Key takeaways:
The recommended first-choice allergy medicine for kids is a nondrowsy antihistamine, such as Allegra (fexofenadine) or Claritin (loratadine). If a nondrowsy antihistamine doesn’t manage symptoms, consider switching to a steroid nasal spray, such as Flonase (fluticasone propionate) or Nasacort (triamcinolone). They are more effective but should 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 age 2, always talk to a pediatrician before using medication to treat allergies.
Seasonal and year-round allergies can affect anyone, including kids. They can 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. Here are six important tips to keep in mind.
Keep in mind: The article covers medications that treat symptoms of allergic rhinitis (also called hay fever). It doesn’t review treatments for other types of allergies, such as food allergies.
1. Some allergy medications are preferred over others for children
If your child has two or more allergy symptoms — such as congestion, a runny nose, or watery eyes — you may want to consider giving them allergy medicine. When choosing an allergy medicine for kids, some medications are safer and more effective than 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, depending on the product. Oral options for kids that you can buy over the counter (OTC) include:
Search and compare options
Allegra and Claritin very rarely cause drowsiness. And Xyzal and Zyrtec are less likely to cause drowsiness than older antihistamines, such as Benadryl (diphenhydramine).
These oral antihistamines all come in dosage forms that are safe for kids as young as age 2. There’s also an OTC antihistamine nasal spray option called Astepro (azelastine). But it’s recommended only for kids ages 6 and up.
Any of these antihistamines could be a good first choice, but be sure to read the OTC label of your product carefully. The recommended dosages can differ by age and vary between products.
Good to know: In rare cases, Xyzal and Zyrtec can cause severe itching when you stop taking them. The risk is highest with long-term use. But it’s possible to experience this side effect with less than 1 month of use. So these two antihistamines may not be the best options for your child. Ask your child’s pediatrician what antihistamine they recommend.
Steroid nasal sprays
You may consider switching to a corticosteroid (“steroid”) 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)
Flonase Sensimist (fluticasone furoate)
Nasonex (mometasone)
Nasacort (triamcinolone)
Rhinocort (budesonide)
Flonase Sensimist, Nasonex, and Nasacort are safe for kids as young as age 2. Flonase Allergy Relief is safe for kids as young as 4. And Rhinocort can be given to kids as young as 6.
Steroid nasal sprays are more effective for preventing persistent or severe 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 most kids shouldn’t use them long term, which we discuss next.
2. Ask a pediatrician how long your child should use steroid nasal sprays
Steroid nasal sprays can be safe and effective 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 some evidence that shows steroid nasal sprays may slow down children’s growth rate. Because of this, it’s not recommended to give OTC steroid nasal sprays to kids for 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. They can offer advice and help monitor your child if growth-related 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 and older.
3. Some allergy medications should be avoided in kids
Some OTC allergy medications are not recommended for kids because of possible side effects or a lack of evidence around safety or effectiveness.
Avoid older antihistamines, such as Benadryl, for treating allergies in kids. These medications haven’t been shown to work any better than the newer, less-drowsy antihistamines discussed previously. And they can sometimes 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 not be used to treat allergies in kids. This includes decongestants taken orally, such as Sudafed (pseudoephedrine), and decongestant nasal sprays, such as Afrin (oxymetazoline). There’s limited safety information about the use of these products in children. But if a healthcare professional does recommend a descogestant for your child, be sure to follow the children’s dosage instructions on your product’s label.
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. Kids younger than 2 shouldn’t take allergy medication without a pediatrician’s OK
There are no OTC allergy medicines labeled for children younger than age 2. For a very young child, 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 administer nasal saline to kids of all ages, including infants and children younger than age 2. 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. Medication dose devices are the safest way to give kids liquid allergy medicine
It’s estimated that a child under age 6 receives a wrong dose of medication from a caregiver every 8 minutes. You can help prevent this type of error by using a dose device to measure your child’s liquid medications. Never use household spoons for this purpose. The sizes aren’t standardized, so they may provide too much or too little medication.
Most OTC liquid medications come with a dose device, such as a syringe or a designated measuring cup. Or you can ask your pharmacist to provide one. When given the choice, opt for syringes rather than spoons or cups. All three types are acceptable, but some studies suggest that syringes are the most accurate dose-measuring method.
6. It’s important to know when to check in with a pediatrician about allergies
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:
Your child’s symptoms seem severe.
They have symptoms of an illness, such as a fever or vomiting.
OTC treatments don’t seem to be helping after about 2 weeks of use.
They have allergy symptoms for more than 2 months total per year.
They have a breathing condition, such as asthma.
Ask a healthcare professional before combining two or more OTC allergy medicines for kids. They may want to examine your child for other possible causes or recommend a different treatment approach.
Frequently asked questions
There’s no single allergy medicine that’s best for all kids. Nondrowsy or less-drowsy antihistamines are a good first option. These medications work well for allergy symptoms with a low risk of side effects. And steroid nasal sprays can be a safe and effective choice for persistent allergy symptoms. Just keep in mind these nasal sprays shouldn’t be used for more than 2 months total in a 12-month period without a pediatrician’s OK.
OTC antihistamine syrups, such as Claritin, can be an option for children’s itching. These syrup medications can be safely given to children as young as age 2. They can also be helpful for older children who have trouble swallowing pills.
But be aware that syrup forms of Xyzal and Zyrtec, like other forms, carry a risk of causing severe itching when you stop taking them. This side effect is rare, but these antihistamines still might not be the best choice for managing itching. Ask your child’s pediatrician what medication they recommend for your child’s symptoms.
The best way to manage kids’ allergies is to avoid allergens (substances that cause allergies) whenever possible. But if you can’t avoid them, antihistamines, steroid nasal sprays, and saline nasal sprays are good options for relieving symptoms.
If your child’s at risk for life-threatening allergic reactions (anaphylaxis) from things like medication or food, work with their prescriber to develop an allergy action plan. This document includes information about how and when to use life-saving treatments like epinephrine (EpiPen, Auvi-Q, neffy).
There’s no single allergy medicine that’s best for all kids. Nondrowsy or less-drowsy antihistamines are a good first option. These medications work well for allergy symptoms with a low risk of side effects. And steroid nasal sprays can be a safe and effective choice for persistent allergy symptoms. Just keep in mind these nasal sprays shouldn’t be used for more than 2 months total in a 12-month period without a pediatrician’s OK.
OTC antihistamine syrups, such as Claritin, can be an option for children’s itching. These syrup medications can be safely given to children as young as age 2. They can also be helpful for older children who have trouble swallowing pills.
But be aware that syrup forms of Xyzal and Zyrtec, like other forms, carry a risk of causing severe itching when you stop taking them. This side effect is rare, but these antihistamines still might not be the best choice for managing itching. Ask your child’s pediatrician what medication they recommend for your child’s symptoms.
The best way to manage kids’ allergies is to avoid allergens (substances that cause allergies) whenever possible. But if you can’t avoid them, antihistamines, steroid nasal sprays, and saline nasal sprays are good options for relieving symptoms.
If your child’s at risk for life-threatening allergic reactions (anaphylaxis) from things like medication or food, work with their prescriber to develop an allergy action plan. This document includes information about how and when to use life-saving treatments like epinephrine (EpiPen, Auvi-Q, neffy).
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 an antihistamine doesn’t work well enough, consider switching to an OTC steroid nasal spray, such as Flonase (fluticasone propionate). These medications are more effective but should be used for only 2 months total per year because they may have growth-related 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
Asthma and Allergy Foundation of America. (2025). Anaphylaxis action plan.
Carroll, A. R., et al. (2024). Health literacy-informed communication to reduce discharge medication errors in hospitalized children. JAMA Network Open.
CVS Pharmacy. (2026). 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.
L. Perrigo Company. (2024). Children’s Nasonex - mometasone furoate spray, metered [package insert]. DailyMed.
Rance, K., et al. (2025). Diagnosis and management of pediatric allergic rhinoconjunctivitis in the US. Journal of Pediatric Health Care.
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., et al. (2023). Diagnosis and management of allergic rhinitis in asthmatic children. Journal of Asthma and Allergy.
