Prescriptions

Best OTC Allergy Medicines 2023 and When to Take Them

Khang T. Vuong, MHA
Khang T. Vuong, MHA8 May 2023

Allergies can be a seasonal nuisance or a year-round battle, causing discomfort and affecting your daily life. Understanding over-the-counter (OTC) allergy medications is essential in finding the right relief for your symptoms. In this comprehensive guide, we will dive into the world of OTC allergy medications, helping you choose the best formula for your sneezy situation, debunking common allergy myths, and providing tips on how to save money on these medications.

Quick Take-Aways

1. Identify your symptoms and choose the appropriate OTC formula

2. Generic medications are just as effective as brand-name ones

3. Take antihistamines before allergen exposure for best results

4. Don't believe every allergy myth you hear!

Which OTC allergy drug should I get? 

A variety of OTC allergy medications are available to help relieve various symptoms. It's essential to understand how each type works and which one might be best suited for your needs.

1. Antihistamines: Great for alleviating itches and sneezes caused by allergies

Antihistamines are often the go-to medication for managing sneezing, itching, and runny nose symptoms caused by allergies. They work by blocking histamine, a chemical released by your body during an allergic reaction (1). Examples of popular antihistamines include cetirizine (Zyrtec), loratadine (Claritin), and fexofenadine (Allegra). For best results without drowsiness, opt for newer non-drowsy versions instead of older ones like diphenhydramine (Benadryl), which might make you feel sleepy.

2. Decongestants: For stuffy nose

Decongestants help alleviate nasal congestion by shrinking swollen nasal tissues and reducing mucus production. Look for ingredients like pseudoephedrine (Sudafed) or phenylephrine (Neo-Synephrine) when choosing a decongestant (2). Keep in mind that decongestants can sometimes raise blood pressure, so be cautious if you have high blood pressure.

3. Nasal Steroids: Inflamed nasal passages 

Nasal steroids, such as fluticasone (Flonase) and budesonide (Rhinocort), can be useful in managing multiple allergy symptoms by reducing inflammation in your nasal passages. These sprays are most effective when used consistently over a few days (3).

4. Eye Drops: For watery eyes

OTC eye drops containing antihistamines or mast cell stabilizers can provide instant relief for those struggling with itchy, watery eyes due to allergies. Consider using ketotifen (Zaditor) to soothe your irritated eyes (4).

Generic vs. Brand Name Allergy Drugs - Is There A Difference?

When choosing allergy medications, it's essential to know that generic drugs are just as effective as their brand-name counterparts and often come at a lower price. The FDA requires generic drugs to have the same quality, strength, and safety as brand-name medications (5). So, save yourself some money without sacrificing effectiveness by opting for generics whenever possible.

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When Should I Take The Meds for Best Relief?

Timing is crucial when it comes to taking allergy medications. Antihistamines work best when taken before exposure to allergens. If you know you'll be spending time outdoors during allergy season, take your medication 1-2 hours beforehand to maximize its effectiveness (6).

Be aware that taking allergy medications daily might cause them to lose their effectiveness over time due to the body developing tolerance. To avoid this issue, consider rotating different types of antihistamines or taking breaks from using them.

Time to Onset of OTC Allergy Medications

Type

Formula

Time to take effect
AntihistaminesCetirizine20 minutes to 1 hour
Loratadine1 to 3 hours
Fexofenadine1 to 2 hours
DecongestantsPseudoephedrine30 minutes to 1 hour
Phenylephrine15 minutes to 1 hour
Nasal SteroidsFluticasoneWithin a few hours; best results after several days of use
BudesonideWithin a few hours; best results after several days of use
Eye DropsKetotifenWithin minutes

Antihistamines vary in their time to onset, with some providing relief within an hour or less, while others may take longer. Here are some popular antihistamines and their average onset times (8)

  • Cetirizine (Zyrtec): 20 minutes to 1 hour
  • Loratadine (Claritin): 1 to 3 hours
  • Fexofenadine (Allegra): 1 to 2 hours

Decongestants typically provide relief within 30 minutes to an hour after administration. However, some formulas may have a longer onset time (9):

  • Pseudoephedrine (Sudafed): 30 minutes to 1 hour
  • Phenylephrine (Neo-Synephrine): 15 minutes to 1 hour

Nasal steroids generally have a slower onset time compared to antihistamines and decongestants, with most starting to work within a few hours but providing optimal relief after consistent use over several days (10):

  • Fluticasone (Flonase): Within a few hours, but best results after several days of use
  • Budesonide (Rhinocort): Within a few hours, but best results after several days of use

Eye drops with antihistamines or mast cell stabilizers typically provide rapid relief for itchy, watery eyes. Onset times may vary depending on the specific formula (11):

  • Ketotifen (Zaditor): Within minutes

Common Myths Debunked

1. Myth: All OTC allergy medications make you drowsy.

Fact: While some older antihistamines (like diphenhydramine) can cause drowsiness, newer ones (like cetirizine, loratadine, and fexofenadine) are less likely to have this side effect (1).

2. Myth: Allergies are just a minor inconvenience.

Fact: Ignoring allergies can lead to serious health issues like sinus infections, asthma, and even sleep problems (7). Don't underestimate the impact allergies can have on your overall well-being.

How To Get OTC Drugs for Cheap?

Allergies can strike at any time, so it's essential to be prepared with the right medications. One way to save money on OTC allergy drugs is to shop ahead and take advantage of discounts. For example, a 24-tablet bottle of Zyrtec can cost as much as $27.

With MiraRX, you can access discount coupons for generic and branded allergy medications, saving you more than 50% off the retail price. Additionally, consider ordering generic cetirizine on Amazon for only $9.5 for a 300-tablet supply.

FAQ Section: Common Questions about OTC Allergy Medications

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1. Can I take more than one type of allergy medication at a time?

Yes, you can combine different types of allergy medications, such as antihistamines and decongestants, to address multiple symptoms. Consult with a healthcare professional for personalized advice.

2. Are natural remedies effective for allergy relief?

Some natural remedies, like saline nasal rinses and herbal supplements, might provide mild relief for some people. However, their effectiveness varies greatly, and OTC medications are generally more reliable.

3. Can I take allergy medications if I'm pregnant or breastfeeding?

Consult your healthcare provider before taking any medication during pregnancy or while breastfeeding. Some allergy medications may be safe to use, but it's essential to get professional advice tailored to your specific situation.

4. How long can I take OTC allergy medications?

Many OTC allergy medications can be taken daily throughout the allergy season or as needed for symptom relief. However, it's essential to follow the dosing instructions on the product label and consult with a healthcare professional if you're unsure.

5. Can children take OTC allergy medications?

Some OTC allergy medications are suitable for children, but always consult with a healthcare professional and follow the product label recommendations for age-appropriate dosing.

6. Can I develop a tolerance to my allergy medication?

It's possible for your body to develop a tolerance to some allergy medications over time, reducing their effectiveness. To avoid this issue, consider rotating different types of antihistamines or taking breaks from using them.

7. Do I need a prescription for stronger allergy medications if OTC options aren't working?

If OTC allergy medications don't provide sufficient relief, consult a healthcare professional. They may recommend prescription-strength medications or other treatments to manage your symptoms better.

Here are the sources for points 1-7 in the article:

1. Simons FE. Advances in H1-antihistamines. - (https://www.nejm.org/doi/full/10.1056/nejmra033121)

2. Horak F, Zieglmayer P, Zieglmayer R, et al. A placebo-controlled study of the nasal decongestant effect of phenylephrine and pseudoephedrine in the Vienna Challenge Chamber. - (https://www.sciencedirect.com/science/article/pii/S1081120610601081)

3. Meltzer EO, Ratner PH, Bachert C, Carr W, Berger WE, Canonica GW. Clinically relevant effect of a new intranasal therapy (MP29-02) in allergic rhinitis assessed by responder analysis. - (https://www.karger.com/Article/FullText/351404)

4. Abelson MB, Smith L, Chapin M. Ocular allergic disease: mechanisms, disease sub-types, treatment. - (https://pubmed.ncbi.nlm.nih.gov/17075647/)

5. U.S Food and Drug Administration. Generic Drugs: Questions & Answers. -(https://www.fda.gov/drugs/questions-answers/generic-drugs-questions-answers)

6. Williams AN, Woessner KM. Monosensitization to Alternaria in a patient treated with omalizumab - (https://www.sciencedirect.com/science/article/pii/S1081120610601977)

7. Dykewicz MS, Wallace DV, Baroody F, et al. Treatment of seasonal allergic rhinitis: An evidence-based focused 2017 guideline update. - (https://www.sciencedirect.com/science/article/pii/S1081120617307300)

8. Church MK, Maurer M. H1-antihistamines and urticaria: how they work, or not, and why. - (https://pubmed.ncbi.nlm.nih.gov/31850610/)

9. Eccles R. Understanding the symptoms of the common cold and influenza. - (https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(05)70270-X/fulltext)

10. Derendorf H, Meltzer EO. Molecular and clinical pharmacology of intranasal corticosteroids: clinical and therapeutic implications. - (https://pubmed.ncbi.nlm.nih.gov/18803648/)

11. Abelson MB, Smith L, Chapin M. Ocular allergic disease: mechanisms, disease sub-types, treatment. - (https://pubmed.ncbi.nlm.nih.gov/17075647/)

Khang T. Vuong, MHA

Khang T. Vuong received his Master of Healthcare Administration from the Milken Institute School of Public Health at the George Washington University. He was named Forbes Healthcare 2021 30 under 30. Vuong spoke at Stanford Medicine X, HIMSS conference, and served as a Fellow at the Bon Secours Health System.