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There
is no cure for allergies, but there are several types
of medicines available -- both over-the-counter and
prescription -- to help ease annoying symptoms like
congestion and runny nose. These include antihistamines,
decongestants, combination medicines, corticosteroids,
and others.
Allergy
shots, which gradually increase your ability to tolerate
allergens, are also available.
Antihistamines
Antihistamines
have been used for years to treat allergy symptoms.
They can be taken as pills, liquid, nasal spray, or
eye drops. Over-the-counter antihistamine eye drops
can relieve red itchy eyes, while nasal sprays can be
used to treat the symptoms of seasonal or year-round
allergies.
Examples
of antihistamines include:
Over-the-counter:
Benadryl, Claritin, Chlor-Trimeton, Dimetane, and Tavist.
Ocu-Hist is an OTC eye drop.
Prescription: Clarinex, Allegra, and Zyrtec. Atarax,
Vistaril, Astelin are prescription nasal sprays. Eye
drops include Emadine and Livostin for allergic conjunctivitis.
How Do Antihistamines Work?
When
you are exposed to an allergen -- like ragweed pollen
-- it triggers your immune system to go into action.
Immune system cells in your nose and sinuses then release
a substance called histamine, which attaches to receptors
in blood vessels located in nasal tissues, causing them
to enlarge. Histamine also binds to other receptors
located in nasal tissues, causing redness, swelling,
itching, and changes in nasal secretions. By blocking
histamine receptors, antihistamines prevent these symptoms.
What
Are the Side Effects?
Many
over-the-counter antihistamines cause drowsiness. Non-sedating
antihistamines are available by prescription.
Decongestants
Decongestants
relieve nasal congestion and are often prescribed along
with antihistamines. They come in nasal spray, eye drop,
or pill form.
Nasal
spray and eye drop decongestants can be used for only
three days, since long-term use can make symptoms worse.
Pills may be taken long-term safely.
Some
examples of decongestants include:
Over-the-counter:
Actifed, Neo-Synephrine, Sudafed, Afrin nasal spray,
and Visine eye drops.
Prescription: Naphcon and Allerest eye drops. Other
prescription decongestants are drugs like Claritin-D
that combine a decongestant with another allergy medicine.
How Do Decongestants Work?
During
an allergic reaction, tissues in your nose swell in
response to contact with the allergen; that swelling
produces fluid and mucous. Blood vessels in the eyes
also swell, causing redness. Decongestants shrink swollen
nasal tissues and blood vessels to relieve the symptoms
of nasal swelling, congestion, mucous secretion, and
redness.
What
Are the Side Effects?
Decongestants
may raise blood pressure, so they are not recommended
for people who have blood pressure problems or glaucoma.
They may also cause insomnia or irritability, and restrict
urinary flow.
Combination
Medicines
Some
allergy medicines contain both an antihistamine and
a decongestant to relieve multiple symptoms. There are
also other combinations, such as those between an allergy
medicine and asthma medicine and an antihistamine eye
drop with a mast cell stabilizer drug (see below).
Some
examples of combination medicines include:
Over-the-counter:
Benadryl Allergy and Sinus, Tylenol Allergy and Sinus,
and Dimetapp.
Prescription: Allegra-D, Claritin-D, Semprex-D, and
Zyrtec-D for nasal allergies. Naphcon-D, Opcon-A, Occuhist,
Vasocon, Zaditor, Patanol, and Optivar for allergic
conjunctivitis.
Corticosteroids
Corticosteroids
reduce inflammation associated with allergies. They
prevent and treat nasal stuffiness, sneezing, and itchy,
runny nose due to seasonal or year-round allergies.
They can also decrease inflammation and swelling from
other types of allergic reactions.
Corticosteroids
are available as pills, for serious allergies or asthma,
inhalers, for asthma, nasal sprays, for seasonal or
year-round allergies, creams, for skin allergies, or
as an eye drop, for allergic conjunctivitis. Often,
a doctor will prescribe a corticosteroid in addition
to other allergy medications, for treatment of severe
allergy symptoms.
The
drugs are highly effective, but they must be taken daily
to be of benefit -- even when you aren't feeling symptoms.
In addition, it may take one to two weeks before the
full effect of the medicine can be felt.
Some
corticosteroids include:
Nasal
corticosteroids: Beconase, Rhinocort, Flonase, Nasonex,
and Nasocort, used to treat nasal allergy symptoms.
Inhaled corticosteroids: Beclovent, Pulmicort, Flovent,
and Asthmacort, used to treat asthma. Advair is an inhaled
drug that combines a corticosteroid with another drug
to treat asthma. Inhaled corticosteroids are available
only with a prescription.
Eye drops: Dexamethasone, Alrex.
Oral steroid: Deltasone, also called prednisone.
What Are the Side Effects?
Corticosteroids
have many potential side effects, especially when given
orally and for a long period of time.
Side
effects with short-term use include:
Weight
gain
Fluid retention
High blood pressure
Side effects with long-term use include:
Growth
suppression
High blood pressure
Diabetes
Cataracts of the eyes
Bone thinning osteoporosis
Muscle weakness
Side effects of inhaled corticosteroids may also cause
cough and yeast infections of the mouth.
Bronchodilators
Bronchodilators
are inhaled medicines used to control asthma symptoms
and are available only with a prescription. A short-acting
bronchodilator is used to provide quick relief for asthma
symptoms during an attack. Long-acting bronchodilators
can provide up to 12-hours of relief from asthma symptoms,
which is helpful to people who suffer from nighttime
asthma problems.
How
Do Bronchodilators Work?
Bronchodilators
relax the muscle bands that tighten around the airways.
This rapidly opens the airways, letting more air in
and out of the lungs, improving breathing.
Bronchodilators
also help clear mucus from the lungs. As the airways
open, the mucus moves more freely and can be coughed
out more easily.
Generally
one or two puffs of the inhaler relieve the wheezing
and chest tightness associated with a mild attack. It
may be necessary to take more puffs for severe attacks.
Some
types of bronchodilators include:
Ventolin,
Proventil, Volmax
Brethaire
Tornalate
Xopenex
Alupent, Metaprel
Maxair
What Are the Side Effects?
Bronchodilators
are potent drugs. If overused, they can cause dangerous
side effects such as high blood pressure and a fast
heartbeat.
Mast
Cell Stabilizers
Mast
cell stabilizers are used to treat mild to moderate
inflammation in the bronchial tubes and are available
only with a prescription. These medications can be used
to prevent asthma symptoms during exercise and can be
given before exposure to an allergen when it cannot
be avoided.
Mast
cell stabilizers come in a nasal spray and like many
drugs it may take several weeks before the full effects
are felt.
Some
examples of mast cell stabilizers include:
Intal
Tilade
Crolom
Alomide
Alocril
Opticrom
Alamast
How Do Mast Cell Stabilizers Work?
Its
unclear how they work.
What
Are the Side Effects?
Throat
irritation, coughing, or skin rashes sometimes can occur
with Crolom treatment. Some people say that Tilade has
a bad taste. Using a spacer to take the medicine and
drinking juice following treatment may decrease the
taste.
Leukotriene
Modifiers
Leukotriene
modifiers are used to treat asthma and nasal allergy
symptoms. They are often prescribed along with an inhaled
corticosteroid for treatment of mild persistent asthma.
These
medications are available only with a doctor's prescription
and come as pills or chewable tablets.
Some
brand names include:
Accolate
Zyflo
Singulair
How Do They Work?
Leukotriene
modifiers block the effects of leukotrienes, chemicals
produced in the body in response to an allergy.
What
Are the Side Effects?
Stomach
pain or stomach upset
Heartburn
Fever
Stuffy nose
Cough
Rash
Headache
Other Over-The-Counter Medications
Salt-water
solution, or saline, is available as a nasal spray to
relieve mild congestion, loosen mucus, and prevent crusting.
They contain no medicine.
Artificial tears, which also contain no medicine, are
available to treat itchy, watery, and red eyes.
Immunotherapy
Immunotherapy,
or allergy shots, may be the most effective form of
treatment if you suffer from allergies more than three
months of the year. These shots expose you to gradually
increasing levels of the offending allergen to help
your immune system build tolerance. See our full article
on allergy shots for more information.
Reviewed
by the doctors at The Cleveland Clinic Department of
Pulmonary, Allergy and Critical Care Medicine.
Edited
by Charlotte E. Grayson, MD, Feb. 2004, WebMD.
Portions
of this page © The Cleveland Clinic 2000-2004
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