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It’s Allergy Season

by The GoodRx Pharmacist on April 10, 2013 at 2:53 pm

It’s that time of the year again—the sun is shining, the temperature is rising (a little later than usual) and the smell of spring is in the air. But with spring comes allergy season and all the sneezing, congestion, and runny noses associated with it. Here are your GoodRx pharmacist’s tips on how to cope during allergy season!

 What to watch for:

Allergic symptoms occur when you’re exposed to an allergen (basically, anything you’re allergic to—commonly, but not limited to dust mites, dander, mold, and pollen), causing an immune response in the body. Symptoms most commonly include:

  • Runny and itchy nose
  • Nasal congestion
  • Watery and itchy eyes
  • Sneezing
  • Rash

Severe allergies can also lead to asthma and sinus and nasal obstruction. In many cases it’s difficult to determine the exact cause of your allergies, but avoiding common allergens and irritants like pollen, pet dander, and cigarette smoke can help.

Over-the-counter (OTC) treatment options:

First-generation antihistamines such as Benadryl (diphenhydramine) and Actifed (chlorpeniramine) work for symptoms like runny nose, sneezing, and itchiness. They work fast but can have more side effects—most commonly increased drowsiness, fatigue, confusion, and dry mouth. They should be avoided if you’re a nursing mother or elderly, and should be only used in young children (less then 4 years of age) with advice from a healthcare provider. They can also interact with some of your other medications, so ask your pharmacist if you have any concerns.

Second-generation antihistamines such as Zyrtec (cetirizine), Claritin (loratadine) and Allegra (fexofenadine) work similarly and have fewer side effects. They don’t work as quickly as the first-generation antihistamines, but they’re better for persistent allergies. They’re also better for use with younger children. However, unlike Benadryl, they aren’t effective against local rashes or itchiness. It should be noted that Zyrtec still causes some drowsiness and works more quickly, similar to first-generation antihistamines.

Decongestants like Sudafed (pseudoephedrine) and Sudafed PE (phenylephrine) treat nasal and sinus congestion. They’re also available in combination with antihistamines for your convenience (Claritin-D, Zyrtec-D, Allegra-D). Decongestants can cause nasal dryness, headache, dizziness, and insomnia. They should be avoided by anyone with cardiovascular disease, hyperthyroidism, or glaucoma as they can increase blood pressure and heart rate. Talk to your pharmacist if you have any of these conditions before taking a decongestant. Finally, remember to take your ID with you; purchases are federally tracked and regulated and decongestants are only available from behind the pharmacy counter in most states.

Decongestants you inhale, such as Afrin (oxymetazoline) and Vicks Vapor Inhaler, should only be used for 3 to 5 days; any longer can cause rebound congestion. However, they are safe to use if you have cardiovascular disease.

If you have mostly eye-related symptoms (itching, irritation, burning, or redness), OTC antihistamine drops like Zaditor (ketotifen) can be helpful. Patanol (olopatadine) is another antihistamine eye drop, but it does require a prescription.
Other treatment options include nasal irrigation systems such as the Neti Pot or normal saline (0.9%) to help with nasal congestion. Normal saline sprays are safe for infants.

Prescription treatment options:

So what should you do if you’ve tried all of the over-the-counter meds and your allergy symptoms won’t budge? Visit your healthcare provider and discuss your prescription allergy treatment options.

Some newer antihistamines are available by prescription only, such as Xyzal (levocetirizine) and Clarinex (desloratadine), and may be more effective for you than the OTC choices. Prescription antihistamines are also available as nasal sprays like Astelin (azelastine) and Pataday (olopatadine).

Corticosteroid nasal sprays—Flonase (fluticasone), Nasonex (mometasone), and Rhinocort Aqua (budesonide), amongst others—work as anti-inflammatories against nasal congestion and draining. Other drugs like Singulair (montelukast) are also recommended for persistent allergy symptoms.

Cost-saving tips:

Whichever allergy med is right for you, there are a few ways you can keep your costs low—especially important if you’re taking something daily for persistent symptoms.

  • Try over-the-counter meds first. Ask your pharmacist for advice on the best option for you.
  • Use store brand or generic versions. They contain the same ingredients and same dose at a much lower price.
  • If you have insurance, check to see if your OTC allergy drugs are covered. You’ll need a prescription if you go this route, but you can compare your copay to the cash price to see if you can get the same medications for less.
  • Prescriptions are exempt from sales tax in some states, so even if your insurance won’t cover your allergy med it may still be cheaper as a prescription.
  • Check if your prescription is available as a generic. Corticosteroid nasal sprays Nasonex, Rhinocort, Qnasl, and Omnaris are all brand-only products, with higher copays and cash prices. Antihistamine nasal sprays Astepro and Patanase are also brand-name only. If your doctor is considering any of these, ask to try a cheaper option first.
  • If a brand-name drug is the best option for you, look for a manufacturer coupon, discount card, or patient assistance if you’re eligible.

The GoodRx Pharmacist

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