Allergy Medication Table
Sneezing, wheezing, coughing, and sniffling. So many allergy
symptoms and so little time to get to the doctor to get a prescription
to relieve you of these irritating and somewhat debilitating symptoms.
Well, now you will have the information necessary to treat your
symptoms with the appropriate over-the-counter (OTC) medications,
which at one time, were prescription products that for one reason
or another, were made into OTC medications. Furthermore, simply
because a medication is available over the counter does not make
it safer or less effective than its prescription equivalent.
We will concentrate on the generic rather than brand names because
there are multiple brands available of the same generic products.
There are also countless combination products available that combine
some of the more popular generics to treat a wider variety of
allergy and cold symptoms. Most brand-name, over-the-counter products
have a generic equivalent. For the most part, brand names and
their generics are comparable as far as efficacy and side effects
go. By understanding what is in your favorite OTC products, you
will be able to save 25 to 75 percent by buying the generic equivalent.
This article will discuss various allergy symptoms along with
the appropriate OTC products that would treat your symptoms.
Sneezing, itchy nose, throat, and ears: These are the most common
complaints of the allergy sufferer. These symptoms can be associated
with seasonal triggers such as grass, tree, or ragweed pollen,
or perennial triggers such as dust mites, roaches, or pets. The
first-line treatment for these symptoms are antihistamines. When
exposed to an allergen, the mast cell, which is found all over
the body, especially in connective tissue such as the skin, releases
histamine. Antihistamines block the action of histamine and prevent
the allergic reaction from taking place. The most popular OTC
antihistamines are diphenhydramine (Benadryl), clemastine (Tavist),
and chlorpheniramine (Chlor-Trimetron).
Some of these products’ manufacturers have used the side
effect of sleepiness to create a new product out of the same drug.
Popular examples include Unisom, Nytol, and Sominex. In fact,
diphenhydramine is almost as popular as a sleep aid as an allergy
Be careful when driving. Over-the-counter allergy products may
impair your judgment as much as alcohol, and when combined with
alcohol, may affect you even more. Also, men with enlarged prostates
may experience urinary retention while taking these products.
For moderate to severe symptoms, or if the side effects of the
treatment are intolerable, a patient will benefit greatly from
consulting an allergy specialist and gaining access to one of
the second generation antihistamines that have a much improved
side effect profile. Another class of products available to treat
these products is mast cell stabilizers.
Nasalcrom nasal spray recently was made available over the counter
for the treatment of allergic rhinitis. This product boasts an
impressive safety profile, but is limited as far as usefulness.
To achieve maximum benefit, one would need to use Nasalcrom (cromolyn
sodium) three to four times per day and give the medicine up to
one month to start to work. Some patients swear by it.
Congestion, sinus pain: These symptoms may or may not be associated
with allergies. If you don’t have sneezing, an itchy nose,
throat, or ears, you may want to avoid combination products that
have antihistamines to minimize occurrences of dry mouth and sedation.
The principal therapy for these symptoms is decongestants. Decongestants
can be taken orally or topically. The most popular oral decongestants
is pseudoephedrine (phenylpropanolamine was previously used but
it has been discontinued by the FDA - See more information). These
same products are also available in prescription strength. Decongestants
work by shrinking the mucous membranes, thereby decreasing the
surface area. Unfortunately, when the medication wears off, so
does the symptom relief. Also, many patients get very jittery
and shaky while taking these products. These patients don’t
usually do well on coffee or other forms of concentrated caffeine,
either. If these symptoms persist, it would be wise for the patient
to consult with an allergist or other sinus specialists such as
an otolaryngologist (ear, nose, and throat doctor) for further
evaluation or treatment.
Remember though, if you don’t have allergy symptoms, you
don’t need to take a combination product with antihistamines.
Often times, decongestants may come with guaifensisin, an expectorant
to loosen the phlegm or mucus and assist with drainage. Although
in theory, this is a good idea, in most OTC products, it is given
at such low dosages, it doesn’t do much. You usually need
the much higher dosages of prescription products to do any good.
If congestion is particularly bothersome, you may want to use
an OTC decongestant spray for a few days to help relieve the symptoms
and allow some of the more long-term prescription and OTC medications
to kick in.
Use of topical decongestants such as phenylephrine (Afrin, Neo-Synephrine,
Vicks Sinex) or oxymetazoline (Afrin Original Nasal Spray, Neo-Synephrine
12 hour) for more than three to four days may lead to a mucosal
dependence (or addiction), making it more difficult to wean off
of these medications. Also, if a patient abuses these products,
they may irreversibly damage the nasal mucous membranes.
Post-Nasal Drip: This symptom
is very difficult to treat. The causes can be an allergy, infection,
or a nasal structural abnormality. Antihistamine decongestant
products are the OTC treatment of choice. I would recommend, however,
seeing an allergy or sinus specialist for a more specific etiology
so that treatment can be optimized.
Cough of two-week duration or less:
This kind of cough in the absence of other underlying medical
problems such as chronic bronchitis or emphysema, or without other
associated symptoms such as a fever is probably due to a cold.
I usually recommend a product with a cough suppressant such as
dextromethorphan and a decongestant such a pseudoephedrine to
dry the post-nasal drip. If the drip is particularly bad, one
can add an OTC antihistamine to help dry the drip further. I would
especially recommend this at night when being sleepy is not as
big of an issue.
Cough of more than two weeks duration:
Now we are approaching the category of “chronic cough.”
The overwhelming majority of chronic coughs are related to three
causes. These include:
- Allergy and asthma
- Sinus infection
- Gastroesophageal Reflux (heartburn)
If a cough persists for more than a few weeks, one should see
an allergist, otolaryngologist, or a pulmonologist (lung specialist).
Itchy, runny eyes: Most over-the-counter
medications treat the systems of eye allergies using a topical
decongestant (oxymetazoline, naphazoline) and an antihistamine
You can use the chart below as a handy reference for looking
up the different products found in OTC allergy products and using
them to treat the appropriate allergy symptoms.
||Benadryl Tylenol Flu
||Tylenol Flu NightTime
Alka-Seltzer Plus NightTime
Cough due to post-nasal drip
||Topical Decongestant Afrin Neo-Synephrine
|Headaches if used too long.
Can become addicting to the nasal mucosa.
Original Nasal Spray Neo-Synephrine 12 Hour
|Headaches and if used
Can become addicting to the nasal mucosa.
Naphazoline Eye Drops
|Red, irritated eyes due to allergy or
||Eye drops have minimal major side effects
if used properly.
||Itchy eyes due to allergy
||Eye drops have minimal
major side effects if used properly
Another factor to consider when deciding on what medicines to
use is cost. Although prescription medications are generally more
expensive, often times they are generally less expensive for the
patient because they are covered by their prescription plan. Also,
the time saved not going to the doctor and self-medicating, may
be lost because of lost productivity and sick days away from work.