Spring allergies will be here soon. If you’re suffering from a runny or congested nose, watery or itchy eyes or sneezing, it’s tempting to grab the first medicine that catches your eye at the pharmacy or rifle through the bathroom drawer for some pills you’re hanging on to.
Not so fast, says Maddy Draper, APRN, a health care provider at OSF OnCall. She says it’s important to know what to take and when to avoid side effects that can be serious.
What to take
Draper says an antihistamine like Astepro, Zyrtec, Allegra or Benadryl is a typical first line of defense.
“There are also decongestants for severe nasal congestion or sinus pain and pressure,” Draper adds. Sudafed is a well-known decongestant.
If a more severe case brings symptoms like face swelling or wheezing, Draper says treatment could be a steroid like Flonase or prednisone.
For more chronic (in other words, long term) allergy cases, the U.S. Food and Drug Administration says a provider may recommend immunotherapy to build up a tolerance. This could be an injection or a tablet under the tongue.
Misuse
It may not seem like over-the-counter allergy medications are ripe for misuse, but it can happen.
Draper says antihistamines, especially Benadryl, can make you drowsy. If you take too much or take it at the wrong time, you could, for example, find yourself sleepy behind the wheel. Or your attentiveness at work or school could suffer.
On the flip side, Draper says Sudafed can make you jittery, irritable or cause heart palpitations (the feeling of an irregular heartbeat). This could be a big issue, she says, for people with a heart condition.
“We want to avoid nasal sprays for people with nasal trauma. Things like a deviated septum or nasal sores,” Draper adds. “Putting something up the nose could cause further tissue damage.”
Draper says to take medication as directed by your provider. Or if it’s over the counter, follow the label instructions. She says these medications typically take a couple of days to start working. So don’t be tempted to take an extra dose if you’re not seeing relief right away.
Think of the children! (and seniors)
Children and seniors may be more impacted by the side effects of allergy medications. An older adult who takes Benadryl, for example, may be drowsy to the point that they fall and suffer a serious injury.
So, Draper says providers will typically start with an antihistamine that doesn’t make you super drowsy. She says Zyrtec is approved for ages six months and up, and that’s often where providers will start.
“Any antihistamine label is going to tell you to consult your provider for use under the age of two,” Draper says. “So you’ll need to be seen by a provider or your pediatrician.” This could be a virtual visit or a message to your provider in your patient portal.
Plan ahead
Draper says knowing your allergy triggers and acting accordingly is key to avoiding unpleasant symptoms. For example, you know grass clippings will cause an allergic reaction, but you have no choice but to mow the lawn.
“Primary care providers and allergists typically recommend starting the medication before exposure,” Draper explains. “If you know you’re going to be outside on that windy, dry day to mow, start the antihistamine a couple days prior so it can fully take effect.”
If you can’t get a handle on a known allergy, or if you have unexpected allergy symptoms, Draper says it’s never a bad idea to go to an urgent care.
Or if you find yourself looking for an over the counter medication option: “Just ask the pharmacist,” Draper suggests. “They’ll give you recommendations.
“There’s usually a specific aisle for allergies,” she adds. “Find the right antihistamine. Flonase is another big one we see people use.”
