The Best Over-the-Counter Allergy Medications

You need to blow your nose continuously, your eyes itch and your head feels like it might explode. On top of all these annoyances, the thought of choosing from among the glut of over-the-counter (OTC) allergy remedies is stressful, too. Here are some pointers to clear up your confusion and your allergy symptoms.

Woman blowing her nose
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  • Active Ingredients: diphenhydramine, chlorpheniramine, loratadine, cetirizine, azelastine.
  • Common Brand Names: Benadryl, Chlor-Trimeton, Claritin, Zyrtec, Allegra. Astepro.
  • How They Work: Antihistamines relieve runny noses, sneezing, itching, and watery eyes. These medications work against histamines, chemicals released by the immune system in reaction to substances such as pollen or dust, which attach to cells and irritate them. In other words, antihistamines work by blocking the action of histamine, a substance in the body that causes allergic symptoms.
  • Typical Dosage: Many antihistamines come in pill and liquid form, as well as in nasal sprays and eye drops. As a pill, Benadryl is taken 25 to 50 mg at a time, three or four times a day; 4 mg of Chlor-Trimeton can be taken up to six times a day. Claritin and Zyrtec are taken once daily, usually 10 mg at a time. Astepro is a non-steroid nasal spray with a dosage of one or two sprays per nostril twice daily. Antihistamines can reduce symptoms by as much as 80%, according to the Asthma and Allergy Foundation of America.
  • Important Information: Benadryl and Chlor-Trimeton cause drowsiness, which may increase with alcohol consumption. Claritin and Zyrtec in the past were prescription-only, but are now available OTC and do not cause drowsiness. Astepro is currently prescription-only until early 2022, when it will be available OTC for adults and children 6 and older. If you are also taking sleeping medication, muscle relaxants, or high blood pressure medicine, or if you have glaucoma, asthma, a stomach ulcer, or difficulty urinating, make sure to speak with your physician before taking antihistamines.

Another type of allergy medication, NasalCrom (cromolyn sodium), differs from the others in that it stabilizes mast cells, preventing the allergic response that releases histamine. NasalCrom is available as either a nasal spray or eye drops. NasalCrom prevents swelling but doesn't reduce it, so this medication should be taken when symptoms are first noticed, or if, possible, before any exposure to allergens. The nasal spray can be used four times a day. NasalCrom is available OTC, but cromolyn eye drops are still only available by prescription.

Nasal Corticosteroids

Nasal corticosteroid sprays are a newer way to treat allergy symptoms recently FDA-approved for sale without a prescription. Brand names include Flonase, Nasacort, Rhinocort, and Flonase Sensimist. They work by reducing inflammation caused by allergies, and can be used long term without the danger of rebound nasal congestion that accompanies decongestants like Afrin. 


  • Active Ingredients: pseudoephedrine, phenylephrine, oxymetazoline
  • Common Brand Names: Sudafed, Sudafed PE, Afrin nose spray. These drugs are available in generics.
  • How They Work: Decongestants help you breathe better by constricting nasal blood vessels, which reduces swollen tissue.
  • Typical Dosage: You can take up to eight 30-mg Sudafed tablets in 24 hours, or as many as six 10-mg Sudafed PE. You should take them with a full glass of water, with or without food. Afrin can be used twice a day.
  • Important Information: In 2006, the US Food and Drug Administration ordered that OTC pseudoephedrine is kept behind the counter to monitor its sales because pseudoephedrine is also used to make the illegal drug methamphetamine. You must speak with the pharmacist before buying it to register your purchase. It could be worth the extra effort, though. A 2007 study published in the British Journal of Clinical Pharmacology stated that pseudoephedrine works better than its substitute phenylephrine (found in Sudafed PE), and restricting its sale has been ineffective in curtailing its use in methamphetamine production.

Talk to your physician before taking antihistamines if you're also taking monoamine oxidase inhibitors (MAOIs), insulin, stimulants, or medications for seizures, blood pressure, or asthma.

A rebound effect with worse symptoms may occur after using nasal decongestants, such as Afrin, any longer than three or four days in a row.

Many OTC remedies, such as Zyrtec-D (cetirizine-pseudoephedrine), combine antihistamines and decongestants, often with pain relievers, as in the acetaminophen product Tylenol Allergy Multi-Symptom (acetaminophen/diphenhydramine and phenylephrine). If you experience skin-related allergy symptoms, you can try treating them with OTC corticosteroid creams.

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6 Sources
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