What if the Over the Counter Medications Aren’t Enough to Treat My Symptoms?

In the past couple weeks, we have discussed seasonal allergies and Over the Counter medications that you can take to treat them. But, what if these aren’t enough to treat your symptoms?

Well, there is a bit of good news for you, because there are still more options. There are inhalers, nasal sprays and prescription medications that you can ask your doctor about, depending on your symptoms.

If you are experiencing a lot of nasal congestion and runny nose, you can ask your Four Corners pharmacist about pseudoephedrine, a decongestant. It comes alone and in combination with the second generation antihistamines that we talked about last week. It is dosed 60 mg every 4 to 6 hours or 120 mg twice per day for the extended release 12-hour formulation. The maximum amount you can take in one day is 240 mg. If you have high blood pressure or other cardiac conditions, you’ll want to talk to your doctor before taking this.

Another OTC medication that you can buy for your nasal congestion is Flonase, or generically fluticasone. Fluticasone is an intranasal steroid. This is a nasal spray that you can use 2 sprays daily in each nostril to alleviate your congestion. Before using this, you’ll want to blow your nose to clear out your sinuses. Also, make sure you wipe the tip of the nasal spray after each use. It may take up to a week of using this to see maximal benefits.

A more short-term nasal spray is Afrin, or oxymetazoline. This will work in a different way than Flonase to relieve your nasal congestion. However, you cannot use this for more than 3 days in a row. Doing so will lead to something caused rebound congestion, which means the spray will cause congestion, instead of helping it. These are just two of the nasal options that are available.  For more information, feel free to stop in and ask your Pharmacist for help!

If you are having trouble breathing, there are a couple options that you will have to get a prescription from your doctor for. The first is Singulair, or montelukast. This is usually dosed 10 mg in the evening. It works to open your airways, by making the muscles relax. The most common adverse effect of this medication is headache. This is a medication that you should take daily during the allergy season.

Other medications you can use are Ventolin or Proair, which are both albuterol inhalers. These are rescue inhalers that you should only use when it is hard to breathe, or you can’t stop coughing. This medication works in a different way to relax the airway muscles.  Both are prescription only medications that you will need to talk to your doctor before getting a prescription. They are also commonly used for treating Asthma.

As always, if you have any questions, please feel free to call or stop in and ask your neighborhood Pharmacist at Four Corners Pharmacy!

References

Seidman MD, Gurgel RK and Lin SY. Clinical Practice Guideline: Allergic Rhinitis. Otolaryngology- Head and Neck Surgery. 2015; 152(1S): S1-S43.

Micromedex. In: In Depth Answers [database on the Internet]. Greenwood Village (CO): Truven Health Analytics; 2018 [cited 2018 Jun 7]. Available from: http://www.micromedexsolutions.com. Subscription required to view.

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Finding the right medication is key to getting through allergy season

In last week’s blog we talked about how to determine if you have seasonal allergies, also known as allergic rhinitis. This week we are going to talk about some oral Over the Counter (OTC) medications you can use to treat your allergies.

The main class of medications used to treat seasonal allergies is called oral second-generation antihistamines. Some examples of these are Zyrtec (cetirizine), Allegra (fexofenadine), Claritin or Alavert (loratadine), and a newly OTC item Xyzal (levocetirizine). All of these second-generation antihistamines are non-drowsy, so they won’t affect your ability to get around during the day.

These will treat your runny/itchy nose, sneezing, watery/itchy eyes and some nasal congestion. If you are experiencing a lot of congestion, some of these drugs come combined with pseudoephedrine, a decongestant. These will treat your more severe nasal congestion.

The brand names of these drugs are Allegra-D, Zyrtec-D and Claritin-D. These drugs are mostly dosed once daily (see chart below) and are rapid acting. For best results, use daily during the allergy season. If you try one drug and it isn’t working for you, you can try another one of these medications, because some people respond differently to each of these.

Check back next week for more info on prescription medications, nasal medications and inhalers to treat some of your more severe allergic symptoms! Thanks for reading and as always, stop in to Four Corners Pharmacy and ask your pharmacist if you have any questions!

Second Generation Antihistamines

Drug Name

Dose

(based on age)

Is it available as a Generic drug?

Common Side Effects

Approved Ages

Cetirizine (Zyrtec)

2-5 y/o: 2.5 mg 1-2/day

6-12 y/o: 5-10 mg/day

12-65 y/o: 10 mg/day

66-76 y/o: 5-10 mg/day

≥77 y/o: 5 mg/day

Yes

Occasional sedation, mucosal dryness, urinary retention

≥6 months old

Levocetirizine

(Xyzal)

2-5 y/o: 1.25 mg/day

6-11 y/o: 2.5 mg/day

≥12 y/o: 2.5-5 mg/day

No

Occasional sedation, mucosal dryness, urinary retention

≥6 months old

Fexofenadine

(Allegra)

2-11 y/o: 30 mg twice/day

≥12 y/o: 60 mg twice/day

              OR 180 mg/day

Yes

Occasional headache

≥2 years old

Loratadine

(Claritin)

2-5 y/o: 5 mg/day

≥6 y/o: 10 mg/day

Yes

Possible sedation at high doses

≥2 years old

References

Seidman MD, Gurgel RK and Lin SY. Clinical Practice Guideline: Allergic Rhinitis. Otolaryngology- Head and Neck Surgery. 2015; 152(1S): S1-S43.