With itchy, watery eyes and uncontrollable sneezing, you run to your local drugstore to buy some over-the-counter allergy medicine. However, the options are overwhelming, and you need help figuring out where to start. In addition, you want something that'll give you quick relief to move on with your day. Here's a simplified guide on what OTC options work for allergies, so you can confidently choose the proper medication.

Allergies happen when your body overreacts to certain substances, such as pollen, food, or medications. Hives, itching, sneezing, and watery eyes are just a few symptoms of allergies, and none of them are pleasant. Moreover, they can be significantly frustrating when they hinder you from eating a delicious meal or engaging in your favorite hobby outdoors. Fortunately, over-the-counter (OTC) allergy medications can relieve most of your symptoms and allow you to enjoy a symptom-free life.

What Are the Benefits of Taking Over-the-counter Medications for Allergies?

Over 100 million people in the U.S. experience one or more allergy symptoms each year. If you are one of these people, you know how it feels to want immediate relief. Having an OTC allergy medication readily available in your purse, glove compartment, or medicine cabinet can quickly relieve these unpleasant symptoms.

Better yet, you'll save time and money. You won't need to take time off work or find childcare to spend hours at a clinic waiting to get your prescription when you could've gotten an equally effective, more affordable option at your local drugstore. Nothing beats the convenience and ability to treat your symptoms in the comfort and privacy of your own home. In addition, instructions for dosing and taking OTC medications are typically easy and hassle-free.

What Types of OTC Allergy Medications Are Available?

Many OTC allergy medications are available, but the three most popular categories are antihistamines, decongestants, and corticosteroids. You can take them as pills, liquids, nasal sprays, or eye drops. Let's review each category to help you choose the proper medication.

Antihistamines

Antihistamines work against histamine, a chemical your body releases during inflammation. Inflammation occurs whenever your immune system detects something you're allergic to. Histamine's role in inflammation is to make your blood vessels swell and dilate, helping fluid move more quickly through blood vessel walls. This process contributes to many allergy symptoms, such as congestion, watery eyes, and hives. Antihistamines block most of the histamine's effects and help relieve those symptoms.

You can take antihistamines by mouth in a liquid or pill form. Here are some examples of OTC antihistamines:

• Cetirizine (Zyrtec)
• Chlorpheniramine (Aller-Chlor)
• Desloratadine (Clarinex)
• Diphenhydramine (Benadryl)
• Doxylamine (Vicks NyQuil)
• Fexofenadine (Allegra)
• Loratadine (Claritin)

A few of these antihistamines—namely diphenhydramine (Benadryl), doxylamine (Vicks NyQuil), and chlorpheniramine (Aller-Chlor)—can cause drowsiness. Choose another option if you need to be awake enough to work or operate heavy machinery (like driving your car). Fexofenadine (Allegra) is the least sedating antihistamine.

You can take antihistamines daily to help keep your symptoms at bay. You can also take them a few weeks ahead of allergy season to get their full benefit.

Decongestants

Decongestants provide quick, temporary relief of congestion by shrinking swollen blood vessels in the nose or sinuses. The most common oral decongestant is pseudoephedrine (Sudafed). You can take pseudoephedrine on its own or in combination with an antihistamine. If there's a "-D" at the end of the medication name, it means it contains a decongestant.

Some combinations you can take by mouth include the following:

• Cetirizine and pseudoephedrine (Zyrtec-D)
• Desloratadine and pseudoephedrine (Clarinex-D)
• Fexofenadine and pseudoephedrine (Allegra-D)
• Loratadine and pseudoephedrine (Claritin-D)

Decongestants also come in the form of nasal sprays and drops. Oxymetazoline (Afrin) is a good example. If you are suffering from red, watery eyes, you can try tetrahydrozoline (Visine).

Although they are effective, decongestants are only meant for short-term use. Don't take oral decongestants longer than seven days and nasal decongestants longer than three days. Otherwise, your symptoms may only worsen.

Take note that OTC decongestants can also increase your risk for heart issues if you take them longer than two weeks.

Corticosteroids

Corticosteroids decrease inflammation and swelling inside your nose and sinuses. They come as nasal sprays and usually work best for uncontrollable sneezing and a runny nose.

You can choose from these OTC steroid nasal sprays:

• Budesonide (Rhinocort Allergy)
• Fluticasone (Flonase Allergy Relief)
• Mometasone (Nasonex 24HR Allergy)
• Triamcinolone (Nasacort Allergy 24HR)

The anti-inflammatory properties of steroid nasal sprays can take up to two weeks to be fully effective.

Are There Any Side Effects Associated with Taking OTC Allergy Medications?

OTC allergy medications have some side effects, and knowing them helps you consider the best remedy for your needs.

Below are some of the possible side effects of OTC allergy medications:

• Blurred vision
• Constipation
• Diarrhea
• Dizziness and headache
• Drowsiness
• Dry eyes
• Dry mouth
• Trouble urinating
• Vomiting

How Do I Determine Which OTC Allergy Medication Is Right for Me?

Choosing the proper allergy medication can be difficult with all the over-the-counter options available. The best choice depends on many factors, such as your health history, symptoms, and preferences.

Steroid nasal sprays are the first choice for symptom relief, but they may not work for everyone.

Taking more than one type of medication can give you better relief from symptoms. This option is safe if you avoid taking multiple drugs from the same category. For example, you can take an antihistamine and a steroid nasal spray together but not two types of antihistamines at once.

Caution: If you are pregnant, you shouldn't take triamcinolone (Nasacort Allergy) or oxymetazoline (Afrin) as they may cause congenital disabilities. Cetirizine (Zyrtec) is a safe alternative for allergies during pregnancy. Also, if you have uncontrolled high blood pressure, don't take decongestants because they could increase your blood pressure even more.

What Should I Do If I Experience Adverse Reactions While Taking an OTC Allergy Medication?

The risk of having an adverse reaction comes with taking any medication. Reactions can range from mild to life-threatening. If you have any concerns or adverse reactions from an OTC allergy medication, stop taking the medication and call your doctor.

If you experience anaphylaxis or a severe allergic reaction, get medical help immediately. The symptoms of anaphylaxis include:

• Facial or throat swelling
• Hives
• Lightheadedness
• Vomiting
• Wheezing

Now you know the three most common categories of OTC allergy medications: antihistamines, decongestants, and corticosteroids. The options don't seem overwhelming anymore, do they?

Sometimes, choosing the proper medication boils down to trial and error because everyone reacts to medications differently. What doesn't work for someone else may work better for you. 

So, decide based on what you know now, and if the drug works for you, then stick with it. Always keep it handy in your medicine cabinet, purse, or diaper bag so you never have to stop what you're doing to make an emergency trip to the drugstore again.

References

Asthma & Allergy Foundation of America. (2023, March). Allergy Facts. https://aafa.org/allergies/allergy-facts/?gclid=CjwKCAjwyeujBhA5EiwA5WD7_YcAZxLjWFxZhRq8r06mjDVmY8qdhlJx939YcWSKkDo5MrBPa-rYmRoCkLYQAvD_BwE

American Academy of Allergy, Asthma, and Immunology. (2020, September 28). Medications and Drug Allergic Reactions. https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/medications-and-drug-allergic-reactions#:~:text=Call%20your%20doctor%20if%20you 

Bérard,, A., Sheehy, O., Kurzinger, M.-L., & Juhaeri, J. (2016). Intranasal triamcinolone use during pregnancy and the risk of adverse pregnancy outcomes. The Journal of Allergy and Clinical Immunology, 138(1), 97-104. https://doi.org/10.1016/j.jaci.2016.01.021‌. https://www.jacionline.org/article/S0091-6749(16)00262-1/fulltext 

Billingsley, A. (2023, April 7). A Guide to the Best OTC Allergy Medications. GoodRX Health. https://www.goodrx.com/conditions/allergies/otc-allergy-medications#decongestants 

Cleveland Clinic. (2022, June 14). Which OTC Allergy Medicine Works Best?. https://health.clevelandclinic.org/best-otc-allergy-medicine/

Mayo Clinic Staff. (2017). Allergy medications: Know your options. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/allergies/in-depth/allergy-medications/art-20047403 

Arleen Veloria, BSN, RN, CPN

Arleen Veloria is a freelance health writer with over 8 years of clinical nursing experience. As a Registered Nurse and Certified Pediatric Nurse, she specializes in writing about health and wellness, nursing, and parenting. She is also a U.S. Navy Nurse Corps veteran, military wife, and mother.