Allergy Medicines That Don't Require a Prescription

Many allergy medicines that were once available only with a practitioner’s prescription are now available over-the-counter (OTC). This usually means they cost much less than they did when they required a prescription, and you save the expense of a visit with your healthcare provider.

Older woman reading package in drug store
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Given the wide variety of OTC allergy medicines, it is now possible for you to treat most symptoms or nasal (allergic rhinitis) and eye (allergic conjunctivitis) without seeing a healthcare provider—assuming that you know which medicine to choose for your symptoms. The symptom-based approach is very important since not all medicines treat all the symptoms of allergies. Take a look at the different kinds of OTC allergy medications and what they can do so you can make the right choice.


Sedating antihistamines, including Benadryl and Chlor-Trimeton (chlorpheniramine), are considered too sedating for routine use. These medicines can result in mental and physical impairment even if you don’t feel sleepy after taking them. You could even be charged with a DUI (driving under the influence) in many states if you drive an automobile after taking these medications.

There are three less-sedating antihistamines, Claritin (loratadine), Zyrtec (cetirizine), Allegra (fexofenadine) and Xyzal (levocetirizine) that have been shown to result in less impairment of mental or physical tasks. (Zyzal is closely related to Zyrtec. It contains the same active ingredient as Zyrtec, but without the part of the drug that causes drowsiness. Both are available over the counter.)


OTC decongestants include an oral form such as Sudafed (pseudoephedrine) and a nasal form such as Afrin (oxymetazoline). Both do a fairly good job at treating nasal congestion.

While some people use Sudafed on a regular basis, side effects are common. Side effects of oral decongestants include insomnia, high blood pressure, anxiety, urinary retention, and headaches. (Decongestants also can interfere with the effectiveness of certain blood pressure medications.) People with these symptoms should check with their healthcare provider prior to using oral decongestants. Oral decongestants are fine for most people for a short period of time but should be avoided for longer control of allergy symptoms.

Nasal decongestant sprays, such as Afrin (oxymetazoline), should only be used for short periods of time, usually for no more than three days. Overuse of Afrin can lead to a medical condition called rhinitis medicamentosa, characterized by worsening nasal congestion that is less responsive or unresponsive to additional Afrin use. This condition requires evaluation and treatment by a healthcare provider.


The combination of antihistamines and decongestants is nothing new. These medications, such as Actifed (chlorpheniramine/phenylephrine) and Dimetapp (brompheniramine/phenylephrine), have been on the market for years. These now include Claritin-D (loratadine/pseudoephedrine), Zyrtec-D (cetirizine/pseudoephedrine) and Allegra-D (fexofenadine/pseudoephedrine).

These medicines are often kept behind the pharmacy counter but do not require a healthcare provider's prescription to purchase. They should only be used for a shorter period of time due to the decongestant component and its side effects.

Nasal Sprays

There are two types of nasal sprays that can be used for an indefinite period of time for the treatment of nasal allergy symptoms.

Nasalcrom is a relatively good medication for preventing allergic rhinitis symptoms but must be used on a regular basis in order to be effective. This medicine works by preventing the release of allergic chemicals such as histamine from mast cells but does nothing to block the effects of the allergic chemicals once released (unlike an antihistamine). NasalCrom is relatively safe, can be used for long periods of time and is OK for adults and children as young as 2 years of age.

Nasacort 24 Hour Allergy and Flonase (fluticasone) are nasal corticosteroid spray available without a prescription. Studies show that nasal corticosteroid sprays are the single most effective medications for treating all symptoms of allergic rhinitis, and are even helpful at treating the symptoms of allergic conjunctivitis.

Common side effects of nasal sprays include nose bleeds, burning, and irritation. Headache, nausea and vomiting, coughing and a sore throat are also common. Talk with your healthcare provider if you develop these symptoms

Astepro (azelastine)

Astepro is a steroid-free antihistamine nasal spray. It became available OTC in 2022 as Astepro Allergy for adults and children 6 years of age and older. The OTC option provides flexible, once- or twice-daily dosing and up to 24-hour relief from congestion, runny nose, and sneezing caused by both indoor and outdoor allergies.

Eye Drops

There are several eye drops available OTC for the treatment of eye allergy. Many contain topical decongestants like those found in Visine (naphazoline), which should only be used for a few days at a time.

When topical decongestants are used long-term, a medical condition called conjunctivitis medicamentosa can develop. Symptoms may include an increase in eye redness and irritation, with more dependence on the eye drop for relief.

Zaditor/Alaway (ketotifen), a topical antihistamine and mast cell stabilizer eye drop, is available over-the-counter for the treatment of eye allergies. It is also available in generic forms. This medication can be used long-term without the potential side effect of conjunctivitis medicamentosa.

A Word From Verywell

You have many choices of medications for the treatment of allergic rhinitis. It is important to understand the actions and side effects of each one. While you may want to treat your symptoms with over-the-counter products, it is worthwhile to discuss your choices with your healthcare provider so you know you are buying the correct product. While some are as effective as their prescription counterparts, others are not available in the concentration and formulation you can get by prescription.

1 Source
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  1. Bayer. FDA approves Astepro® Allergy nasal spray for over-the-counter use in the United States.

Additional Reading

By Daniel More, MD
Daniel More, MD, is a board-certified allergist and clinical immunologist. He is an assistant clinical professor at the University of California, San Francisco School of Medicine and currently practices at Central Coast Allergy and Asthma in Salinas, California.