Over-the-Counter Medicines for Allergies

Topic Overview

Many over-the-counter medicines are available to control symptoms of allergies, including allergic rhinitis. These medicines work well but can have side effects. Be safe with medicines. Read and follow all instructions on the label.

It is usually best to take only single-ingredient allergy or cold preparations, instead of those containing many active ingredients. Talk with a pharmacist if you have any questions.

Over-the-counter medicines used to control the symptoms of allergies, including allergic rhinitis, include:

• Corticosteroid nasal sprays. These clear up a stuffy (congested) nose. They also help relieve red, itchy, watery eyes. An example is Nasacort.
• Antihistamines. These reduce or stop sneezing, runny noses, and itching.
  • Examples of nonsedating over-the-counter antihistamines include fexofenadine (such as Allegra) and loratadine (such as Claritin). Older antihistamines like chlorpheniramine (such as Chlor-Trimeton) and diphenhydramine (such as Benadryl) are less expensive but can make you feel sleepy or tired.
  • Don't give antihistamines to a child unless you've checked with the doctor first.
• Decongestants. These clear up a stuffy nose. They may be pills or liquids (oral), or a nasal gel, drop, or spray.
  • Possible problems with nasal sprays include irritation, burning or itching of nasal passages, and sneezing. Overuse can make your congestion worse (rebound congestion). So don't use the medicine longer than the label says. Examples of spray decongestants are oxymetazoline (such as Afrin, Dristan, or Zicam Extreme Congestion Relief) and phenylephrine (such as Neo-Synephrine).
  • Decongestants you take by mouth (oral) can cause you to feel nervous or shaky, have a rapid heart rate, or have trouble sleeping. If you have high blood pressure, oral decongestants may make it worse. You should use them only if your high blood pressure is under control. Examples of nonprescription oral decongestants include phenylephrine, such as Sudafed PE.

  Note: Decongestants may not be safe for young children or for people who have certain health problems. Before you use them, check the label. If you do use these medicines, always follow the directions about how much to use based on age and in some cases weight.

• Antihistamine/decongestant combinations. These combination pills work on most of the symptoms of allergies. Usually the decongestant decreases the drowsiness caused by the antihistamine. But some people feel nervous and sleepy at the same time ("tired and wired"). Examples of over-the-counter antihistamine/decongestant combinations include pseudoephedrine/chlorpheniramine maleate (such as Allerest) and pseudoephedrine/triprolidine (such as Actifed).
• Decongestant eyedrops. These medicines reduce itching and watering of eyes. Don't use them for more than 3 days in a row. They can cause symptoms when you are not having allergy symptoms. This effect is similar to the rebound congestion of nasal spray decongestants. Examples of over-the-counter eyedrops include naphazoline (Clear Eyes) and tetrahydrozoline (such as Visine). (Saline-only eyedrops for dry eyes may feel good but do not reduce allergy symptoms.)

If over-the-counter medicines do not improve your symptoms, or if they cause bothersome side effects, such as drowsiness, talk with your doctor about prescription medicines.

When you take either over-the-counter or prescription medicines, you may want to keep a medicine record. Use a notebook to record information on medicine you use, including:

• Name of the medicine.
• Form of the medicine, such as tablet, capsule, liquid, eyedrops, or spray.
• How much you take or use and how many times a day you use it.
• Special instructions.
• Side effects you notice.