Choosing the right OTC (over-the-counter) allergy medicine

For many allergy sufferers, the allergy medicine aisle can be very daunting, especially given the numerous medications available claiming to relieve allergic symptoms. Because many allergy sufferers do not feel well, this experience is made even more difficult. Surprisingly enough, despite the known side effects associated with Benadryl, many people end up purchasing Benadryl simply because it is almost synonymous with “allergy relief”. However, in a report published in JAMA Internal Medicine, researchers offer compelling evidence of a link between long-term use of anticholinergic medications like Benadryl (diphenhydramine) and dementia.

What the study found:

A team led by Shelley Gray, a pharmacist at the University of Washington’s School of Pharmacy, tracked nearly 3,500 men and women ages 65 and older who took part in Adult Changes in Thought (ACT), a long-term study conducted by the University of Washington and Group Health, a Seattle healthcare system. They used Group Health’s pharmacy records to determine all the drugs, both prescription and over-the-counter, that each participant took during the 10 years before starting the study. The participants’ health was tracked for an average of seven years. During that time, 800 of the volunteers developed dementia. When the researchers examined the use of anticholinergic drugs such as Benadryl, they found that people who took these drugs were more likely to have developed dementia compared to those who did not take them. Moreover, dementia risk increased along with the cumulative dose. Taking an anticholinergic for the equivalent of three years or more was associated with a 54% higher dementia risk than taking the same dose for three months or less.

“This study is another reminder to periodically evaluate all of the drugs you’re taking. Look at each one to determine if it’s really helping,” says Dr. Sarah Berry, a geriatrician and assistant professor of medicine at Harvard Medical School.

With this in mind, it is very important to truly understand your allergy medication choices which are available OTC, and what medication will work best for your symptoms.

Non and low sedating antihistamines (Allegra, Zyrtec and Claritin): Antihistamines manage the symptoms of allergies and allergic rhinitis by blocking the action of histamine, a chemical released by the immune system in allergic reactions. These newer medications are considered much safer than Benadryl, as they have a much lower incidence of causing sedation and other side effects.

Nasal steroids (Flonase, Rhinocort, Nasacort): Nasal corticosteroid sprays are considered one of the most effective treatments for runny nose, sneezing and nasal congestion. 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.

Allergy Eyedrops (Zaditor /Alaway): In some cases, allergy eyedrops may provide quicker relief of itchy, watery eyes, as compared to oral antihistamines. Although they have a quick onset of action, relief may only last for a few hours. These products are safer to use on a long term basis than medications like Visine and Naphcon-A which contain decongestants.

Ultimately, identifying your specific allergies is the key to effective allergy management. By knowing what you are allergic to, you can take other steps, besides just using medications, to control your symptoms.


Spring allergy season is upon us. If you or your loved ones are suffering from runny nose, nasal congestion or itchy watery eyes, let us help you determine what you are allergic to and discuss the best treatment plan to alleviate your symptoms. Give us a call. We are here to help!

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