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Which OTC Allergy Medication is Right for You?

From Nancy Larson, for About.com

Updated February 12, 2009

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

(LifeWire) - You're blowing your nose with one hand and rubbing your eyes with the other. On top of that, your head feels like it might explode. The thought of choosing from among the glut of over-the-counter (OTC) allergy remedies is stressful enough to make you break out in hives as well. Here are some pointers to clear up your confusion and your allergy symptoms.

Antihistamines

Active Ingredients: diphenhydramine, chlorpheniramine, loratadine, cetirizine.

Common Brand Names: Benadryl, Chlor-Trimeton, Claritin, Zyrtec. Generic brands are available for each.

How They Work: Antihistamines relieve runny noses, sneezing, itching and watery eyes. They work against histamines, chemicals released by the immune system in reaction to substances such as pollen or dust, which attach to cells and irritate them. It works by blocking the action of histamine, a substance in the body that causes allergic symptoms.

Typical Dosage: Many come in pill and liquid form, as well as in nasal sprays and eye drops. As a pill, Benadryl is taken 25 to 50 mg at a time, three or four times a day; 4 mg of Chlor-Trimeton can be taken up to six times a day. Claritin and Zyrtec are taken once daily, usually 10 mg at a time. Antihistamines can reduce symptoms by as much as 80%, according to the Asthma and Allergy Foundation of America.

Important Information: Benadryl and Chlor-Trimeton cause drowsiness, which may increase with alcohol consumption. Claritin and Zyrtec in the past were prescription-only, but now they are both available OTC and do not cause drowsiness. Before taking an antihistamine, talk with your doctor if you are also taking sleeping medication, muscle relaxants or high blood pressure medicine, or if you have glaucoma, asthma, a stomach ulcer or difficulty urinating.

Another antihistamine, NasalCrom (cromolyn sodium), differs from the others in that it curtails the release of histamine. It is produced as a nasal spray or eye drops. NasalCrom prevents swelling, but doesn't reduce it. So it should be taken when symptoms are first noticed. The nasal spray can be used four times a day.

Decongestants

Active Ingredients: pseudoephedrine, phenylephrine, oxymetazoline

Common Brand Names:  Sudafed, Sudafed PE, Afrin nose spray. These drugs are available in generics.

How They Work: Decongestants help you breathe better by constricting nasal blood vessels, which reduces swollen tissue.

Typical Dosage: You can take up to eight 30-mg Sudafed tablets in 24 hours, or as many as six 10-mg Sudafed PE. You should take them with a full glass of water, with or without food. Afrin can be used twice a day.

Important Information: In 2006, the US Food and Drug Administration ordered that OTC pseudoephedrine be kept behind the counter to monitor its sales because pseudoephedrine is also used to make the illegal drug methamphetamine. You must speak with the pharmacist before buying it to register your purchase. It could be worth the extra effort though. A 2007 study published by the British Journal of Clinical Pharmacology stated that pseudoephedrine works better than its substitute phenylephrine (found in Sudafed PE), and restricting its sale has been ineffective in curtailing its use in methamphetamine production.

Talk to your doctor before taking either decongestant if you're also taking monoamine oxidase inhibitors (MAOIs), insulin, stimulants, or medications for seizures, blood pressure or asthma.

A rebound effect with worse symptoms may occur after using nasal decongestants, such as Afrin, any longer than three or four days in a row.

Many OTC remedies, such as Zyrtec-D (cetirizine pseudoephedrine), combine antihistamines and decongestants, often with pain relievers, as in the acetaminophen product, Tylenol Allergy Multi-Symptom (acetaminophen/diphenhydramine/phenylephrine). If you experience skin-related allergy symptoms, you can try to treat it with OTC corticosteroid creams.

More Information About Allergies:

Sources:

"Allergies." ils.nlm.nih.gov. 15 Feb. 2007. National Institutes of Health. 26 Jan. 2009 <http://wwwils.nlm.nih.gov/medlineplus/ency/article/000812.htm>.



"Allergy Medication." lvh.org. 29 Dec. 2008. Lehigh Valley Health Network. 26 Jan. 2009 <http://www.lvh.org/lvh/Your_LVH/LVH_News/Ask_Our_Expert/Our_Expert_on_Lung_and_Respiratory_Care%7C2600>.



"Antihistamines: Understanding Your OTC Options." familydoctor.org. Oct. 2006. American Academy of Family Physicians. 26 Jan. 2009 <http://familydoctor.org/online/famdocen/home/otc-center/otc-medicines/857.html>.



"Decongestants: OTC Relief for Congestion." familydoctor.org. Dec. 2006. American Academy of Family Physicians. 26 Jan. 2009 <http://familydoctor.org/online/famdocen/home/otc-center/otc-medicines/859.printerview.html>.



"Diphenhydramine." myhealth.ucsd.edu. 13 Feb. 2004. University of California San Diego. 26 Jan. 2009 <http://myhealth.ucsd.edu/library/healthguide/en-us/DrugGuide/topic.asp?hwid=d00212a1&>.



Eccles, Ronald. "Substitution of Phenylephrine for Pseudoephedrine as a Nasal Decongeststant. An Illogical Way to Control Methamphetamine Abuse." British Journal of Clinical Pharmacology 63 (2007): 10-4. 26 Jan. 2009 <http://cat.inist.fr/?aModele=afficheN&cpsidt=18488205>.



"Legal Requirements for the Sale and Purchase of Drug Products Containing Pseudoephedrine, Ephedrine, and Phenylpropanolamine." fda.gov. 8 May 2006. U.S. Food and Drug Administration. 27 Jan. 2009 <http://www.fda.gov/CDER/news/methamphetamine.htm>.



"Over-the-Counter Medications." aafa.org. 2005. Asthma and Allergy Foundation of America. 26 Jan. 2009 <http://www.aafa.org/display.cfm?id=9&sub=24&cont=346>.



"Oxymetazoline Nasal." familydoctor.org. 13 Feb. 2004. American Academy of Family Physicians. 27 Jan. 2009 <http://myhealth.ucsd.edu/library/healthguide/en-us/DrugGuide/topic.asp?hwid=d00772a1&>.



"Tips to Remember: Asthma and Allergy Medications." aaaai.org. 2007. American Academy of Allergy, Asthma and Immunology. 26 Jan. 2009 <http://www.aaaai.org/patients/publicedmat/tips/asthmaallergymedications.stm>.


LifeWire, a part of The New York Times Company, provides original and syndicated online lifestyle content. Nancy Larson is a St. Louis-based freelance writer whose work has appeared in dozens of local and national print and online publications including CNN.com, The Weather Channel, Health magazine and The Advocate.
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