Combining Allergy Medications

When dealing with allergies, knowing which medicines are safe to mix is key. It’s okay to use an antihistamine and decongestant together when needed. This combo can tackle allergy symptoms well.² But, avoid pairing different antihistamines or using a decongestant with an antihistamine/decongestant mix.¹⁵

Safe Combinations

Taking an antihistamine like Loratadine, Cetirizine, or Fexofenadine with a decongestant like Pseudoephedrine or Phenylephrine is safe.¹⁶ It helps with symptoms caused by histamine and eases congestion from allergies.

Unsafe Combinations

Avoid mixing specific allergy meds, as it could cause problems. Don’t use Claritin with Benadryl, as it might make you very sleepy.¹⁵ Combining too many antihistamines can even be dangerous, leading to poisoning.

Always talk to a doctor before mixing allergy drugs. They can give you the right amount and check for any bad interactions.¹⁵

FAQ

What are the different types of allergy medications?

Allergy medications come in many forms. There are pills, liquids, nasal sprays, and more. Some you can buy without a prescription. The main types include antihistamines, decongestants, and corticosteroids. There are also allergen immunotherapy, biological meds, and emergency epinephrine shots.

How do antihistamines work?

To know how antihistamines work, understand histamine first. It’s a chemical causing allergies. Antihistamines block this. They stop sneezing, itchy eyes, and runny nose. Some make you sleepy; others don’t.

What are antihistamine nasal sprays and steroid nasal sprays?

Antihistamine sprays, like azelastine, ease sneezing and runny nose. Steroid sprays, such as fluticasone, reduce swelling. Combining sprays and oral antihistamines can cover all allergies well.

How do decongestants work?

Decongestants shrink blood vessels in your nose. This eases nasal and sinus blockage. There are oral decongestants and sprays. But, use sprays briefly to avoid more blockage later.

What are corticosteroids and how do they help with allergies?

Corticosteroids reduce inflammation that causes allergy signs. Nasal sprays and eye drops are common. Use them regularly for best results. Oral corticosteroids treat severe reactions, but with more side effects.

How do mast cell stabilizers work?

Mast cell stabilizers stop histamine release, easing allergies. Some you buy without a prescription. Eye drop versions are available if needed. They work well but take time to work fully.

What are leukotriene inhibitors and how do they help with allergies?

Leukotriene inhibitors are prescriptions that stop chemicals worsening allergies. Montelukast is one, good for hay fever. They may affect mood negatively in some, so watch for that.

What is the best allergy medicine?

The best allergy medicine varies person to person. It depends on the symptoms and preferences. Working with a healthcare provider is key. This helps find the right fit for you.

What is allergen immunotherapy?

Allergen immunotherapy is when you get doses of your allergens to desensitize you. It can reduce symptoms, even in asthma. It’s done with shots or under-the-tongue tablets.

What are biological medications for allergies?

Biological meds are new and focus on specific immune reactions. They include dupilumab for skin allergies and omalizumab for asthma. Given by injection, they work when others don’t. Just watch for minor injection site reactions.

When are epinephrine auto-injectors used for allergies?

Epinephrine auto-injectors treat severe allergy cases, like anaphylaxis. They’re critical to have in an emergency. Always keep two with you, and learn how to use them.

Can I combine allergy medications?

Taking an antihistamine with a decongestant is usually fine for allergies. But, avoid mixing different antihistamines or pairing a decongestant with another combo. It’s smart to check with a doctor first.