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Fighting Allergy: List of commonly prescribed medications for allergies

2013-03-23 18:14
Fight against allergies

While it still looks and feels like winter in northern states of the U.S., spring allergy season is already underway in other parts of the nation. And it’s starting earlier each year due to warmer weather patterns, according to a report published in the March 2013 Harvard Health Letter.

"When winter is shorter and less severe, it means there will be pollens and molds present for a longer period of time," says Dr. Stacey Gray, an allergy expert at Harvard-affiliated Massachusetts Eye and Ear Infirmary.

Accordingly, people who suffer from allergies need to take charge of fighting their allergy symptoms by arming themselves with antihistamines, nasal sprays, and/or decongestants in order to minimize being exposed to allergens like tree pollen.

The latest issue of Harvard’s health newsletter advises those with allergies to start at home:

• Make sure all air conditioning and heating filters and vents are clean.
• Close windows and consider wearing a mask for outdoor yard work.
• Better yet, avoid going outside when pollen levels are highest.

Dr. Gray also recommends using nasal saline irrigations after working in the yard or being outside for an extended time, especially since certain irritants in the environment – including cigarette smoke and air pollution – can worsen allergy symptoms. If at all possible, avoid such irritants, and take precautions even before allergy season hits. One strategy Dr. Gray suggests is starting a nasal steroid spray a few weeks before spring allergies begin.

What more can you do to arm yourself better so you can breathe easier?

Spring allergy seasons continue to start earlier each year. It started last year in February, and pollen counts continue to rise. Scientists say this rise is due to the effects of climate change, which are making allergy seasons worse. Indeed, research presented at the American College of Allergy, Asthma and Immunology in November 2012 suggests that pollen counts are expected to doubly by the year 2040.

"I do think that the allergy seasons seem to be longer,” says Dr. Gray. “When winter is shorter and less severe, it means there will be pollens and molds present for a longer period of time," she added.

What are the offenders?

Grass, weeds, and trees release tiny pollens into the air each spring, summer, and fall. Inhaling these pollens can trigger a reaction of the immune system, known as hay fever. Symptoms vary, but typically include a runny nose, sneezing, itching, and burning or watery eyes.

If you have asthma or chronic obstructive lung disease, pollen can increase your risk for flare-ups. Additionally, there are other floating pollutants in the air that can also cause allergic reactions – such as mold spores and dust mite droppings – although mites aren't a seasonal problem, and mold can be a year-round problem in warm climates.

You can find out what you are allergic to by having an allergy testing at a doctor's office, where either a blood test or a skin test will be performed. The skin test involves pricking the surface of the skin and exposing it to allergens. If you experience redness and swelling at a test spot on the skin, it indicates an allergic reaction.

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What kind of medications are available for treating allergies?

Once you know which allergen you're dealing with, your doctor will help you develop a treatment strategy, which usually involves medications. Which drugs your doctor prescribes depends on a number of factors, including the symptoms you're having, and the medications you're taking for other conditions because of possible interactions.

Here is a list of commonly prescribed medications for allergies:

Antihistamines – These counteract a protein called histamine, which is released by tissue cells deep inside the skin during an allergic reaction. Over the counter (OTC) examples are chlorpheniramine (Chlor-Trimeton) and diphenhydramine (Benadryl).

"Antihistamines like Benadryl are an old stand-by, but there are several newer non-prescription medications that work well without causing drowsiness, which is one of the main side effects of Benadryl," says Dr. Gray. These include fexofenadine (Allegra), loratidine (Claritin), and cetirizine (Zyrtec). Cetirizine can sometimes still cause some drowsiness for some patients.

There are now topical nasal antihistamine sprays available by prescription, such as azelastine (Astelin) and olopatadine (Patanase), which can help with sneezing and runny nose. There are also topical antihistamine eye drops that can be used for the symptoms of watery eyes, such as ketotifen (Zaditor), which is available OTC, as well as olopatadine (Patanol), which is available by prescription.

Corticosteroid nasal sprays – These are steroids similar to hormones your adrenal glands produce. They reduce inflammation and help reduce nasal congestion, runny nose and nasal itching. These are available by prescription, such as mometasone furoate (Nasonex) and fluticasone propionate (Flonase), and can be used long term.

Non-steroidal nasal sprays – These contain cromolyn sodium (NasalCrom), which are available OTC, and target the root cause of symptoms by keeping allergens from reaching cells that release histamine. They can be used long term, but Dr. Gray says the sprays are often not as effective as nasal steroid sprays.

Decongestants – These help by reducing swelling in the nasal passages, but they can cause problems for people with high blood pressure or heart problems, and in general should not be used long term, points out Dr. Gray. Decongestants are also available in sprays, but they should not be used for more than a few days, since they can actually make congestion worse when used long-term. Decongestants are available without a prescription, such as pseudoephedrine (Sudafed), but are kept behind the counter because some people use them to make illegal methamphetamines.

Immunotherapy – This is a series of allergy shots that help build up immunity over a period of three to five years. Immunotherapy is usually used as a last resort for people who don't respond to medications.

Since allergy seasons appear to be worsening, Dr. Gray suggests starting medications early – before allergy season starts.
"For instance, start using a nasal steroid spray a few weeks before the spring allergies begin," says Dr. Gray.

SOURCES: Harvard Health Letter (March 2013), American College of Allergy, Asthma and Immunology