The Allergy and Asthma Clinic
Andrew C. Engler, M.D.
Medical Director
(650)343-4597
290 Baldwin Avenue
San Mateo, California 94401

Antihistamines & Corticosteroids

Medications used to treat allergic conditions may include:

Antihistamines

Antihistamines work well for treating allergy symptoms, especially when symptoms do not happen very often or do not last very long.

Antihistamines taken by mouth can relieve mild to moderate symptoms, but can cause sleepiness. Many may be bought without a prescription. Talk to your doctor before giving these medicines to a child, as they may affect learning.
Newer antihistamines cause little or no sleepiness. Some are available over the counter. They usually do not interfere with learning. These medications include fexofenadine (Allegra), loratadine (Claritin) and cetirizine (Zyrtec).
Azelastine (Astelin), Astepro and Patanase are antihistamine-based nasal sprays that are used to treat allergic rhinitis.

CORTICOSTEROIDS (Nasal and Lung sprays)

Nasal corticosteroid sprays are the most effective treatment for allergic rhinitis. Anti-inflammatory lung sprays are also very effective in the treatment and management of asthma. Although these products contain a corticosteroid, they are considered very safe, especially when used as prescribed.
These products work best when used daily, but they can also be helpful when used for shorter periods of time, especially during the times of the year when the patient’s symptoms are most active.
Some of the nasal sprays are approved for the pediatric population age 2 and up.

DECONGESTANTS

Decongestants may also be helpful in reducing symptoms such as nasal congestion. However, these products can be associated with side effects, such as jitteriness and insomnia. Used indefinitely, decongestants also have the potential to raise blood pressure.
Nasal spray decongestants should not be used for more than 3 days because of their habit forming potential and “rebound” side effects.
Be careful when using over-the-counter saline nasal sprays that contain benzalkonium chloride. These may actually worsen symptoms and cause infection.

Oral decongestants are drugs that constrict the blood vessels in the nose, thus decreasing nasal congestion. Sudafed is a popular oral decongestant available over the counter, without a prescription. They typically have no effect on nasal itchiness, runny nose, or watery eyes.

Since decongestants may act throughout your body and not just in your nose, they should be used with caution in patients with heart disease, thyroid problems, or high blood pressure. Although often very effective at relieving symptoms of stuffy nose or sinus congestion, they often have side effects such as jitteriness, irritability or difficulty sleeping at night (such as many people experience with coffee)

Topical Decongestants are nasal sprays (i.e.,Afrin or Neo-Synephrine) available over the counter. Since they are applied directly to the effected site, they relieve nasal congestion rapidly and can quickly open clogged nasal passages.

Nasal decongestant sprays can be effective at relieving the symptoms of the common cold. However due to the potential that the nasal mucosa can become dependent on these sprays for congestion they should not be used for more than 3 days in a row. However, the nasal mucosa can become “dependent” on these sprays for congestion especially if they are used for more than 3 days in a row.

OTHER MEDICATIONS

The leukotriene inhibitor Singulair is a prescription medicine approved to help control asthma and to help relieve the symptoms of seasonal allergies.

Specific illnesses that are caused by allergies (such as asthma and eczema) may require other treatments.

Immunotherapy - Allergy Injections / Allergy Drops - Immunotherapy is occasionally recommended if the allergen cannot be avoided and if symptoms are hard to control. This includes regular injections of specific allergens, given in increasing doses (each dose is slightly higher than the previous dose) that may help the body adjust to the antigen.

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