Many allergy and sinus medications are now available over the counter (OTC) without a prescription.  This gives patients direct access to medications that could potentially help their allergy symptoms, however, not all of these medications are effective for every type of allergy symptom and some of them are not safe for some people. Here we review some of the common ones – and which ones to stay away from!

–       The newer, longer acting antihistamines like Cetirizine (Zyrtec) or Fexofenadine (Allegra): these can be helpful at relieving some allergy symptoms, especially certain types of itchy skin or hives.

–       The older antihistamines, like Diphenhydramine (known more commonly as Benadryl), are generally not recommended for continued use due to lots of associated short and long-term side effects, such as drowsiness.

–       Nasal steroid sprays are considered first-line for treatment of allergic rhinitis and can help treat symptoms like nasal congestion, post-nasal drainage, and runny nose. These are also safe for most people to take long-term. Proper nasal spray technique is super important, so make sure you ask your healthcare provider to show you how to properly use nasal sprays!

–       OTC-strength nasal decongestants like Oxymetazoline (Afrin) unfortunately are not safe to take long-term and can cause a problem called rhinitis medicamentosa, where essentially your nasal passages become “addicted” to the spray. This spray is great for short-term use, 3 days or less.

–       Eye drops: There are many OTC eye drops that state they can be helpful for “itchy, watery, and red eyes” but unfortunately only a few of them are actually both effective and safe long term. Ask your allergist to give you the best advice on which eye drops to use, based on your specific symptoms!

–       Oral decongestants, such as pseudophedrine (or Sudafed), are used for temporary relief of severe congestion.  Unfortunately, they have a lot of concerning side effects and drug interactions and for most people, should not be used long-term

–       Primatene Mist, which is inhaled epinephrine, can offer significant relief of asthma-type symptoms. However, it can be considered dangerous in patients who actually have more severe inflammation and should only be rarely used. If you notice asthma symptoms such as wheezing, chest tightness, cough, shortness of breath – be sure you consult with a medical provider like an allergist to get better recommendations!

Seeing an allergist and discussing your allergy symptoms is the best way to get the best and safest recommendations to help treat your specific symptoms!