Allergy Medications

Non-Sedating Antihistamines

Antihistamines are effective for sneezing, runny nose, and itchy eyes.
They are less effective for post-nasal drip, and have little effect on nasal congestion. Unlike over-the-counter antihistamines, the following antihistamines are non-sedating; they will not make you tired, nor will they impair motor function or mental acuity. Their onset of action is relatively rapid, so they may be taken as needed; however, they will work better if taken on a daily basis. Preparations with a "-D" on the ends of their names contain a decongestant (go to the links on the left for more information on decongestants).

You will need to stop the antihistamines four days prior to allergy testing.
Claritin: 1 tablet per day as needed
Claritin Reditabs: 1 tablet per day as needed
Claritin Syrup: Check with your doctor for proper dosage and instructions
Claritin-D 12-hour: 1 tablet twice a day as needed
Claritin-D 24-hour: 1 tablet per day
Allegra: 1 tablet twice a day as needed
Allegra-D: 1 tablet twice a day as needed

Low-Sedating Antihistamines

Some of the newer antihistamines are considered to be "low sedating." This means that while over-the-counter antihistamines cause sedation in more than 30% of patients, and decrease motor function and mental acuity in even more, these newer antihistamines only cause sedation in a few patients out of a hundred.

Zyrtec causes sedation in about 7% of adults (4% of children), while about 6% of patients on Astelin are sedated. Because there is a small possibility of sedation, care should be taken with the first few doses.

You will need to stop the antihistamines four days prior to allergy testing.

Zyrtec: 1 tablet per day as needed
Zyrtec Syrup: Check with your doctor for proper dosage and instructions
Astelin: 2 sprays in each nostril twice a day as needed

Decongestants

The "D" in Allegra-D and Claritin-D refers to the decongestant pseudoephedrine. This and the decongestant phenylpropanolamine are used alone or in conjunction with other medications to relieve nasal congestion. Side effects include nervousness and difficulty sleeping. Some patients, especially those with enlarged prostates, may have difficulty urinating. Many of these side effects can be avoided by giving the pediatric dose, which is one-half of the adult dose.

Decongestants should not be taken by patients with hypertension, glaucoma, diabetes, or thyroid problems without your doctor's approval.

Entex LA: ½ - 1 tablet twice a day as needed
Entex PSE: ½ - 1 tablet twice a day as needed
Duratuss: ½ - 1 tablet twice a day as needed
Guaifed: 1 tablet twice a day as needed
Guaifed-PD: 1 tablet twice a day as needed
Dura-Vent: ½ - 1 tablet twice a day as needed

Mucolytics

Guaifenesin helps to thin out thick secretions in the sinuses and lungs. It is helpful in treating coughs as well. There are no serious side effects to this medication. It may be prescribed alone or in a combination pill with a decongestant and/or a cough suppressant such as dextromethorphan. Brand names of these medications include, but are not limited to, Duratuss-G, Duravent, Guaifed, Humibid, and Fenesin. Water is an excellent mucolytic, so drinking large quantities of water is often helpful.

Duratuss-G (Guaifenesin): 1 tablet twice a day as needed for postnasal drip

Nasal Steroids

Nasal steroids are very effective in preventing most of the symptoms of allergic rhinitis. They usually take a few days to reach their peak effect, and they must be used in advance to prevent symptoms from occurring, so they should be used every day. They are not very good at relieving symptoms once they have started.

Although they are steroids, they are very safe because almost all of the medicine stays in the nose. Side effects are uncommon, but can include headaches, sore throat, nasal irritation, burning and drying, and nose bleeds. The nose bleeds usually are not severe and can be avoided by directing the spray away from the nasal septum.

There are two types of devices for delivering nasal steroids:

Aqueous sprays
• Flonase
• Nasacort AQ
• Nasonex
• Vancenase AQ

Aerosol sprays
• Nasarel
• Nasacort
• Rhinocort
• Vancenase Packethaler

Check with your doctor for proper dosage and instructions.