Allergies: Is the treatment worse than the problem?

For many allergy sufferers, it’s a jolt. Antihistamines help with the itching but make you sleepy. Decongestants open your airways but keep you awake. Prescription eye drops are soothing but cost a fortune. Steroids work wonders but cause weight gain and bloating.

Is there a way to treat allergies without experiencing side effects?

For most people, the answer is yes, although it may take some experimenting. Here are three medications you can trust to provide significant relief with minimal side effects.

1. Clarinex. Clarinex is the newest addition to the class of non-sedating antihistamines. This group includes Claritin, Allegra, Zyrtec and generics thereof. Claritin and Zyrtec were originally prescription-only, but are now available without a prescription. Allegra and Clarinex remain prescription only. Non-sedating antihistamines were developed in response to the most common complaint of antihistamine use, ie drowsiness. Sedating antihistamines are still available (Benadryl, Chlorpheniramine, and others) and are still helpful for overnight allergy symptoms. They are the sedative ingredients in over-the-counter sleeping pills.

Clarinex is the only non-sedating antihistamine not yet available in generic form, and therefore the most expensive, costing over $100 for a month of medication. Check online at the Clarinex website for options to reduce your out-of-pocket costs. You may want to consider trying loratadine (generic Clartin) or another generic for less than $10 a month first.

2. nasal chrome. Another medication that was previously a prescription drug, over-the-counter NasalCrom (cromolyn sodium) nasal spray works by making your nose less sensitive to allergens (pollen, dander, dust, and other particles you’re allergic to). In this sense, it is similar to nasal steroids (such as Flonase, Nasacort, Nasonex), which currently cost between $60 and $120 a month. At a cost of less than $20, NasalCrom is a bargain.

Each of these inhaled medications is intended to prevent, rather than treat, the symptoms of nasal itching, drainage, and congestion. They all work best when taken regularly. If you wait until you experience symptoms to use them, you may find them ineffective. If you only need medicine occasionally, you’re probably better off using Clarinex or another non-sedating antihistamine.

3. Singular. When it was first released, Singulair was intended solely as an asthma medication. However, asthma often has an allergic component, and the drug is especially useful in people who suffer from both asthma and allergies. A few years ago it received the indication for its use also in non-asthmatic allergic patients.

In general, Singulair does not cause drowsiness or have the caffeine-like effect typical of decongestants. Like inhaled steroids and NasalCrom, it is better at preventing allergy symptoms than treating them. It is currently available by prescription only for approximately $130 per month supply. The manufacturer offers savings options on the Singulair website.

The above medications can be used alone or in combination. These are not the only options available, nor are they the least expensive, but all three are quite reliable in relieving symptoms without bothersome side effects.

Copyright 2010 Cynthia J. Koelker, MD