The Best Medications to Treat Allergies

Treating Both the Cause and Symptoms

There are several different classes of drugs used to treat nasal 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 provide longer-lasting relief. The choice depends largely on the types of symptoms you have, their frequency, and their severity.

A patient is using a nasal spray
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Steroid Nasal Sprays

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

They are also effective for treating non-allergic rhinitis and may be beneficial for treating 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. They only alleviate the nasal symptoms. People who have allergic rhinitis tend to get the best response if they use the spray on a daily basis. It takes about two weeks before these medications achieve their full effect.

If you can't adhere to daily treatment, you may need to explore other options, such as antihistamines.

Side Effects

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

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) oral medication choices like:

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

The Food and Drug Administration has also approved the first OTC antihistamine nasal spray, Astepro (azelastine), which became available in 2022.

Antihistamines work quickly, usually within an hour or so, and can be used on an as-needed basis.

Side Effects

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 with the newer generation antihistamines) and resolve within hours to days.

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 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, they aren't enough on their own. As such, they are usually prescribed in combination with other drugs such as antihistamines or nasal or inhaled steroids.

Side Effects

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.

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5 Sources
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  1. Kuna P, Jurkiewicz D, Czarnecka-Operacz MM. The role and choice criteria of antihistamines in allergy management - expert opinionPostepy Dermatol Alergol. 2016;33(6):397–410. doi:10.5114/pdia.2016.63942

  2. Trangsrud AJ, Whitaker AL, Small RE. Intranasal Corticosteroids for Allergic RhinitisPharmacotherapy. 2002;22(11):1458-1467. doi:10.1592/phco.22.16.1458.33692

  3. Randall KL, Hawkins CA. Antihistamines and allergyAust Prescr. 2018;41(2):41–45. doi:10.18773/austprescr.2018.013

  4. Church DS, Church MK. Pharmacology of antihistaminesWorld Allergy Organ J. 2011;4(3 Suppl):S22–S27. doi:10.1097/WOX.0b013e3181f385d9

  5. Korenblat PE. The role of antileukotrienes in the treatment of asthmaAnnals of Allergy, Asthma & Immunology. 2001;86(6):31-39. doi:10.1016/s1081-1206(10)62309-5

Additional Reading
  • Scott, P. and Peters-Golden, M. "Antileukotriene Agents for the Treatment of Lung Disease." Amer J Respir and Clin Care Med. 2013; 188(5):538-44. DOI: 10.1164/rccm.201301-0023PP.

  • Wheatley, L. and Togias, A. "Allergic Rhinitis." N Engl J Med. 2015; 372:456-63. DOI: 10.1056/NEJMcp1412282.