The Best Medications to Treat Allergies

There are several different classes of drugs used to treat allergy symptoms. The most common include antihistamines, nasal steroid sprays, and antileukotrienes such as Singulair (montelukast).

Each of these medications has a different mechanism of action. Some may be used to treat acute symptoms while others aim to achieve longer-lasting relief. The choice depends largely on the types of symptoms you have as well as their severity.

Steroid Nasal Sprays

Nasal sprays are most effective for treating symptoms of allergic rhinitis (hay fever). Inhaled corticosteroid drugs open the nasal passages so that you can breathe easier.

They are also effective in treating non-allergic rhinitis and may even benefit people with eye allergies.

Some of the more commonly prescribed steroid nasal sprays include:

• Beconase AQ (beclomethasone)
• Flonase (fluticasone)
• Nasacort AQ (triamcinolone)
• Nasarel (flunisolide)
• Nasonex (mometasone)
• Rhinocort Aqua (budesonide)

While effective, nasal sprays do not treat the underlying allergy but rather alleviate the nasal symptoms. Persons with allergic rhinitis tend to get the best response if they use the spray on a daily basis. Moreover, they would need to use the spray for around two weeks before they achieve the full effect.

Side effects may include headaches, sore throat, cough, nasal dryness, nausea, and muscle or joint pain.

These are just some of the things you will need to consider before starting treatment. If you are not the type who can adhere to daily treatment, you may need to explore other options such as antihistamines.

Antihistamines

Antihistamines are an effective way to treat all forms of mild to moderate allergy.

This class of drug suppresses histamine, the chemical produced by the immune system that triggers allergy symptoms. Older-generation drugs such as Benadryl (diphenhydramine) are used less commonly today because of their sedating effect.

Newer-generation drugs largely avoid this and include over-the-counter (OTC) choices like:

• Allegra (fexofenadine)
• Claritin and Alavert (loratadine)
• Clarinex (desloratadine)
• Zyrtec (cetirizine)

All of the above are oral medications. The Food and Drug Administration has also approved the first OTC antihistamine nasal spray, Astepro (azelastine), which should become available in early 2022.

Antihistamines work quickly, usually within an hour or so, and can be used on an as-needed basis. Side effects may include dry mouth, headache, drowsiness, dizziness, restlessness (mostly in children), difficulty urinating, blurred vision, nausea, vomiting, and confusion. Side effects tend to be mild (particularly in newer generation antihistamines) and resolve within an hour or two.

If you are prone to experiencing breathing problems during an allergy attack, you should be evaluated by a physician to determine whether you need a rescue inhaler or other medications to help with breathing.

Antileukotrienes

Antileukotrienes are allergy medications that work similarly to antihistamines but, rather than blocking histamine, block inflammatory compounds known as leukotrienes.

The antileukotriene drugs currently approved in the U.S. are:

• Accolate (zafirlukast)
• Singulair (montelukast)
• Zyflo CR (zileuton)

Antileukotrienes can be used to treat both asthma and allergy but in some cases do not suffice on their own. As such, they are usually prescribed in combination with other drugs such as antihistamines or oral steroids.

While antileukotrienes may be effective in alleviating congestion, they are less helpful in easing nasal symptoms. Side effects may include headaches, stomach pain, nausea, diarrhea, toothache, fatigue, sore throat, hoarseness, cough, and mild rash.

Singulair also comes with a black box warning due to the fact that it may have dangerous psychiatric side effects.