Choosing the right allergy medicine comes down to a few key differences. Your choice should be informed by knowing why non-drowsy antihistamines usually work faster than nasal sprays and when it's time to call a doctor instead.
'Tis the season. Allergy season, that is. Pollen is in the air. Freshly cut grass lines the sidewalks. Then there's you — sneezing and sniffling.
When allergies strike, you already know the drill: Grab some allergy meds and the softest facial tissue you can find. But after staring at the sea of over-the-counter allergy medicine options, most of us will leave the drug store wondering: Did I even buy the right thing?
To effectively fight allergies, you'll first want to be sure it's indeed allergies, and not a cold, the flu or COVID-19.
The symptoms of allergies include:
- Itchy, watery eyes
- Nasal congestion
- Runny nose
- Sneezing
- Scratchy throat
Whether your allergies are seasonal or just a one-time thing, Dr. Hays is here to help you navigate the options you'll find in the allergy medicine aisle.
“Allergies occur when things in the air around you, such as pollen and grass, cause your nasal passages to become inflamed. For most people, they're easily treated with over-the-counter allergy medicine.”
Dr. Brad Hays
Primary Care Physician at Houston Methodist
Step 1: Take an antihistamine — but choose the right one
As soon as allergy symptoms set in, Dr. Hays says your first line of defense should be antihistamines.
"Antihistamines are really effective for treating allergies," says Dr. Hays. "They need to be taken every day while you're experiencing symptoms, and people with seasonal allergies should proactively take them throughout both the fall and spring allergy seasons."
There are two things you need to know when it comes to choosing the right antihistamine. Dr. Hays says the best antihistamines are ones that are long-acting and non-sedating. To find one that meets this criteria, look for the following types of antihistamines:
- Cetirizine
- Fexofenadine
- Levocetirizine
- Loratadine
Some antihistamine drugs — such as diphenhydramine — are effective, but can make you very drowsy. Dr. Hays recommends taking this type of antihistamine only before bed.
Whether you're buying name-brand or generic, the antihistamine drug name will be mentioned somewhere on the box — typically on the front.
"One of the main advantages of antihistamines is that they help with the majority, if not all, of your allergy symptoms," Dr. Hays explains. "In addition, they kick in pretty quickly. You should notice a reduction in your symptoms in just a few hours."
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Step 2: Add a nasal steroid spray
Antihistamines can relieve the mild congestion that comes along with most bouts of allergies, but some people may experience more severe congestion. If this sounds like you, Dr. Hays recommends using a nasal steroid spray in addition to taking an antihistamine.
Until recently, nasal steroid sprays were offered only by prescription. Now, there are a few you can buy over-the-counter, including:
- Budesonide
- Fluticasone
- Triamcinolone
"Nasal steroid sprays won't help with all of your allergy symptoms, such as itchy and watery eyes, but they do help with nasal congestion, post-nasal drip and scratchy throat," Dr. Hays explains.
Just like antihistamines, Dr. Hays says that nasal steroid sprays need to be used every day to be effective. The good news is that they're also generally safe and well-tolerated.
"However, unlike antihistamines, nasal steroid sprays don't provide quick relief from allergy symptoms," Dr. Hays says. "It can take a few days for a nasal steroid spray to take effect."
A parting warning about nasal sprays: Don't confuse nasal steroid sprays with nasal decongestants. Not only do the two treat your symptoms differently, nasal decongestant sprays can cause rebound congestion if taken more than three consecutive days.
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Step 3: If your allergy symptoms worsen, see a doctor
"A long-acting antihistamine, either alone or in combination with a nasal steroid spray, will relieve most people's allergy symptoms," says Dr. Hays.
If you're taking over-the-counter allergy medicines and your symptoms continue or worsen, it may be a sign of a more serious condition, such as chronic sinus infections or sinus polyps. Follow up with your doctor if your symptoms are serious or frequent.