What to Use for Allergies: OTC and Prescription Products

Different Types of Allergies

Allergies are caused by an over-reactive immune system to substances that are typically harmless, like cat hair or grass pollen. Your body mistakenly perceives these substances as threats, triggering allergic reactions. They are a wide array of allergies, each with distinct causes and associated symptoms or responses.

• Airborne Allergies
  These include allergies to pollen, pet dander, and dust mites. These allergens travel through the air and typically manifest as itchy, congested eyes, and a runny nose.
• Food Allergies
  Food allergies usually manifest after ingesting the allergenic food, but severe reactions can occur even through contact with the mouth. Reactions can range from mild skin rashes to life-threatening conditions like anaphylaxis.
• Chemical Allergies
  This category encompasses a broad range of allergies, including reactions to medications, bee Food Allergies stings, and latex. Reactions can span from mild skin rashes to severe anaphylactic responses.

Allergy Treatment

Given the diversity and severity of allergies, there is a wide range of available treatments, including:

Decongestants (Available Behind the Counter and by Prescription)

• Decongestants are medications designed to alleviate nasal symptoms by reducing nasal swelling, thereby opening airways for easier breathing.
• They come in nasal spray and oral forms, and should be only used for for a maximum of three days as they can result in worse congestion when used long-term.
• Decongestants are typically available “behind the counter”, which means they do not require a prescription, but you need to speak with someone before purchasing. In some cases, a higher-strength version may be available by prescription.

Corticosteroids (Available Over-the-Counter and by Prescription)

• Corticosteroids work by diminishing itching and inflammation and are available in various formats, including skin creams/ointments, nasal sprays, and eye drops.
• Over-the-counter corticosteroid creams/ointments usually have a strength of 1% or less. For uncontrolled skin allergies, stronger topical corticosteroids may be prescribed.
• Corticosteroid nasal sprays are accessible both over-the-counter and by prescription, generally with similar efficacy and side effects. Cost and personal preference may vary between the two.
• Corticosteroid eye drops are only available by prescription.

Antihistamines (Available Over-the-Counter and by Prescription)

• Antihistamines are medications used to block histamine release, a significant contributor to allergic reactions, providing relief from symptoms like itchy eyes, mild rashes, and runny nose.
• Older-generation antihistamines like Benadryl may induce drowsiness, aiding in sleep.
• Over-the-counter antihistamines typically have lower concentrations and milder effects and side effects than prescription options.

Mast Cell Stabilizers (Prescription Only)

• Mast cell stabilizers prevent the release of histamine into the body, relieving symptoms such as itchy eyes and runny nose.
• These medications are available in both eye drop and nasal spray forms, requiring a prescription.

Epinephrine (Prescription Only)

• Epinephrine is crucial for individuals with a history of anaphylaxis. It functions by constricting blood vessels, raising blood pressure, and reducing anaphylactic swelling.
• Portable devices known as "EpiPens" contain epinephrine and should be carried at all times, especially in situations where allergen exposure is possible.

Immunotherapy (Prescription Only)

• Immunotherapy is an option for select individuals to decrease the severity of allergic reactions by gradually introducing small amounts of the allergen over time.
• Immunotherapy is an option for select individuals to decrease the severity of allergic reactions by gradually introducing small amounts of the allergen over time.

When Do You Need Prescription Medication?

Certain situations necessitate prescription allergy medications. For instance, if you have a history of anaphylaxis, you must have an epinephrine pen, which is exclusively available by prescription. The same applies to mast cell stabilizers and immunotherapy. However, there are instances when medications are available both with and without a prescription. To determine when a prescription is required for these products, consider efficacy and concentration.

• Many over-the-counter (including behind-the-counter) medications are formulated with concentrations that balance safety and effectiveness.
• Some individuals may find that these lower-concentration medications do not sufficiently relieve their symptoms.
• In such cases, consulting a healthcare provider to explore the possibility of obtaining a higher-strength medication through a prescription may be necessary.
• This approach ensures the increased concentration is safe for your use, and it allows your healthcare provider to monitor you for potential safety concerns during treatment.