Red, Itchy Eyes: Which Allergy Medications Can Help

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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‘Tis the season for allergy eyes, so what medications really work?

Allergic conjunctivitis is the name for the red itchy eyes you get from allergies. It’s an annoying problem that brings people to the doctor, with at least 20 percent of people affected at some point during the year. You need to know what medications work for red itchy eyes.

First, here are some weird facts. Allergic conjunctivitis is a disease of young adults, with an average age of onset of 20 years of age. Symptoms, for some reason, tend to decrease with age. Half of patients have a personal or family history of other allergic symptoms.

What you feel is itching, tearing, red and puffy lids, watery discharge, burning, and light may bother your eyes. It’s usually in both eyes but sometimes one will bug you more than the other.

Before you decide on a treatment you will want your doctor to make sure your red eye is NOT infectious “pink eye,” dry eye, or blepharitis. If your eyes itch, that’s a strong sign it is allergic and not infection. Also, start with some basic “treatment” before you get your prescription medications: don’t rub your eyes as that will cause worsening of symptoms, you can use artificial tears to help dilute and remove allergens, and cool compresses help too.

Ok, you did that, but you are still suffering. So, some medications for red, itchy eyes that really work:

The prescription eye drops that are your best choice are eye drops with both antihistamine and mast cell stabilizing properties. Olopatadine (only available as brand names Pataday and Patanol) was the first drug in this class to be approved.

Other popular brands in this class that work well for red itchy eyes include Optivar (available as generic azelastine), Alocril (nedocromil),and Alamast (pemirolast potassium). The only generic in this class also available over the counter is ketotifen fumarate (known as Claritin Eye, Itchy Eye, Alaway, or Zaditor).

Over-the-counter choices that don’t work as well are naphazoline/pheniramine maleate (available as Naphcon-A, Opcon-A, and Visine-A). These products are intended for short-term use only!

If you hate eye drops you can also try over-the-counter or prescription antihistamines, but eye drops are faster-acting and less likely to cause systemic side effects, so are usually preferred. Fexofenadine (generic for Allegra), loratadine (generic for Claritin), desloratadine (Clarinex), cetirizine (Zyrtec), and levocetirizine (Xyzal) are examples.

Dr. O.

Prescription brand name medications with no generic equivalent, like Xyzal, Clarinex, Optivar, Alocril, and Alamast, will likely be considered Tier 2 or 3 medications by insurance companies, meaning you will have a moderate to high co-pay. Many of these medications can cost $100 per month or per bottle of drops. Generic versions are more likely to be covered under your lowest co-pay as Tier 1 medications, and range from about $20 – $80 per month or per bottle. The over-the-counter eye drops tend to range in price from $5 – $15 per bottle.

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