Friday, May 16, 2008


Allergy season has arrived, but symptoms can be controlled

In our part of the country the onset of spring is a great time of year. It brings flowers, green trees, warm weather, and – for an estimated 36 million Americans – allergies.

Seasonal allergic rhinitis (SAR) is a predictable group of symptoms that include nasal congestion, sneezing, postnasal drip and watery, itchy eyes. The most common cause of seasonal allergies is pollen.

Seasonal allergies can be very troublesome for many individuals, but rarely does it cause serious medical problems. Because it is a self-limiting condition, many people can safely manage their allergy symptoms using medications available over the counter. The anti-allergy medications generally fall into one of two categories: antihistamines and decongestants.

Antihistamines are considered first-line treatment for SAR. Over the counter preparations include tablets, capsules, liquids, and thin strips. Older antihistamines such as diphenhydramine (sold as Benadryl and other generic versions) and chlorpheniramine (sold as Chlor-Trimeton and other generic versions) are very effective at treating and preventing sneezing, itching, and a runny nose.

But these medications also cause drowsiness in most people who take them.

Newer “non-sedating” antihistamines are also available over the counter and tend to cost a bit more. Non-sedating antihistamines include Zyrtec (cetirizine) and Alavert and Claritin (loratadine). Be aware that even the non-sedating antihistamines may make some people drowsy.

Whenever taking an antihistamine for the first time, be sure to not drive or perform any activities that need you to be highly alert until you know how the new medications will affect you.

Decongestants include phenylephrine and pseudoephedrine (now kept behind the counter) and the nasal spray oxymetazoline (sold as Afrin and other generic versions).

Decongestants can ease coughing due to postnasal drip as well as that “stuffy” feeling many allergic people experience. Decongestants must be used with caution because they can worsen common medical conditions such as high blood pressure, diabetes, and glaucoma. The nasal spray should not be used for more than 3-5 days or rebound congestion can occur.

Pharmacy shelves are also stocked with many combination products. Combination products can make allergy treatment more convenient but need to be chosen wisely. Combinations of medications you don’t need only increase your risk of medication side effects with out adding any additional symptom relief.

Treatment can begin a week or more before you expect the pollen count to rise in order to prevent symptoms from occurring.

Seasonal allergies can often be managed by the use of over the counter medications alone without the need for a physician office visit. But to do so safely requires you to follow a few guidelines:

 Be sure to read the labels closely and take as directed without exceeding the recommended doses.

 Check with your pharmacist to make sure your allergy medications do not interact with other prescription or OTC medications you may be taking.

 People with pre-existing medical conditions should speak to their doctor before choosing a decongestant.

 If you find the OTC medications do not provide you with relief, seek your physician to discuss prescription medications that are available to treat SAR.

Michael Smith is a pharmacist and Clinical Coordinator in the Department of Pharmacy Services at The William W. Backus Hospital. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, go to the Healthy Living blog at or E-mail Smith and all of the Healthy Living columnists at

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