Allergies: Don't Sneeze at Allergy Relief (cont.)

Pollen allergy, commonly known as hay fever, affects about 1 out of 10 Americans, according to the National Institute of Allergy and Infectious Diseases (NIAID). For some, symptoms can be controlled with occasional over-the-counter (OTC) medicine. Others have reactions that may more seriously disrupt the quality of their lives. Allergies can trigger or worsen asthma and lead to other health problems such as sinusitis and ear infections in children.

"You can distinguish allergy symptoms from a cold because a cold tends to be short-lived, results in thicker nasal secretions, and is usually associated with sore throat, hoarseness, malaise, and fever," says Badrul Chowdhury, M.D., Ph.D., an allergist and immunologist in the FDA's Division of Pulmonary and Allergy Drug Products. Many people with seasonal allergic rhinitis notice a seasonal pattern with their symptoms, but others may need a doctor's help to find out for sure that pollen is the source of their misery. If these symptoms crop up year-round, dust mites, pet dander or another indoor allergen could be the culprit. This is known as perennial allergic rhinitis.

Chowdhury suggests you see a doctor if you're experiencing allergies for the first time, if your symptoms interfere with your ability to function, if you don't find relief in over-the-counter (OTC) drugs, or if you experience allergy symptoms on a chronic basis. You may need an allergy test, the most common of which is a skin test that shows how you react to different allergens, including specific pollen allergens like ragweed or grass pollen.

Once you know you have seasonal allergies, probably the most important step you can take is to avoid pollen as much as possible. Try to stay indoors when pollen levels are highest. In the fall ragweed pollen season, pollen levels are highest in the morning. During the grass pollen season in the spring and summer, pollen levels are highest in the evening. Pollen counts measure how much pollen is in the air and are expressed in grains of pollen per square meter of air collected during a 24-hour period.

It may also help to keep windows closed in your house and car and to run the air conditioner. If possible, avoid mowing grass and other yard work.

Of course there will be times when pollen is inescapable. Here's a rundown of drug options that can help you survive the sneezing season:

  • Nasal corticosteroids: These are typically sprayed or inhaled into the nose once or twice a day. The newer drugs in this category are Nasonex (mometasone furoate) and Flonase (fluticasone propionate). Side effects may include stinging in the nose.

  • Oral antihistamines: These drugs, which are available in both OTC and prescription forms, counteract the action of histamine, a substance released in the body during an allergic reaction. Benadryl (diphenhydramine) and Chlor-Trimeton (chlorpheniramine) are examples of OTC antihistamines. Drowsiness is a common side effect, so don't take the drug when you have to drive, operate machinery, or engage in other activities that require you to be alert. You could try newer and relatively non-sedating antihistamines that are available by prescription such as Clarinex (desloratadine), Claritin (loratadine), or Allegra (fexofenadine). Zyrtec (cetirizine), also available by prescription, has sedation frequency slightly higher than the relatively non-sedating antihistamines mentioned above. Last May, the FDA held a public hearing that discussed whether Claritin, Allegra and Zyrtec should be moved from prescription to OTC status. The FDA has not made a final decision yet.

  • Decongestants: Decongestants are available both by prescription and over-the-counter. These drugs come in oral and nasal spray forms, and are sometimes recommended in combination with antihistamines. Antihistamines alone do not have an effect on nasal congestion. Allegra D (fexofenadine and pseudoephedrine) is an example of a prescription drug that contains both an antihistamine (fexofenadine) and a decongestant (pseudoephedrine). Note that prolonged use of nose sprays and drops can result in even worse nasal congestion.

  • Non-steroidal nasal sprays: NasalCrom (cromolyn sodium) nasal spray which is available without a prescription, can help prevent symptoms of allergic rhinitis if used before symptoms start. It's a non-steroidal anti-inflammatory drug and needs to be used more often than the nasal steroids, three to four times a day.