The information provided here is meant to give you a general idea about each of the medications listed below. Only the most common side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.
There are many types of medications—both over the counter and prescription—that can be used to treat symptoms of allergic rhinitis, and each class of medications works differently in the body.
However, once a definite diagnosis of allergic rhinitis is made, the first-line treatment of choice is nasal corticosteroid spray, as it is has been shown to be the most effective with the fewest side effects. Ask your doctor which medications may offer the best prevention against allergic rhinitis symptoms.
Antihistamines Diphenhydramine (Benadryl)Fexofenadine (Allegra)Loratadine, prescription strength (Claritin)Cetirizine hydrochloride (Zyrtec)Chlorpheniramine (Chlor-Trimeton)Brompheniramine (Dimetane)Dexbrompheniramine and pseudoephedrine (Drixoral)Clemastine (Tavist)Chlorpheniramine and pseudoephedrine (Triaminic Cold and Allergy)
Oral Decongestants Loratadine and pseudoephedrine (Claritin-D)Pseudoephedrine (Sudafed)Triprolidine and pseudoephedrine (Actifed Allergy Daytime)Naphazoline (Allerest)
Nasal Decongestants Oxymetazoline (Afrin)Phenylephrine (Neo-Synephrine)
Saline Nasal Spray Salinex
Common names include: Desloratadine
Antihistamines block or reduce the action of histamine, a chemical that is released when the immune system reacts to an allergen. The release of histamine leads to the symptoms of allergic rhinitis.
Possible side effects include: DrowsinessLightheadednessBlurry visionChange in ability to think clearlyDry mouth, nose, or throatGastrointestinal upset, stomach pain, or nauseaIncreased appetite and weight gainThickening of mucus
Increased effects in people with
due to slower removal from the body
Nasal antihistamine sprays are also available, such as
Common names include: Fexofenadine and pseudoephedrine (Allegra-D)Acrivastine and pseudoephedrine (Semprex-D)Azatadine and pseudoephedrine (Trinalin)
Decongestants help to narrow the blood vessels, which results in a clearing of nasal congestion. Antihistamines help stop or reduce the production of histamine, a chemical that is released when the immune system reacts to an allergen.
Possible side effects of the oral decongestant/antihistamine combinations include: DrowsinessCoughIncrease in blood pressureHeadacheNervousness, difficulty sleepingNauseaRapid heart rate
Common names include: Beclomethasone
Nasal corticosteroids are sprayed or inhaled into the nose to help relieve the stuffy nose and discomfort of allergies.
Possible side effects include: Burning, dryness, or other irritation inside the nose (mild, lasting only a short time)Increase in sneezingIrritation of the throat
Common name: Cromolyn sodium (Intal)
Cromolyn is unique in that it is preventative. It changes the body's immunological response to allergens. It is most effective when used before coming into contact with substances that cause allergies or before allergy season. Cromolyn may be used alone or with other medications.
Possible side effects include: Burning, stinging, or irritation inside of noseFlushingIncrease in sneezing
This medication is also used to prevent allergy symptoms. It works by decreasing how many leukotrienes (chemicals) the body creates in response to an allergen.
Possible side effects include: Flu-like symptomsNervousnessHeadache and stomach acheNausea and vomitingNasal congestion
The US Food and Drug Administration (FDA) recommends that this medicine have a label that warns that there may be a link between taking this medicine and having suicidal thoughts. Talk to your doctor if you have any suicidal thoughts. If you are taking Singulair, do not stop right way. Talk to your doctor first.
The following medications are available without a prescription. Many of these are older or first-generation antihistamines. First-generation antihistamines can cause drowsiness. However, both loratadine and cetirizine are nonsedating second-generation antihistamines. Diphenhydramine
(Benadryl)Chlorpheniramine (Chlor-Trimeton)Brompheniramine (Dimetane)Dexbrompheniramine and pseudoephedrine
(Tavist)Chlorpheniramine and phenylpropanolamine (Triaminic Allergy)
Several second-generation antihistamines are also available over the counter. Second-generation antihistamines are nonsedating. Loratadine
Antihistamines help reduce or block the action of histamine, a chemical that is released when the immune system reacts to an allergen. The release of histamine leads to the symptoms of allergic rhinitis.
Possible side effects include: Drowsiness
(Claritin, Zyrtec, and Allegra are nonsedating.)Slowed reaction timeDry mouth
Common names include: Pseudoephedrine-containing products (such as, Sudafed, Actifed, Drixoral)
Decongestants help to narrow the blood vessels, which results in a clearing of nasal congestion. One possible side effect is an increase in blood pressure.
Common names include: AfrinNeo-Synephrine
Nasal sprays help relieve the stuffy nose and discomfort of allergies.
Possible side effects include: Burning, stinging, or irritation inside of noseFlushingIncrease in sneezingRebound (increased nasal congestion) if nasal decongestant sprays are used for more than three days
is a nasal spray that contains a saltwater solution to rinse your nose and help relieve mild congestion, loosen mucus, and prevent crusting. Though it can be useful for relieving symptoms of a stuffy nose and has no side effects, saline cannot prevent allergy symptoms from occurring, as some other allergy treatments can.
Whenever you are taking a prescription medication, take the following precautions: Take them as directed—not more, not less, not at a different time.Do not stop taking them without consulting your doctor.Do not share them with anyone else.Know what effects and side effects to expect, and report them to your doctor.If you are taking more than one drug, even if it is over the counter, be sure to check with a physician or pharmacist about drug interactions.Plan ahead for refills so you do not run out.
Advice from your allergist: rhinitis. American College of Allergy, Asthma, & Immunology
website. Available at:
http://www.acaai.org/public/advice/rhin.htm. Accessed September 15, 2008.
Leukotriene inhibitors: montelukast (marketed as Singulair), zafirlukast (marketed as Accolate), and zileuton (marketed as Zyflo and Zyflo CR).
US Food and Drug Administration website. Available at:
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm166246.htm. Updated August 2009. Accessed August 8, 2011.
Levocetirizine. EBSCO Health Library website. Available at:
http://www.ebscohost.com/healthLibrary. Updated December 2009. Accessed February 10, 2010.
Montelukast. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed/what.php. Updated August 2008. Accessed September 15, 2008.
United States Pharmacopeial Convention.
USP DI. 21st ed. Englewood, CO: Micromedex; 2001.
5/6/2010 DynaMed's Systematic Literature Surveillance.
http://www.ebscohost.com/dynamed/what.php. Segall N, Gawchik S, et al. Efficacy and safety of levocetirizine in improving symptoms and health-related quality of life in US adults with seasonal allergic rhinitis: a randomized, placebo-controlled study.
Ann Allergy Asthma Immunol.
Last reviewed September 2014 by Marcin Chwistek, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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