9 ways to get the most out of OTC allergy medications

Itchy eyes, a stuffy nose, sneezing that won’t quit. That’s life for the nearly 1 in 3 American adults who are allergic to pollen, pet hair, and other indoor and outdoor allergens.¹ Getting fast relief often means a stop at the drugstore for over-the-counter (OTC) medications.

These OTC remedies come in 3 types. There are antihistamine tablets, steroid nasal sprays and eye drops. But which is best for which type of allergy? And how best to take them so they help reduce symptoms?

Shuba Iyengar, M.D., chief medical officer of Allermi, a telehealth company, explains how to get the most out of OTC allergy medications.

Antihistamine tablets

When the immune system comes into contact with pollen, ragweed or whatever it is allergic to, the allergy cells in the body produce multiple chemicals, including histamines. Histamines contribute to sneezing, itching, runny nose, even hives. Antihistamines treat these symptoms by blocking the action of histamine.²

Some people need to take antihistamines every day. Others only take them as needed or when they know they’ll encounter a specific trigger, such as a family member’s pet.² To make sure oral antihistamines work as best as possible, keep the following in mind, suggests Dr. Iyengar.

Pay attention to side effects

“Although they are generally well-tolerated, allergy medications can have side effects,” says Dr. Iyengar. Those include dry mouth, headache, dizziness and especially sleepiness.

This is especially true of so-called first-generation antihistamines, such as diphenhydramine.³ Newer antihistamines (and their generic equivalents) — including loratadine and fexofenadine — are less likely to cause side effects.³ But older adults and those with health problems may still be at risk.

“Be aware of these potential unwanted effects and consult a health care professional if you experience severe symptoms,” says Dr. Iyengar.

Check for safety

Some oral antihistamines may not be a good option for people with certain medical conditions, notes Dr. Iyengar. Here are a few examples.

• First-generation antihistamines: People who have high blood pressure, asthma, heart disease or chronic obstructive pulmonary disease should talk to the pharmacist or the provider before taking these.³
• Newer antihistamines: Those with liver or kidney problems need to consult the pharmacist or provider before using these, notes Dr. Iyengar.

Always read the warning on the label to make sure the antihistamine is safe for a health condition, Dr. Iyengar adds.

Avoid alcoholic beverages

Drinking alcohol while taking any type of antihistamine can make people even sleepier. To be safe, skip the wine, beer or hard liquor when taking oral antihistamines.

Nasal sprays

OTC nasal sprays are a form of steroids.4 They’re generally used by people with hay fever or other allergies that cause the nose to get stuffy, itchy or runny. They help by lowering inflammation in the nose and relieving swelling.^{4, 5}

Some people also use saline nasal spray to flush their nasal passages and keep them moisturized. To use a spray effectively, here are 3 key things to know.

Follow the doctor’s suggested technique

Many people tilt their head back while spraying. But this causes the spray to run down the back of the throat.

Instead, try what Dr. Iyengar calls the “nose to toes” technique. Tilt the head down slightly so the feet are in view while spraying. Also, point the spray’s nozzle toward the outside of the nostril because “the middle of the nose is very sensitive, and you don’t want to poke it with the spray nozzle,” she explains.

Do saline first

Some people also use a saline spray, and it should be spritzed before the steroid spray.

This helps get excess mucus out of the nasal passages and keep them moist, which allows the steroid spray to work better. “If you use saline after, it may wash some of the medication out,” says Dr. Iyengar.

Create a regular routine

Some people only use steroid nasal sprays when they’re having symptoms. But nasal sprays sometimes take several days to work, so it’s best to use the spray daily for at least a week before allergy season starts.⁴ For those who have year-round allergies, use a steroid spray daily.⁴

Eye drops

Allergy triggers — from weeds to pet fur to mold — can cause the eyes to water, itch or turn red. Usually oral antihistamines can clear up those symptoms. But if not, there are OTC eye drops.⁶ They include artificial tears, decongestants (to get the red out) and antihistamine drops.

To get maximum relief from eye drops, remember the following.

Shake the bottle before using

Some eye drops need to be shaken before they are used. When a person doesn’t do this, the medication may not be evenly distributed, notes Dr. Iyengar.

Avoid touching the dropper

Don’t touch the dropper with your fingers (whether washed or unwashed). They can transfer bacteria onto the tip of the dropper, which can then get into the eye. That can possibly lead to an infection, Dr. Iyengar explains.

Don’t overuse eye drops

Eye drops are meant for short-term relief.⁶ “While it may be tempting to use eye drops more frequently, excessive use can lead to rebound redness or irritation,” Dr. Iyengar says.

It’s best to use eye drops for 2 or 3 days, tops.⁶ Some antihistamine eye drops may dry out eyes out too — and make allergy symptoms worse.

When to see an allergist

There may come a time when seeing an allergist is advised. Dr. Iyengar recommends making an appointment if the following happens with OTC drugs:

• When allergy symptoms are chronic and a person is using OTC drugs all the time
• When people are using the recommended dose and symptoms are still bad

“An allergist can help determine the most effective short-term and long-term regimen for you, as well as if allergy testing would be helpful,” Dr. Iyengar says.

For many people, though, OTC allergy medications can bring relief. Just follow the instructions to make sure to get the most out of them.