Choosing an Allergy Medication: Avoid These 7 Common Mistakes

Allergies affect millions of children and adults in the U.S. every year. Common symptoms of allergies include sneezing, congestion, and itchy eyes.

From Flonase to Claritin and Allegra to Zyrtec, there are many allergy medications to choose from. But with so many options that you can find over the counter (OTC), it’s easy to pick one that might not work well for your situation — especially when you don’t know what to look for.

So let’s walk through seven common mistakes when it comes to choosing allergy medications and what to do instead.

1. Not trying a steroid nasal spray like Flonase or Nasacort

For severe or persistent allergy symptoms, experts recommend corticosteroid (steroid) nasal sprays. These medications work better than allergy pills for many people. Examples include Flonase (fluticasone), Nasacort Allergy (triamcinolone), and Nasonex (mometasone).

Keep in mind that steroid nasal sprays may take up to 2 weeks to be fully effective. So start using it a few weeks in advance if you know you usually experience allergies at a certain time of the year.

Many steroid nasal sprays are available OTC. There are also prescription steroid nasal sprays, such as Qnasl (beclomethasone). Talk with a healthcare professional to find out what type of steroid nasal spray might be best for you.

2. Not considering an antihistamine nasal spray

While Flonase and other nasal steroid sprays are effective, they might not work for everyone. If they don't provide enough relief, try switching to an antihistamine nasal spray. These products have the benefit of providing both fast-acting relief and symptom prevention.

Astepro (azelastine) is an OTC antihistamine nasal spray. But there are others that are available with a prescription, such as Patanase (olopatadine).

There are also prescription combination nasal sprays — like Dymista (fluticasone / azelastine). These nasal sprays contain a steroid and an antihistamine. In some cases, you may need to use both types of nasal sprays. These medications can help simplify your allergy regimen.

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3. Using a nasal decongestant spray for too long

It’s possible to overuse nasal decongestant sprays, such as Afrin (oxymetazoline) and Neo-Synephrine (phenylephrine). These are not the same as Flonase or Astepro. And you should only use them occasionally.

If you use these sprays for more than 3 days in a row, you might notice rebound congestion. This is congestion that gets worse after you stop using the spray. It may make you think using more of the spray will help, when, in fact, it can lead to worse symptoms.

4. Not trying Claritin or another nondrowsy antihistamine

If nasal sprays aren’t right for you, consider an oral nondrowsy antihistamine. As the name suggests, nondrowsy antihistamines shouldn’t make most people sleepy. These include Claritin (loratadine) and Allegra (fexofenadine). They can help relieve many allergy symptoms, like sneezing and watery eyes.

When compared to steroid nasal sprays, oral antihistamines aren’t as effective. But they’re good at quickly relieving mild or moderate allergy symptoms. And if needed, you can safely combine the two. This means you can take Flonase with Claritin or Allegra.

Good to know: Even “nondrowsy” antihistamines carry a small risk for drowsiness. Some people are more sensitive to this side effect than others. But most people can take them without feeling sleepy. If it’s your first time trying an oral antihistamine, take your first dose when you don’t have to perform tasks that require focus.

5. Accidentally choosing an OTC medication with a sedating antihistamine like Benadryl

It’s easy to confuse drowsy (“older”) and nondrowsy (“newer”) antihistamines. OTC antihistamines that commonly cause drowsiness include Benadryl (diphenhydramine) and chlorpheniramine. These medications are also included in many “nighttime” cold and allergy medications. It’s best to stay away from these medications during the day.

Zyrtec (cetirizine) is a newer antihistamine that has a higher risk of drowsiness than Claritin or Allegra. But it’s still less likely to make you sleepy than Benadryl or chlorpheniramine. So if you’re going to try Zyrtec, be cautious about driving until you know how it makes you feel.

Take our quiz: Allergy medications

6. Not knowing when to try or avoid allergy medicines ending with ‘-D,’ like Claritin-D and Zyrtec-D

Sudafed (pseudoephedrine) is an oral nasal decongestant. It’s an active ingredient in some allergy medications that have “-D” at the end of their names.

For example, Claritin contains loratadine. But with the addition of pseudoephedrine, Claritin becomes Claritin-D (loratadine / pseudoephedrine). Similar medications include Zyrtec-D (cetirizine / pseudoephedrine) and Allegra-D (fexofenadine / pseudoephedrine).

Short-term Sudafed use is safe for many people. And when combined with an oral antihistamine, it may provide better allergy relief. But avoid using it for longer than 7 days without a healthcare professional’s OK.

Sudafed can cause many unwanted side effects, such as increased blood pressure and heart rate. The risk for these issues goes up the longer you take it. These side effects also make it a risky choice for people with heart conditions or high blood pressure.

7. Not using eye drops for red, itchy eyes

For red and itchy allergic eyes, consider antihistamine eye drops. They quickly relieve eye symptoms. They also have a lower risk of bodywide side effects than oral antihistamines. They could be a good option if your allergy symptoms only include the eyes.

But keep in mind their effects don’t last as long as oral or nasal antihistamines. And they can potentially cause dry eye, which may worsen eye allergy symptoms. So it’s a good idea to ask a healthcare professional if they’re the best choice for your symptoms.

Some examples of OTC antihistamine eye drops include:

• Zaditor (ketotifen)

• Alaway (ketotifen)

• Pataday (olopatadine)

• Lastacaft (alcaftadine) 

Antihistamine eye drops are also available as prescription products. Examples include Zerviate (cetirizine) and Bepreve (bepotastine).

Can you take Flonase and Zyrtec together?

Yes, you can take Flonase and Zyrtec together. This combination is safe, since the two medications work differently in the body. But it doesn’t always provide more allergy relief for everyone.

Steroid nasal sprays like Flonase typically work better than oral antihistamines like Zyrtec. So, if you’re already using a steroid nasal spray, there’s usually no benefit to adding an oral antihistamine. Using a steroid nasal spray with an antihistamine nasal spray, such as Astepro, is often a more effective combination.

But everyone reacts differently to medications. So it's possible your healthcare team may suggest taking Flonase and Zyrtec together.

When to see a healthcare professional for allergy symptoms

Many people can manage allergy symptoms at home with OTC medications. But there are times where you should seek a healthcare professional’s guidance.

Talk to a healthcare professional about allergy symptoms if you:

• Also have a fever, body aches, or other symptoms of an infection

• Also have difficulty breathing

• Also have neck pain or stiffness

• Suddenly develop hives or dermatographia (“skin writing”)

• Experience swelling of the lips, tongue, or throat

• Don’t experience any relief with OTC allergy medications

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Written by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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