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Best Allergy Medications: What You Need to Know
May 26, 2023
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Read Time - 5 minutes
Written by
Medically Reviewed by
Last updated on March 18, 2024

Your guide to antihistamines, nasal steroid sprays, and decongestant allergy medication

Allergies make life miserable. Whether you have seasonal allergies or year-round irritation, allergy symptoms can seriously affect your day.

Unfortunately, no one has found a way to cure allergies yet. The upside is that many medication options are available to reduce these symptoms and improve quality of life.

We’ve detailed some of the best allergy medication options available to help you find the best treatment for your allergies.

Common causes of allergies


It’s helpful to understand why allergies happen. Allergies are caused by your immune system. It mistakes things like pollen or pet dander as harmful. When this happens, your immune system releases a substance called histamine. It defends the body against what it thinks is a dangerous invader. However, the release of histamines causes the symptoms we call an allergic reaction.

Common allergens include:

  • Pollen (from weeds, trees, flowers, and grass)
  • Mold and mildew
  • Animal dander
  • Dust mites

When triggered, allergy symptoms include:

  • Runny nose
  • Stuffy nose (nasal congestion)
  • Itchy nose
  • Sneezing
  • Itchy eyes
  • Watery eyes
  • Sinus congestion/ sinus pain
  • Postnasal drip (mucus dripping down the nasal passages)
  • Hives
  • Sore throat
  • Changes in sense of smell or taste
  • Puffiness under the eyes
  • Fatigue
  • Headache

The best allergy medicine


The best allergy medication for you depends on your triggers. It also depends on the symptoms you have. We’ve broken down your best options by best overall relief, best long-term symptom treatment, and the best medication for instant relief.

Best medicine for allergy relief

Oral antihistamines (pills and liquids)

Oral antihistamines are your best bet for treating off and on allergy symptoms. These drugs are particularly helpful for seasonal allergies. Antihistamines block the body’s release of histamines, which bond to body cells and cause allergic symptoms, including a runny and stuffy nose, watery eyes, and sneezing (medically known as allergic rhinitis).

Over-the-counter (OTC) antihistamines are the best treatment option for mild-to-moderate seasonal allergies.

OTC antihistamines include:

  • Cetirizine (generic for Zyrtec)
  • Diphenhydramine (generic for Benadryl)
  • Fexofenadine (generic for Allegra)
  • Levocetirizine (generic for Xyzal)
  • Loratadine (generic for Alavert and Claritin)

A review of multiple studies shows that fexofenadine 180 mg (generic for Allegra) reduced symptoms the most among the commonly used OTC antihistamines. However, the differences between fexofenadine and other drugs were not significant. Most OTC antihistamines are equally effective. Potential side effects (like drowsiness) and cost should be your main considerations before you purchase an OTC antihistamine.

For more severe allergy symptoms, prescription antihistamines may be needed. In addition, if you have persistent allergy symptoms that don’t go away after OTC treatment, your provider may choose to prescribe you prescription-strength antihistamines.

Prescription antihistamines include:

Your healthcare provider will determine the best prescription-strength antihistamine for you.

Best medicine for long-term allergy prevention

Nasal steroid sprays

Some people experience allergy symptoms throughout the year. Nasal corticosteroids may take several weeks to work but are considered the most effective year-round allergy prevention option. Steroidal nasal sprays prevent the release of histamines before an allergic response occurs.

OTC steroid nasal sprays include:

  • Mometasone (generic for Nasonex)
  • Budesonide (generic for Rhinocort)
  • Triamcinolone (generic for Nasacort)
  • Fluticasone (generic for Flovent and Flonase)

Best medicine for immediate relief

Decongestants

Decongestants will provide immediate relief for nasal allergy symptoms (like congestion). These drugs should only be used on a short-term basis. Decongestants reduce inflammation in the nasal passages, making it easier to breathe.

Decongestants are available as oral tablets or nasal sprays. Most decongestant drugs are available in over-the-counter and prescription-strength options. Some medications contain antihistamines and decongestants. These drugs relieve symptoms and fight the body’s allergic response.

OTC decongestants include:

  • Loratadine and pseudoephedrine (generic for Claritin-D)
  • Cetirizine and pseudoephedrine (generic for Zyrtec-D)
  • Fexofenadine and pseudoephedrine (generic for Allegra-D)

Prescription decongestants include:

Decongestant nasal sprays include:

  • Oxymetazoline (generic for Afrin)
  • Tetrahydrozoline (generic for Tyzine)--also available as eye drops


Allergy Medication Basic Facts


AntihistaminesNasal Steroid SpraysDecongestants
Popular brand names:Zyrtec, Allega, ClaritinNasonex, Rhinocort, FlonaseClaritin-D, Allegra-D, Zyrtec-D
Best for:Allergy symptom reliefAllergy symptom preventionNasal congestion relief
When to use it:DailyDailyDaily, as needed
How long to use it:Year-round; or, 2-4 weeks before allergy season Year-round; or, 2-4 weeks before allergy seasonAs needed for no more than 7 days in a row
Potential side effects:Dry mouth, dry eyes, dizzinessNosebleeds, nose irritation, unpleasant tasteHeadaches, dry mouth, congestion
How long it takes to work:30 minutes2-4 weeks15-30 minutes




When to take allergy medications


Almost as important as what medication you’re taking is when you’re taking it. Antihistamines and steroid nasal sprays need to be taken for several weeks. On the other hand, decongestants should be used sparingly. Frequent use of decongestants can actually make your symptoms worse.

  1. Antihistamines: You can take an OTC antihistamine every day to prevent allergy symptoms. If you don’t want to take one every day, it is recommended that you start taking antihistamines 2-4 weeks before allergy season starts.

  2. Nasal steroid sprays: Nasal steroid sprays are the top choice for year-round allergies. If you have mild or moderate allergy symptoms year-round, use a nasal spray every day. If you have seasonal allergies and don’t want to use a nasal spray every day, start these medicines 2-4 weeks before allergy season.

  3. Decongestants: Decongestants provide immediate relief for allergy symptoms. But they should be used on a short-term, as-needed basis. Studies have shown that nasal decongestant sprays make congestion worse. This happens when they are used for more than a few days. In addition, decongestants can raise blood pressure. They are not recommended for patients with high blood pressure or those at risk of heart disease.

Do allergy medications make you drowsy?


OTC and prescription-strength allergy medications are generally considered safe. Most people do not experience side effects from these drugs, and those who do usually only experience mild reactions.

It is important to note that first-generation antihistamines may cause drowsiness.

First-generation antihistamines include:

  • Brompheniramine (generic for Dimetane)
  • Chlorpheniramine (generic for Chlor-Trimeton)
  • Clemastine (generic for Dayhist)
  • Diphenhydramine (generic for Benadryl)
  • Doxylamine (generic for Vicks NyQuil)

Do not use any machinery or try to do daily activities after taking a first-generation antihistamine.

Alternative allergy treatment


If you experience persistent and severe allergy symptoms, talk to an allergist. Allergists specialize in allergy diagnosis and treatment.

An allergist might suggest allergy shots. These shots desensitize your body to the allergen. Allergy shots contain a small amount of the allergen that triggers your symptoms. Allergy immunology regularly exposes your body to these irritants. After several years, your body will stop attacking these allergens, preventing further symptoms. Allergy shots are very effective and are safe for most patients. Immunology takes several years to work, however, so it is not the best choice for immediate relief.

Allergy shots are very effective and are safe for most patients. Immunology takes several years to work, however, so it is not the best choice for immediate relief.

How Sesame can help


Get same-day allergy relief with online allergy appointments on Sesame. Connect with a provider right away. Talk about your symptoms and the best treatment for you. If appropriate, providers can prescribe allergy medication. Doctors will send prescriptions to your local pharmacy. They are usually ready for pickup within minutes of your appointment.


Sources:

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Medical disclaimer

Sesame content is not intended to be a substitute for professional medical advice, diagnosis or treatment. If you have a medical concern, it is critical to seek the advice of your physician or another qualified health provider with any questions. If you are facing a medical emergency, call 911 or visit the nearest emergency room immediately.