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Best Non-Drowsy Allergy Medicine

There are many options out there for treating allergy symptoms. Allergy medications come in pills, nasal sprays, injections, creams, and eye drops. Some of these medications are available over the counter, while others are only available with a prescription. Having a runny nose, watery eyes, and congestion is never ideal. With so many choices at the drugstore or pharmacy, what is the best non-drowsy allergy medicine, and what should you look for to relieve symptoms the fastest?

Antihistamines

Antihistamines block a symptom-causing chemical called histamine, which your immune system releases during an allergic reaction. They are available both over the counter and with a prescription. Some antihistamines can cause drowsiness (ex. Benadryl, diphenhydramine, chlorpheniramine, or other ‘first-generation’ antihistamines) , so it is important to be cautious and read drug facts provided by the manufacturer or pharmacist. Before driving or operating heavy machinery after taking any new medication, make sure medication is non-drowsy and be sure to observe how medications affect you specifically. 

Non-Drowsy Antihistamines

Pills and Liquids:

  • Cetirizine (Zyrtec, Zyrtec Allergy)
  • Loratadine (Alavert, Claritin)
  • Fexofenadine (Allegra, Allegra Allergy)
  • Desloratadine (Clarinex)
  • Levocetirizine (Xyzal, Xyzal Allergy)

These medications can help ease runny nose, itchy or watery eyes, hives, swelling, and other signs or symptoms of allergies.

Eye Drops:

  • Olopatadine (Pataday, Patanol, Pazeo)
  • Ketotifen (Alaway, Zaditor)
  • Pheniramine and naphazoline (Visine, Opcon-A)

Antihistamine eye drops will help relieve itchy, watery eyes due to allergies. Most are available over the counter. 

Nasal Sprays:

  • Azelastine (Astelin, Astepro)
  • Olopatadine (Patanase)

Antihistamine nasal sprays are only available by prescription and may cause some drowsiness.

Corticosteroids

Corticosteroids work to relieve symptoms by suppressing allergy-related inflammation. 

Non-Drowsy Corticosteroids 

Pills and Liquids:

  • Prednisolone (Prelone)
  • Prednisone (Prednisone Intensol, Rayos)
  • Methylprednisolone (Medrol)

Oral corticosteroids are used for severe allergic reactions and are only available with a prescription from your doctor. Long-term use can result in severe side effects. 

Eye Drops: 

  • Prednisolone (Omnipred, Pred Forte)
  • Fluorometholone (Flarex, FML)
  • Loteprednol (Alrex, Lotemax)

In cases where allergy symptoms are not relieved by other medications, your eye doctor may prescribe and monitor the use of one of these prescription corticosteroid eye drops. These are usually only used in short courses as needed and as directed by and eye doctor.

Nasal Sprays:

  • Budesonide (Rhinocort)
  • Fluticasone propionate (Flonase Allergy Relief)
  • Fluticasone furoate (Flonase Sensimist)
  • Triamcinolone (Nasacort Allergy 24 Hour)
  • Mometasone (Nasonex)

Over-the-counter nasal sprays are used to relieve nasal congestion, runny nose, and sneezing. Side effects may include nose bleeds, unpleasant taste, and nasal and throat irritation. 

Decongestants 

Decongestants are used to treat temporary nasal and sinus congestion as symptoms occur. Many of the common decongestants are available over-the-counter. Any product containing pseudoephedrine must be purchased from behind the pharmacy counter, but is available over the counter. Ask your doctor before use if you have high blood pressure, as oral decongestants can increase the blood pressure.

Non-Drowsy Decongestants

Pills and Liquids:

  • Phenylephrine (Sudafed PE)
  • Pseudoephedrine (Sudafed)

Nasal Sprays:

  • Tetrahydrozoline (Tyzine)
  • Oxymetazoline (Afrin)

You shouldn’t use decongestant nasal sprays for long periods of time, as the use of a nasal spray for more than three consecutive days can result in worsening congestion. It is always best to speak with your doctor to find the best treatment options for your allergy symptoms and find out the best non-drowsy allergy medicine for you.

Non-Drowsy Decongestants With Antihistamines

Pills and Liquids:

  • Cetirizine and pseudoephedrine (Zyrtec-D 12 Hour)
  • Loratadine and pseudoephedrine (Claritin-D)
  • Fexofenadine and pseudoephedrine (Allegra-D)
  • Desloratadine and pseudoephedrine (Clarinex-D)

Many over-the-counter medications contain both Antihistamines and Decongestants. Many people find that the best non-drowsy allergy medicine for them includes both. 

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Resources:

“Allergy medications: Know your options”. Mayo Clinic, 6 May 2021, https://www.mayoclinic.org/diseases-conditions/allergies/in-depth/allergy-medications/art-20047403
“Choosing an over-the-counter allergy medication”. Harvard Health Publishing- Harvard Medical School, 6 May 2021, https://www.health.harvard.edu/diseases-and-conditions/choosing-an-over-the-counter-allergy-medication

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ABOUT THE AUTHOR

Dr. Andrea M. Jones

Dr. Andrea M. Jones is a clinical pharmacist specializing in transitions of care to facilitate a smooth transition for patients between the hospital and outpatient settings. Dr. Jones graduated from the University of Colorado School of Pharmacy and completed post-graduate year 1 residency at the Southern Arizona VA Healthcare System in Tucson, Arizona. Dr. Jones also worked in retail/community pharmacies for over 5 years during undergraduate studies at the University of Kentucky and pharmacy school at the University of Colorado.

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