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Allergy medications: Know your options

Provided by: MayoClinic.com
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Because you can't always avoid allergy triggers, you may need medication to help alleviate allergy symptoms.

Allergy medications are available in pill, liquid, nasal spray, eyedrop and skin cream (topical) forms. Some are available over-the-counter while others are available by prescription only.

The best medication or combination of medications for you depends on your symptoms, what other health conditions you have and what other medications you take. Certain allergy medications work better for some people than others. You may need to try a few different medications to determine which ones are most effective and have the least bothersome side effects.

To choose the best allergy medications for you, learn what's available to treat your symptoms — and work with your doctor to figure out what medications is best for you.

Corticosteroids

Type Purpose Side effects

Nasal sprays

Examples include:

  • Beclomethasone (Beconase)
  • Fluticasone (Flonase)
  • Triamcinolone (Nasacort)
  • Budesonide (Rhinocort)
  • Flunisolide (Nasarel)
  • Mometasone (Nasonex)

These prescription medications prevent and relieve allergy symptoms such as nasal stuffiness, sneezing, and itchy, runny nose. For many people, these nasal sprays are the most effective treatment for allergy symptoms caused by hay fever or pets.

It may take a few days or longer of regular use before your symptoms improve. Nasal corticosteroids are generally safe for extended use.

Mild side effects can include:

  • Unpleasant smell or taste
  • Irritation, especially during the winter
  • Crusting and nosebleeds, especially in the winter

Eyedrops

Examples include:

  • Dexamethasone (Decadron, Maxidex, others)
  • Fluorometholone (FML, Fluor-Op, others)
  • Prednisolone (Pred Forte, Econopred, others)

Corticosteroid eyedrops are prescription medications used to treat severe allergy symptoms such as red, watery and itchy eyes caused by hay fever and allergic conjunctivitis. They are used for only a short period of time when other types of eyedrops don't work.

You may be advised to avoid these medications if you are pregnant or plan to become pregnant.

These medications can cause:

  • Blurred vision and other mild side effects
  • Increased risk of eye infections, glaucoma and cataracts with prolonged use

Skin creams

Examples include:

  • Hydrocortisone (Cortaid, Ala-cort, others)
  • Triamcinolone (Triderm, Kenalog, others)

These medications relieve the scaling and itching caused by eczema (atopic dermatitis). Some low-potency corticosteroid creams are available without a prescription, but you should always talk to your doctor before using any topical corticosteroid.

Side effects can include:

  • Skin irritation
  • Skin discoloration

Pills and liquids

Examples include:

  • Prednisone (Prednisone, Prednisone Intensol, others)
  • Prednisolone (Prednisolone, Prelone, others)

Oral corticosteroids are sometimes used to treat severe allergy symptoms. Because they can cause serious side effects, they're usually prescribed for only short periods of time.

Long-term use of these medications can cause serious side effects such as:

  • Cataracts
  • Osteoporosis
  • Muscle weakness

Leukotriene modifiers

Type Purpose Side effects

Pills and tablets

Leukotriene modifiers are available only by prescription. They're produced in pill and chewable tablet form.

Examples include:

  • Montelukast (Singulair)
  • Zileuton (Zyflo)
  • Zafirlukast (Accolate)

These drugs block the effects of leukotrienes, inflammatory chemicals released by your immune system during an allergic reaction. Such medications have proved most effective in treating asthma, but montelukast also relieves hay fever symptoms.

Side effects differ for each type of leukotriene inhibitor, but can include:

  • Cough
  • Dizziness
  • Headache
  • Stomach upset or pain
  • Stuffy nose
  • Tiredness
  • Insomnia
  • Muscle weakness
  • Liver damage (zileuton)

Cromolyn and mast cell stabilizers

Type Purpose Side effects

Nasal spray

Available over-the-counter, the nasal spray cromolyn sodium (examples include NasalCrom, Children's NasalCrom) works best when you take it before your symptoms develop. Some people need to use the spray three or four times a day.

Mast cell stabilizer nasal sprays prevent the release of the symptom-triggering chemical histamine. They reduce symptoms associated with hay fever and allergic conjunctivitis.

This medication can cause minor side effects, which include:

  • Unpleasant taste
  • Drowsiness
  • Headache
  • Nasal irritation
  • Sneezing

Eyedrops

Several different mast cell stabilizer eyedrops are available by prescription. None are sold over-the-counter.

Examples include:

  • Cromolyn sodium (Crolom)
  • Lodoxamide (Alomide)
  • Pemirolast (Alamast)
  • Nedocromil (Alocril)

Mast cell stabilizer eyedrops prevent the release of the symptom-triggering chemical histamine. They reduce symptoms associated with hay fever and allergic conjunctivitis.

Cromolyn sodium and lodoxamide can cause:

  • Burning or stinging eyes
  • Rarely, other side effects

Pemirolast may cause:

  • Chills
  • Coughing and sneezing 
  • Sore throat

Nedocromil may cause side effects including:

  • Blurred vision
  • Changes in color vision
  • Breathing problems or wheezing
  • Insomnia
  • Eye irritation or swelling
  • Headache
  • Increased sensitivity of eyes to sunlight
  • Nasal congestion

Injectable epinephrine: First aid for severe allergic reactions

If you're highly allergic to certain foods, such as peanuts, or to bee or wasp venom, you may be at risk of anaphylactic shock — a sudden, life-threatening allergic reaction. To be on the safe side, your doctor may suggest that you carry an injectable dose of epinephrine (adrenaline). Epinephrine can help slow the reaction while you seek emergency medical treatment. You may be able to administer the drug by yourself, after being taught how to use a self-injecting syringe and needle. A friend, family member or medical professional called in response to a severe anaphylactic reaction also may administer the medication.

Work with your doctor

By understanding how allergy medications work, you can work with your doctor to develop a treatment plan that's best for you. Before taking any medication — prescription or over-the-counter — be sure to tell your doctor if you are pregnant or breast-feeding, if you have any chronic health problems such as diabetes, glaucoma or high blood pressure, or if you're taking any other medications. This will help you avoid a drug interaction or other adverse effect.

Keep track of your symptoms, when you use your medications, and how much you use — that way you and your doctor can figure out what works best. It may not be possible for you to avoid allergy symptoms altogether — but working with your doctor to find the right medications can help.

Last Updated: 06/25/2007

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