Over-the-counter medicines for allergies

Many over-the-counter medicines are available to control symptoms of allergies, including allergic rhinitis. These medicines work well but can have side effects.

Medicines that are safe when they are used alone can sometimes cause problems if you take them with other medicines. Talk with your doctor or pharmacist if you are taking medicine for something else and want to try an over-the-counter medicine for your allergy.

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

• Antihistamines. Antihistamines reduce or stop sneezing, runny noses, and itching. Over-the-counter ("first-generation") antihistamines often make you feel sleepy or tired. They may also affect your coordination, even when they do not make you drowsy. Because of this, you should not take them before you drive or operate machinery. Another common side effect is a dry mouth. Taking these antihistamines at bedtime may help with side effects. Examples of over-the-counter antihistamines include chlorpheniramine (such as Chlor-Trimeton), diphenhydramine (such as Benadryl), or a newer, nonsedating ("second-generation") antihistamine such as loratadine (Claritin, for example).
• Decongestants. Decongestants clear up a stuffy (congested) nose. They come in nasal spray or pill form.
  • Possible problems with nasal sprays include irritation, burning or itching of nasal passages, and sneezing. You should not use them for more than 3 days in a row, because they can make your congestion worse (rebound congestion). An example of an over-the-counter spray decongestant is oxymetazoline, such as Afrin, Neo-Synephrine, or Dristan.
  • Decongestants you take as pills (oral decongestants) 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. Do not give decongestants to a child younger than 2 unless your child’s doctor has told you to. If your child’s doctor tells you to give a medicine, be sure to follow what he or she tells you to do.
• 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. Do not use them for more than 3 days in a row, because they can cause symptoms when you are not having an allergic reaction. This effect is similar to the rebound congestion of nasal spray decongestants. Examples of over-the-counter eyedrops include tetrahydrozoline (such as Visine) and naphazoline (Clear Eyes). (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 taking 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.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)