Allergies Guide

Several treatments are available to treat allergies including both over the counter and prescription drugs.

Antihistamines comprise a broad class of drugs that help prevent the symptoms of allergies by blocking the effects of histamine. These drugs do not prevent the release of histamine from mast cells, but they prevent histamine from interacting with cells and causing inflammation. First-generation antihistamines such as diphenhydramine (Benadryl) and chlorpheniramine (Chlor-Trimeton) are available over the counter but these may tend to cause sedation. However, people react differently to different antihistamine medications: one person may get relief from their symptoms but experience sleepiness, while another person might have less sleepiness but also less help with their symptoms.

Newer generation antihistamines are non-sedating and may be available over the counter or by prescription including fexofenadine (Allegra), loratidine (Claritin), and cetirizine (Zyrtec). Some of these drugs now add a decongestant along with the antihistamine and go by names like Allegra-D, Claritin-D, and Zyrtec-D. Caution: these medications should not be combined, or mixed with alcohol. Avoid driving or using machinery while taking these medications.

Several types of nasal sprays can alleviate the nasal congestion that accompanies allergic reactions.

Nasal irrigation using warm saline (salt water) can clear out excess mucus and particulate while at the same time moisturizing the nasal cavities. This can be accomplished using a fluid-filled syringe, a small squeeze bottle, or by using a neti pot. This technique can be difficult to do at first, but can help mild nasal congestion without using medications.

Antihistamine nasal spray uses a small localized dose of histamine-blocking medicine delivered directly to the nasal passages. Other sprays include steroids that have anti-inflammatory effects in the nasal tissue (Flonase and Nasonex for example). Cromolyn Sodium can be used to help with allergies, but must be started before allergy symptoms begin.

Some over the counter nasal sprays include nasal decongestants that can offer temporary relief from nasal allergy symptoms such as Afrin and Dristan. CAUTION: do not use these sprays for more than three days. They can cause "rebound congestion," where people become dependent on their use due to the nasal tissue adjusting to the decongestant so much that medicine must be administered to get the same relief.

Also called allergy shots, immunotherapy is the only medical treatment that offers prolonged relief from allergy symptoms. It involves subcutaneous (under the skin) injections of increasing concentrations of the allergens to which you are sensitive. Over time, the body begins to make less IgE antibodies against the allergens and instead makes IgG antibodies, which do not trigger allergies. The effects of immunotherapy may last for only as long as the shots are being administered, or they may last for years longer. Talk to your doctor about how often these shots will need to be administered and how long you can expect the effects to last.

People who have had a severe allergic reaction in the past or who may be at risk for such a reaction may want to talk to their doctor about whether to carry an epinephrine auto-injector such as an EpiPen (Epinephrine auto-injector) with them at all times. The auto-injector allows someone to self administer a shot of epinephrine during a serve allergic reaction to prevent the occurrence of anaphylactic shock. Epinephrine increases blood pressure, counteracting the effect of widespread histamine release which can decrease blood pressure below the point necessary to maintain consciousness.