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What over-the-counter medications can I take for allergy relief?

Allergic rhinitis, more commonly known as hay fever or allergies, occurs when your body perceives tiny particles in the air as "foreign" and rallies your immune system against them. Particles capable of causing this immune response are called allergens. Allergens include tree and grass pollen, pet dander, dust mites, and mold spores. The symptoms of allergic rhinitis include sneezing, runny nose, stuffy nose, and itchy and watery eyes.

Seasonal allergies, or hay fever, occur only during certain times of the year. They're common in the spring, summer, and fall when airborne pollen is widespread. You have perennial allergic rhinitis when you experience symptoms year round. It's typically caused by indoor allergens, such as animal dander, molds, and dust mites.

Many over-the-counter products can help to ease the symptoms of allergic rhinitis. The mainstays are products containing antihistamines and decongestants or combinations of the two.

For symptoms of sneezing, runny nose, and watery and itchy eyes, people usually try antihistamines in oral form first, such as diphenhydramine (brand name Chlor-Trimeton), and clemastine (>Tavist-1). In some people, these products can cause drowsiness and dry mouth. You should not take antihistamines if you’re driving or operating heavy equipment (due to the drowsiness danger) or if you have certain medical conditions such as bronchitis, glaucoma, or difficulty urinating. Loratadine (>Claritin) is now available over-the-counter and was approved by the FDA as a non-drowsy allergy treatment. Cetirizine (>Zyrtec) which is also an effective allergy treatment and is also available over-the-counter.

A decongestant such as pseudoephedrine (>Sudafed) can help relieve a stuffy nose. Check with your doctor first if you have high blood pressure, since decongestants can temporarily raise blood pressure. Sudafed is now located only behind the pharmacy counter and its use is restricted. Many new products contain phenylephrine (Neo-Synephrine) instead of pseudoephedrine. Oxymetazoline (Afrin) is another option.

Eye drops like pheniramine and naphazoline (>Opcon-A) combine an antihistamine and a decongestant to relieve itchy, red eyes.

Cromolyn (>NasalCrom) is a nasal spray that can relieve sneezing or a runny or itchy nose. Cromolyn can also be used preventively—if you know you're going to be exposed to a cat, for example—since it turns off the allergic process in the nose before it can start. Cromolyn causes few side effects and—an advantage over antihistamines—it won't make you drowsy.

While none of these products will cure allergies, each helps prevent or relieve different symptoms. When choosing an allergy medicine, try to pick one that treats just the symptoms you’re having at that time. That way you minimize your exposure to drugs you don’t need and that could cause side effects.

Sources:
The Merck Manual of Medical Information: Home Edition. Merck & Co., 1997.
Drug Facts and Comparisons. Facts & Comparisons, 2006.
Diseases and Conditions, "Hay Fever." http://www.mayoclinic.com. Mayo Clinic Health. Last accessed 12/20/2006.

This answer prepared 9/14/2000.
This information updated 06/25/2008.