Brandon practices as a community pharmacist in MN. He started as a pharmacy tech in 2003 and received his PharmD in 2011 from the U of M.
Ask a Pharmacist
A 26-year-old man is walking up and down the allergy aisle at his local pharmacy. He's trying to figure out what to take to help with his sneezing, itchy eyes, coughing, and runny nose. After reading over a half dozen products, he decides that there are just too many choices.
He asks, "What should I take for my allergies? What are my choices?"
The Short Answer
There are actually not as many choices as it seems. The best thing to do is figure out which symptoms are bothering you the most—and make a choice based on that. In general, you want a 24-hour antihistamine daily, and then add-ons that target the symptoms you need to address. If you explain your symptoms to your pharmacist, they can make a recommendation.
The Long Answer
All allergy symptoms, regardless of what you are allergic to, are cause by the chemical histamine. Because of this, the first choice for any allergy is an anti-histamine. You should choose one of the three 24-hour antihistamine products; Claritin, Zyrtec, or Allegra. All of them are very similar, though one may work better for you. It's hard to guess which one that might be, so you may need to try them for yourself.
Here's a chart that reviews some differences to help you choose.
|Brand name||Generic name||Note|
Best in children
May cause a little drowsiness, but also might work best
Newest, rarely causes drowiness
The antihistamine you choose should be taken once daily. To work best, you should start it a few weeks before your allergy season and continue through the entire season. Or continue if until you aren't exposed to your allergies anymore.
Along with your antihistamine, you should choose add-on medicine to treat specific symptoms. Usually, these add-ons are temporary, and only need to be used when the symptom they treat gets bad. These medications include eye drops, nasal sprays, and decongestants. There are also a few prescription products available if nothing else works. Keep reading to find out more information on each type of add-on medication.
Here's a chart that covers the medications you'll find below.
Over-the-Counter Products That Treat Allergies
|Type of medication||Example of product (generic names)||When should I use it?||Notes|
Daily while exposed to allergies
Should be first choice for almost everyone
Fast acting antihistamine
When you need relief quickly
Causes drowsiness, wear off
When eye symptoms are a big problem
Great for gummy morning eyes
When nasal congestion is the worst
Safe for long-term use if necessary
To target nasal congestion quickly
Can only be used for 3 days in a row
Mast cell stabilizer
If other products don't work
Not a great first choice, others are better
A Quick Note on Combination Products
A lot of products are available to treat allergies. Many of these have 2, 3, or even 4 different kinds of medicine in each dose. While it's tempting to use a combination product and just take everything, it's not usually necessary and might expose you to something you don't want to take. You may get side effects or may have interactions with other medications. And, really, when you do feel better you won't even know which medication it was that helped.
Use the medications separately so you can take exactly what you need, and nothing extra.
Sometimes I do recommend combination products just to make medication easier to take, but I usually say it's better to use the medications separately so you can take exactly what you need and nothing extra.
Use these for first-line treatment of all allergies.
Like I talked about before, 24-hour antihistamines should be the first choice for all cases of allergies. They work effectively for all types of allergies and all allergy symptoms, and they rarely have any side effects. they should be taken starting a few weeks before allergy season (if you know when that is) and continued once daily throughout.
The three choices are Claritin, Zyrtec, and Allegra. There is very little difference between these choices, but after trying them you might find that works better for you then the others. If anything, Zyrtec is more likely to cause drowsiness than the others. In my experience, Allegra works the best for the most people, so that's the one I usually recommend people try first. Claritin has been shown to usually be the best in kids.
Unfortunately, these medicines don't work right away. You will get some relief of symptoms starting about 2 hours after your first dose, but to really get the most benefit you have to take them daily for 3 to 5 days. That's why you should start before your allergies get bad, if you can.
Use these when you need fast relief and don't mind being tired.
Before the 24-hour antihistamines were invented, there was diphenhydramine. Diphenhydramine goes by the brand name Benadryl. It works in the same way as the 24-hour products, but it works faster and stronger. The downside, is that is wears off much faster and will almost always cause drowsiness.
One does will only last 4 to 6 hours. During that time, it treats all allergy symptoms from any cause. It doesn't take time to build up in your system like the 24-hour antihistamines. It works right away.
And, as I mentioned, it almost always causes drowsiness. And the drowsiness can be bad enough that you shouldn't work or drive while taking it. In fact, it's the same medicine people sometimes use to help kids sleep at night or on airplane rides. It's also what is used to stop food allergy symptoms.
In general, fast acting antihistamines should only be used if you absolutely need relief quickly. They shouldn't be used if you are already taking a 24-hour antihistamine. And, if they are used, be very careful because you will most likely become drowsy.
Use these for itchy, watery, red eyes; or for crusty morning eyes.
There are two kinds of eye drops that treat allergies. The first are lubricant drops, and the second are antihistamine drops.
Lubricant drops, such as Visine, Blink, Refresh, and many others, provide soothing relief to irritated eyes. They do not treat allergy symptoms directly, but they keep eyes from drying out and getting crusty. A moist eye is a healthy eye. They can also be used to rinse they eye of whatever it is you are allergic to. For example, if you are allergic to pollen and have to spend some time outside, using Refresh during or afterwards can help get the pollen out of your eye.
There is only one antihistamine eye drop over the counter, and it's generic name is ketotifen (brand names include Alaway and Zaditor). These work just like the 24-hour antihistamines, except that they are focused in the eye and work much better for eye-related symptoms. They can be used along with your 24-hour antihistamine. They do only work for 12 hours though, so you need to put them in your eye twice a day. If you have problems with waking up in the morning with crusty eyes, a dose of Zaditor right before bedtime can make a big difference.
Use these for a stuffy or runny nose, or sneezing. Or with other meds to get better relief.
It's only been a few years since the first nasal steroid became available over-the-counter, but they are used very commonly for allergies. There are 3 products available; Flonase, Nasacort, and Rhinocort. They all work in the same way. They all target nasal symptoms of allergies, but can also be used alone to help with all symptoms.
Nasal steroids can be used in place of 24-hour antihistamines to treat all allergy symptoms. They can also be used along with 24-hour antihistamines to get even more relief. If the worst part of your allergies are nasal congestion, runny nose, or sneezing then nasal steroids are a great choice. They can all be used safely for the entire allergy season. They work quickly and can be used only on "bad days" if needed.
They are all very similar, although it is important to say that Nasacort does not have a strong scent, where Flonase smells like roses. Other than that, you may find one works better for you, but in most cases they are all the same.
Use these for hard-to-treat stuffy noses. But only use them short term, and know about their side effects.
Nasal decongestants are often used for cold symptoms, but can also be used temporarily for allergy symptoms. They treat stuffy noses that you can't breathe through. The go-to product is Sudafed, but many other products are available that add a nasal decongestant with another product (such as Zyrtec-D, Claritin-D, or Allegra-D).
Nasal decongestants are very effective at what they do. If you are using other allergy medication, but still find it hard to breathe through your nose, then using a nasal decongestant is a great idea. They are available in 4 hour, 12 hour, and 24 hour. They should be used "as needed." If used daily, you should only use them for 5 to 7 days. They should not be used through the entire allergy season. And they should not be used alone for allergies.
Nasal decongestants are known to raise blood pressure and should not be used if you have high blood pressure. They also cause insomnia and will keep you awake if you take them too close to bedtime.
Mast Cell Stabilizers
Use these for allergy symptoms that aren't fixed with other products. But keep in mind they don't usually work all that well.
Cromolyn is the generic name for a nasal spray that is sometimes used for allergies. It is designed to help with all allergy symptoms, but works best on nasal symptoms.
In my opinion, there is no benefit to this over other products, and in fact I more often than not see people unhappy with the results. Rarely, it will work when other kinds of medication didn't, so it is worth a shot if all else fails. I would never recommend it as a first line treatment.
Most of the time, allergies can be effectively treated with over-the-counter medicine. But, of course, if you can't find relief from those products, it's worth it to talk with your healthcare provider about prescription options.
There are some medications that are stronger, some that target certain allergies, and sometimes allergy symptoms can really be caused by something more serious.
If after a few weeks of treatment you don't have relief, talk to your healthcare provider.
The information provided on this page is intended for general educational and informational use only. It is not specific, personalized healthcare advice for you. For healthcare advice regarding your particular situation, talk to members of your healthcare team.
This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.