Medicines That Relieve Environmental Allergy Symptoms

Reviewed by: HU Medical Review Board

Allergy treatments usually focus on making symptoms better. Most environmental allergy symptoms can be managed with a combination of avoidance and over-the-counter (OTC) or prescription drugs.1-3

Environmental allergens include:1-3

  • Pollen
  • Dust
  • Mold
  • Dust mites
  • Cockroaches
  • Pets

The goal of allergy treatment is to make you feel better. This means reducing symptoms such as itchy eyes, runny nose, or sneezing. There are a wide range of drugs available to treat allergy symptoms. However, these drugs are not a cure for allergies.1-4

Common allergy treatments

Allergy drugs come in many forms. The most common treatments are pills and nasal sprays. Most are available over the counter. Some require a prescription. The main types of drugs used to treat environmental allergies include:1-4

  • Antihistamines
  • Decongestants
  • Nasal sprays (corticosteroids)
  • Leukotriene receptor antagonists (LTRAs)
  • Mast cell stabilizers (cromolyn sodium)
  • Allergy shots (immunotherapy)

These treatments work to block the action of or prevent the allergic process. Depending on your symptoms, your doctor may suggest a combination of drugs.2-3

Antihistamines

Antihistamines are drugs used to treat symptoms of an allergic reaction. Antihistamines work by blocking the effects of histamines, a chemical released by cells during an allergic reaction. These drugs treat:1-6

  • Runny nose
  • Itchy or watery eyes
  • Hives
  • Swelling
  • Sneezing
  • Other symptoms

Oral antihistamines are the most commonly used therapy to treat hay fever (allergic rhinitis). These are often the first line of treatment after avoidance. They are less effective for nasal congestion. Some cause drowsiness.1-6

Antihistamines come in pills, liquids, nasal sprays, and eye drops. They are mostly used to treat seasonal and indoor allergies. Side effects include drowsiness.4

Decongestants

Decongestants are used to reduce nasal congestion. They work by constricting blood vessels in the nasal passages. This reduces the swelling that makes your nose feel stuffy.4-6

Side effects of oral decongestants include insomnia, irritability, high blood pressure, and headaches. Long-term use of decongestants can cause a condition called rebound congestion.4-6

Steroid nasal sprays

Steroid nasal sprays (corticosteroids) treat allergies by reducing swelling and inflammation. These drugs make breathing through the nose easier. Nasal sprays are thought to be most helpful for nasal allergies. It is very important to use the correct technique for nasal sprays to be effective. Aim the nozzle toward the ear on the same side of the nose and sniff gently.1,6

Nosebleeds are a common side effect of nasal sprays.1,6

Leukotriene receptor antagonists

LTRAs are drugs taken by mouth to treat both allergy and asthma symptoms. These work by blocking the action of chemicals in the body called leukotrienes. Leukotrienes cause symptoms like nasal congestion, runny nose, and sneezing. Leukotriene inhibitors help make it easier to breathe.1

In some people, LTRAs may cause mood or behavior changes.1

Mast cell stabilizers

Mast cell stabilizers (cromolyn sodium) help stop your body from releasing histamines. These drugs come as pills, eye drops, or nose sprays. They help with itchy, watery eyes or itchy, runny nose. The nose spray may be used before exposure to allergens or as a maintenance drug.1,3

Other treatment options

Immunotherapy is a treatment that gradually introduces small amounts of specific allergens into the body. The body gradually becomes less sensitive to that allergen so symptoms are reduced. This process is called desensitization. Immunotherapy is not a drug but a series of allergy shots, pills, or skin patches.1,2

Nasal irrigation involves rinsing the nose and sinuses with a special saline (salt) solution. This helps clear out mucus and allergens from your nose and sinuses, and softens mucus. It is not a medicine but can be helpful in relieving allergy symptoms that affect breathing.3,5

Epinephrine is used for a serious allergy reaction called anaphylaxis. This is when an allergic reaction causes breathing problems, a drop in blood pressure, or the heart to stop beating. It is life-threatening.7

Things to know about allergy drugs

These are not all the possible side effects of allergy medicines. Talk to your doctor about what to expect when taking allergy drugs. You also should call your doctor if you have any changes that concern you when taking these medicines.

Before starting any allergy medicine, talk to your doctor about all your health conditions, and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.

Choosing an over-the-counter allergy medicine can be confusing. Talk to your doctor or pharmacist to try figure out which product is right for you.4

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