6 Things Parents Should Know About Allergy Medicine for Kids
Key takeaways:
The recommended first-choice allergy medicine for kids is a nondrowsy antihistamine, like Allegra (fexofenadine) or Claritin (loratadine). If a nondrowsy antihistamine doesn’t control symptoms, consider switching to a steroid nasal spray, like Flonase (fluticasone propionate) or Nasacort (triamcinolone). They are more effective but can be used for only a short time.
Avoid giving children decongestants, such as Sudafed (pseudoephedrine), or older antihistamines, such as Benadryl (diphenhydramine). They tend to cause bothersome side effects, and there isn’t a lot of evidence that they work well for allergies in kids.
Pay attention to the age ranges listed on medication packages. For children younger than 2 years old, always talk to a pediatrician before giving medication to treat allergies.
Table of contents
Allergies can affect anyone, including kids. They could cause sneezing, itchy eyes, or a runny nose, so it’s natural to want to help your kids feel better. But before heading to the pharmacy, there are things that all parents should know about choosing an allergy medicine for their kids.
1. Some allergy medications are preferred over others for children
Consider starting an allergy medication if your child has two or more allergy symptoms, such as congestion, a runny nose, or watery eyes. When choosing an allergy medicine for kids, experts recommend some medications over others. Here are the ones you should try first and why.
Nondrowsy or less drowsy antihistamines
Try treating allergies with a nondrowsy or less drowsy antihistamine first. These medications are generally well tolerated and start working in 1 to 3 hours. Oral options for kids that you can buy over the counter (OTC) include:
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These oral antihistamines all have dosage forms that are safe for kids as young as 2 years old. There’s also an OTC antihistamine nasal spray called Astepro (azelastine). But it’s recommended only for kids ages 6 and up.
Any of these antihistamines can be a good first choice, but be sure to read the OTC label of your product carefully. The doses will be different based on your child’s age and can vary between products.
Steroid nasal sprays
You may consider switching to a steroid (corticosteroid) nasal spray if a nondrowsy or less drowsy antihistamine doesn’t relieve your child’s allergy symptoms. Ones that you can buy OTC include:
Flonase Allergy Relief (fluticasone propionate): safe for kids as young as 4 years old
Flonase Sensimist (fluticasone furoate): safe for kids as young as 2 years old
Nasonex (mometasone): safe for kids as young as 2 years old
Nasacort (triamcinolone): safe for kids as young as 2 years old
Rhinocort (budesonide): safe for kids as young as 6 years old
Steroid nasal sprays are more effective for preventing allergy symptoms than antihistamines. But they also come with some disadvantages. It may take up to 2 weeks until they reach their maximum effect. And kids shouldn’t use them long term (more on that next).
Allergy knowledge: Knowing how allergies affect kids can help you get a head start on treating symptoms. Here, you’ll find everything you need to know about allergies in kids.
Early symptoms: Infants can have allergies too, although they’re more common in older children. Here’s how you can tell if your baby might be more likely to develop allergies.
Tips for success: It’s common for children to have both allergies and asthma. One mom shares her tips for managing her children’s conditions.
2. Check with a pediatrician about how long your child should use steroid nasal sprays
Steroid nasal sprays can be safe and powerful tools for treating children’s allergies. But it’s recommended to use them only for a short time without a pediatrician’s OK.
There’s conflicting evidence that nasal steroid sprays may slow down children’s growth rate. Because of this, it’s recommended to limit OTC nasal steroid sprays in kids to no longer than 2 months total in a 12-month period.
Check with a pediatrician about how long your child can safely use a steroid nasal spray, especially if your child has frequent allergy symptoms throughout the year. A pediatrician can offer advice and help monitor your child if growth side effects are a concern.
Good to know: If you’re concerned about steroid side effects, consider using steroid-free Astepro. This OTC antihistamine nasal spray is safe for kids ages 6 years and older.
3. Some allergy medications should be avoided in kids
Some OTC allergy medicines for kids cause troublesome side effects or don’t have good evidence that they’re safe or effective for kids with allergies.
Avoid older antihistamines, like Benadryl (diphenhydramine), for treating allergies in kids. There’s no good evidence that these work any better than the newer, less-drowsy antihistamines discussed previously. And they can cause unusual behavior in children. Some kids become agitated or hyperactive instead of drowsy after taking them.
Unless recommended by a pediatrician, nasal decongestants should also be avoided for treating allergies in kids. This includes oral decongestants, like Sudafed (pseudoephedrine), and decongestant nasal sprays, like Afrin (oxymetazoline). There’s limited safety information about the use of these products in children.
Good to know: Pediatricians will sometimes recommend giving children Benadryl for mild allergic reactions, such as hives or rashes. This is different from giving this medication for seasonal allergy symptoms.
4. Ask a pediatrician before giving any allergy medication to children under 2 years old
There are no OTC allergy medicines labeled for children younger than 2 years old. For very young children, you should talk to a pediatrician about safe treatment options. They can evaluate your child and determine if a prescription allergy medication is right for them.
But there’s a medication-free option for even the smallest noses. You can use nasal saline for kids of all ages, including infants and children younger than 2 years old. It’s available OTC as drops or a gentle nasal spray, and it can be used as often as needed. For some children, nasal saline may reduce the need for other medications.
5. Use medication dose devices to give liquid allergy medications to your child
In the U.S., a child receives a wrong dose of medication from a caregiver every 8 minutes. You can help prevent these errors by using a dose device to measure your child’s liquid medications. Never use household spoons for this purpose. They’re not standardized and may provide too much or too little medication.
Most OTC liquid medications come with a dose device, such as a syringe or a cup. If not, ask your pharmacist to provide one. When given the choice, opt for syringes rather than spoons or cups. All three are acceptable, but some studies show that syringes are the most accurate dose-measuring method.
6. Know when it’s time to check in with a pediatrician
If your child has occasional mild to moderate allergy symptoms, you can usually treat them at home with an age-appropriate OTC allergy medication. But it’s important to know when to check in with a healthcare professional for guidance.
Call your child’s pediatrician if:
Symptoms seem severe
There are symptoms of an illness, such as a fever or vomiting
OTC treatments don’t seem to be helping after using them for about 2 weeks
Allergy symptoms last longer than 2 months total per year
Your child has a breathing condition, like asthma
Ask a healthcare professional before combining two or more OTC allergy medicines for kids. There could be another cause for their symptoms or a different treatment they’d recommend.
The bottom line
If your child has allergies, the recommended first-choice medication is an over-the-counter (OTC) nondrowsy or less drowsy antihistamine. Top examples include Zyrtec (cetirizine), Allegra (fexofenadine), and Claritin (loratadine).
If these antihistamines don’t work well enough, consider switching to an OTC steroid nasal spray, such as Flonase (fluticasone propionate). They’re more effective but should be used for only 2 months total per year because they may have growth side effects.
Avoid giving children decongestants, such as Sudafed (pseudoephedrine), or older antihistamines, such as Benadryl (diphenhydramine). These medications can cause bothersome side effects or have limited evidence to support their use for allergies in children.
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References
AmerisourceBergen. (2023). Budesonide spray, metered [package insert]. DailyMed.
Daley-Yates, P. T., et al. (2021). Intranasal corticosteroids: Topical potency, systemic activity and therapeutic index. Journal of Asthma and Allergy.
Euforea. (2021). Pocket guide: Allergic rhinitis in children.
L. Perrigo Company. (2023). Children’s Nasonex- mometasone furoate spray [package insert]. DailyMed.
Saaka, Y., et al. (2022). Assessment of the availability and accuracy of dosing devices packaged with oral liquid medications in the Ho municipality of Ghana. Scientifica.
Scadding, G. K., et al. (2021). Allergic rhinitis in childhood and the new EUFOREA algorithm. Frontiers in Allergy.
Tenero, L. (2023). Diagnosis and management of allergic rhinitis in asthmatic children. Journal of Asthma and Allergy.
