Key takeaways:
Preferred allergy medications for older adults are corticosteroid (steroid) nasal sprays, such as Flonase Allergy Relief (fluticasone propionate), and antihistamine nasal sprays, such as Astepro (azelastine). Non-drowsy oral antihistamines, such as Claritin (loratadine), are also safe options.
NasalCrom (cromolyn) nasal spray and antihistamine eye drops, such as Zaditor (ketotifen) are also safe for older adults. But they may be less effective for managing allergies.
Older adults should avoid antihistamines that cause drowsiness, such as Benadryl (diphenhydramine), and oral decongestants, such as Sudafed (pseudoephedrine). These come with a risk of serious side effects, such as a higher risk of falls or high blood pressure.
There are ways to save on your allergy medications. Many options are available as lower-cost generics. And if a healthcare professional writes you a prescription for over-the-counter allergy treatments, GoodRx can help make your medication more affordable.
Save on related medications
There are some medications that older adults should avoid due to their risk of side effects. This includes some of the most well-known allergy medications. But that doesn’t mean you have to avoid all allergy medications if you’re over the age of 65. There are plenty of treatment options that are still safe and effective for older adults with seasonal allergies.
6 of the best allergy medicines for seniors
There isn’t just one best allergy medicine for older adults. You have a choice between lots of safe, effective options. Let’s take a look at safe over-the-counter (OTC) allergy treatment options.
| Medication type | Medication names |
|---|---|
| Steroid nasal sprays |
|
| Antihistamine nasal spray |
|
| Oral antihistamines (second- and third-generation) | |
| Mast cell stabilizer |
|
| Antihistamine eye drops |
|
| Decongestant nasal sprays (for 3 days or less) |
|
*Brand name no longer available
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1. Steroid nasal sprays
Corticosteroid (steroid) nasal sprays are a first-choice option for treating allergies and are safe for older adults. They’re the most effective option for treating multiple allergy symptoms, including eye symptoms. But you’ll need to use them daily, and it may take up to 2 weeks to see their full effects. So if you know when your allergies tend to start, you should begin using a steroid nasal spray about 2 weeks before to help prevent symptoms.
OTC steroid nasal sprays include:
Flonase Allergy Relief
Flonase Senismist — a finer, gentler spray than regular Flonase Allergy Relief
Nasonex 24HR Allergy
Nasacort Allergy 24HR
Rhinocort Allergy — brand name no longer available
How to save on steroid nasal sprays
There are ways to save on steroid nasal sprays, which are available as brand-name and generic medications. If a healthcare professional writes you a prescription for an OTC steroid nasal spray, you can use GoodRx to help you save on it.
Below is a list of how much you may save at certain pharmacies by using a free GoodRx coupon on your steroid nasal spray:
2. Astepro nasal spray
Astepro (azelastine) is the only antihistamine nasal spray available OTC, and it can be a first-choice option for treating allergies. It works fast — within 15 to 30 minutes — and is safe for older adults. It treats multiple allergy symptoms and may work better than oral antihistamines, especially for treating congestion.
It’s unclear how Astepro compares to steroid nasal sprays. Some studies show they’re similarly effective, while others suggest Astepro works better.
Good to know: Astepro can cause drowsiness for some people who use it. Make sure you use it when you don’t have to drive or perform tasks that require attention until you know how it makes you feel.
How to save on Astepro
Astepro is available as a brand-name and generic medication. If a healthcare professional writes you a prescription for it, GoodRx can help you save up to 80% off the generic version. With GoodRx, you may pay as low as $13.61 per bottle for generic azelastine.
3. Non-drowsy or less-drowsy oral antihistamines
Newer, second- and third-generation antihistamines are also first-choice options for treating allergies. They’re generally considered safe for most older adults. They start working about 1 to 3 hours after you take them and last for about 24 hours. They treat multiple allergy symptoms but may be less effective than the nasal sprays listed above for chronic symptoms.
Non-drowsy or less-drowsy antihistamine pills and liquids include:
Allegra
Claritin
Xyzal
Zyrtec
Just be sure to avoid any products that have a “-D” after their name, such as Allegra-D (fexofenadine / pseudoephedrine). These contain an oral decongestant. And as we’ll detail later on, oral decongestants aren’t considered a safe allergy medicine for older adults.
Good to know: Even though these are labeled as non-drowsy antihistamines, they can still cause mild sleepiness for some people. This is especially true for Zyrtec, which is more likely than the others to cause drowsiness. Consider trying Allegra first, as it’s the least likely of all antihistamines to make you sleepy.
How to save on less-drowsy antihistamines
GoodRx can also help you save on oral antihistamines, all of which are available as both brand-name and generic medications. You’ll just need a healthcare professional to write you a prescription for an OTC antihistamine in order to apply a GoodRx coupon to it.
Here’s what you could save by using GoodRx for oral antihistamines:
4. NasalCrom nasal spray
NasalCrom nasal spray is a safe choice for older adults when it comes to preventing and treating allergy symptoms. But it’s less effective than other options and may take up to 6 weeks to be fully effective. It’s recommended to start it at least a month before you expect allergy symptoms to start. It may be an option if you can’t tolerate the medications discussed above.
How to save on NasalCrom
You can also use GoodRx to save on NasalCrom, which is available as a brand-name and generic medication. With GoodRx, you could pay as low as $13.29 per bottle for cromolyn nasal spray.
5. Antihistamine eye drops
Sometimes allergy symptoms only affect the eyes (called allergic conjunctivitis). If you’re just treating red, itchy eyes, consider trying an antihistamine eye drop. These drops are also sometimes labeled as “antihistamine / mast cell stabilizer” eye drops since they work like both antihistamine and mast cell stabilizer medications.
Examples of antihistamine eye drop brands include:
Alaway
Pataday (comes in three different doses)
Zaditor
When choosing an allergy eye drop, look out for combination products. These often include a decongestant. Decongestant eye drops only treat red-looking eyes, not allergy symptoms. And they should only be used for up to 3 days in a row. Using them longer than this can cause redness to be worse when you stop using them (“rebound redness”).
How to save on antihistamine eye drops
GoodRx can also help you save on antihistamine eye drops. Check out how much you may save with a free GoodRx coupon at certain pharmacies:
6. Decongestant nasal sprays
Short-term use of decongestant nasal sprays is generally considered safe for most older adults. But they only treat congestion, not other types of allergy symptoms. They work very fast (within 10 minutes). But you should only use them for up to 3 days in a row. After that, there’s a risk of rebound congestion (worsening congestion when you stop using them).
Consider saving decongestant nasal sprays for just when you have severe congestion. You can find them OTC under many brand and generic names. A few popular examples are:
Afrin
Neo-Synephrine
Sinex
Good to know: There’s conflicting information on whether decongestant nasal sprays raise blood pressure. To be safe, ask a healthcare professional before using one if you’ve been diagnosed with high blood pressure or other heart problems.
How to save on decongestant nasal sprays
There are ways to save on decongestant nasal sprays which are available as brand-name and generic medications. If you use GoodRx, you may be able to save on the following products:
Which allergy medications aren’t recommended for older adults?
Steer clear of older, first-generation antihistamines that you take by mouth, such as Benadryl (diphenhydramine). These older antihistamines don’t work any better than newer ones. And they come with more drug interactions and side effects, such as dizziness and a higher risk of falls.
Older adults should also avoid oral decongestants, such as Sudafed (pseudoephedrine). Decongestant pills and liquids aren’t recommended for older adults because they can raise heart rate and blood pressure. They can also be risky if you have certain health conditions, such as thyroid problems, glaucoma, or an enlarged prostate.
Can you treat allergies without medication?
Yes, there are some medication-free options for managing allergies. If possible, avoid or limit your exposure to allergens. Strategies for this might include more frequent vacuuming, using air purifiers, or keeping the windows of your house closed to keep pollen out.
Nasal saline can also help soothe nasal passages and clear mucus. You can find it OTC in many forms including nasal sprays, rinses, or drops. Any type of nasal saline can be helpful. And since it doesn’t contain medication, you can use it as often as needed. Just be sure to use distilled water if you’re using a saline rinse (neti pot). Using tap water can lead to infections.
For eye allergies, consider using artificial tears. These don’t contain medication and can be used to rinse out allergens and soothe irritated eyes. Other tips for eye allergies include wearing sunglasses or a wide-brimmed hat when outdoors to prevent allergens from getting into your eyes.
Frequently asked questions
Allegra shouldn’t cause diarrhea. This isn’t a listed side effect for the medication. But it’s possible that you may be sensitive to one of the inactive ingredients in the product.
If you experience diarrhea after taking Allegra, try switching the dosage form you’re taking (such as switching from tablets to capsules). Or try changing to a different manufacturer (such as switching from brand-name Allegra to generic fexofenadine). Different products may contain different inactive ingredients. And you may tolerate one better than others.
People taking Claritin have experienced nosebleeds. But this doesn’t mean that the medication definitely caused it. Nasal congestion due to allergies is a common cause of nosebleeds. There are also other medications that are more likely to cause this side effect, such as steroid nasal sprays.
Using saline nasal spray or gel can help keep nasal passages moist. This can help limit or prevent nosebleeds. If you’re experiencing frequent nosebleeds, or they last for longer than 10 minutes, contact a healthcare professional. This isn’t typical, and you should be evaluated.
If your allergies seem to be worse now than when you were younger, you’re not alone. Many people develop new or worse allergies as they get older. This happens because of how your immune system changes with age. Some immune functions, such as responding to vaccinations, decrease over time. But others, such as reacting to allergens, can increase.
Allegra shouldn’t cause diarrhea. This isn’t a listed side effect for the medication. But it’s possible that you may be sensitive to one of the inactive ingredients in the product.
If you experience diarrhea after taking Allegra, try switching the dosage form you’re taking (such as switching from tablets to capsules). Or try changing to a different manufacturer (such as switching from brand-name Allegra to generic fexofenadine). Different products may contain different inactive ingredients. And you may tolerate one better than others.
People taking Claritin have experienced nosebleeds. But this doesn’t mean that the medication definitely caused it. Nasal congestion due to allergies is a common cause of nosebleeds. There are also other medications that are more likely to cause this side effect, such as steroid nasal sprays.
Using saline nasal spray or gel can help keep nasal passages moist. This can help limit or prevent nosebleeds. If you’re experiencing frequent nosebleeds, or they last for longer than 10 minutes, contact a healthcare professional. This isn’t typical, and you should be evaluated.
If your allergies seem to be worse now than when you were younger, you’re not alone. Many people develop new or worse allergies as they get older. This happens because of how your immune system changes with age. Some immune functions, such as responding to vaccinations, decrease over time. But others, such as reacting to allergens, can increase.
The bottom line
Corticosteroid (steroid) nasal sprays, such as Flonase Allergy Relief (fluticasone propionate), are some of the best allergy medicines for older adults. Astepro (azelastine) nasal spray and non-drowsy oral antihistamines, such as Allegra (fexofenadine), are also first-choice options. All of these allergy medications are safe for older adults.
NasalCrom (cromolyn) and antihistamine eye drops, such as Zatidor (ketotifen), are also safe but may be less effective. Older adults should avoid older antihistamines, such as Benadryl (diphenhydramine), and oral decongestants, such as Sudafed (pseudoephedrine). They have a greater risk for more serious side effects.
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