White Paper – Allergy Season Solutions

Allergy Season Solutions

Allergies are the 6th leading cause of chronic illness in the United States. With spring arriving, it is important to recognize seasonal allergy symptoms, non-prescription treatment options, and when to think about prescription alternatives.

Seasonal allergies symptoms are typically intermittent throughout the year and include runny and/or stuffy nose, watery eyes, itchy eyes, nose, or throat, and sneezing. Nasal drainage down the back of the throat may also lead to a cough and hoarseness. These reactions, also known as hay fever, are common in the spring and fall as a result of pollen from trees, grasses, and weeds in the air.

There are typically three pollen seasons that can ause trouble for allergy sufferers. Trees pollinate in the spring, grass pollen is released in the summer, and finally in the fall weeds can lead to issues. The best way to prevent symptoms is to avoid exposure to the allergen. Some ways to accomplish this include keeping windows closed and running the air conditioner, showering or changing clothes after being outside, or avoiding the outdoors altogether on days when there is high pollen count. Pollen counts are predicted, just as a weather forecast and can be easily found online.

Unfortunately, avoiding exposure is not always a practical option. This is where medications can play a role. Antihistamines are most commonly used as there are many options, and they are available without a prescription. They block the release of histamine, which is responsible for the symptoms commonly associated with allergies. They are most effective when used one to two hours prior to exposure of the offending allergen or can be taken daily during peak symptom periods. The most common antihistamines include Claritin® and Allegra® which cause little to no drowsiness, Zyrtec® which may lead to slight drowsiness, and Benadryl® which causes significant drowsiness. It’s important to note that the “non-drowsy” claim is only applicable when the medications are taken as directed. Taking more than the recommended dose, may increase the risk for sedation. Everyone can be affected differently, so it is important to not participate in any activities requiring alertness after taking a medication for the first time. A bedtime dose of antihistamine drugs that cause drowsiness may actually be of benefit in those individuals who are having difficulty sleeping due to their symptoms. However, there is a risk of residual sleepiness the next day. Antihistamines may also cause urinary retention, nausea, and heartburn. It is best to use only one antihistamine at a time, so it is important to check ingredients in sleep aids and cold medicines, as many of these may contain one. Zaditor® is an over the counter eye drop that can alleviate itchy, red eyes when oral options aren’t enough. All over the counter antihistamines are available in generic alternatives that are just as effective and typically much lower in price.

Allergy Season Solutions (Continued)

Decongestants, both oral and intranasal, are a short term option if an antihistamine doesn't cut it. These medications can improve air flow by bringing down swelling in the nasal mucosa. Nasal sprays, such as Afrin®, can be very effective if used for a few days. However, if used longer than 3-5 days, they can actually make congestion worse. The oral decongestants, such as Sudafed®, do not cause this "rebound congestion,” but take longer to start working and may cause sleeplessness and an increase in blood pressure.

Several prescription options are an alternative or can be used in addition to over the counter products. Steroid nasal sprays are among the most common. Again, these are most effective if begun before experiencing symptoms and peak response may not be seen for a couple of weeks. They have limited side effects including stinging sensation and headache. Prescription antihistamines are also available in nasal sprays and eye drops. Lastly, your physician could refer you to an allergist for immunotherapy. This may involve receiving several tiny injections to determine what particular antigen an individual is allergic to. Then, the patient receives injections of increasing dosing of that particular antigen over a period of time, typically several years. The hope is that the body will gradually learn to tolerate the allergen.

Spring should be an enjoyable time to get outdoors and enjoy the nice weather. With proper management of symptoms, allergy suffers should not be forced to stay inside. It is important to inform your primary care physician of any medication you begin taking on a regular basis, especially if you have any chronic health conditions. For more information regarding allergy symptoms and their treatment go to the National Institutes of Health website www.nih.gov and search "allergy".

AuBurn Pharmacy Intern Danielle Mattox University of Kansas School of Pharmacy Pharm D Candidate 2013