utorak, 18. ožujka 2014.

About Allergies: Should You Use Nasacort, Zyrtec, Claritin or Allegra for Allergy Symptoms?

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From Daniel More, MD, your Guide to Allergies

In February 2014, Nasacort AQ became available over-the-counter (OTC) without a prescription. It is currently referred to as Nasacort Allergy 24 Hour, and is the same medication as the prescription version. OTC Nasacort hits the shelves just in time for spring allergy season, but should you use this medication, or one of the newer OTC antihistamines, such as Zyrtec, Claritin or Allegra? The answer depends on the type and severity of your symptoms. Nasacort, an intranasal corticosteroid, is probably the most effective OTC medication for the treatment of nasal allergy symptoms. A downside to Nasacort is that it will not work on an as-needed basis; intranasal corticosteroids take time to work -- the may begin to give relief to allergy symptoms after about 6-10 hours, but full relief may not be obtained for days.

Antihistamines, such as Zyrtec, Claritin and Allegra, on the other hand, tend to work fairly quickly, usually within a couple of hours (or less) of taking the medication. Therefore, these medication work well when taken on an as-needed basis, as opposed to medications like Nasacort, which need to be taken most of the time for them to work. Antihistamines work best for the treatment of itchy nose, itchy eyes and sneezing -- and less well for symptoms of nasal congestion or runny nose. Of the three types of newer (and less sedating) antihistamines mentioned above, Zyrtec and Allegra work particularly well for the treatment of nasal allergies -- and usually within about an hour. Claritin, on the other hand, doesn't work as well, and takes about 3 hours to fully take effect. All three of these antihistamines are a good choice for spring allergy relief, and would be recommended over taking a sedating antihistamine such as Benadryl.

 

Over the Counter Nasacort Allergy 24 Hour
In July 2013, the U.S. Food and Drug Administration’s (FDA) Committee on Non-Prescription Drugs voted to allow Nasacort AQ (triamcinolone) nasal spray to be sold over-the-counter (OTC) without a prescription. Nasacort AQ would be the first intranasal corticosteroid nasal spray to be sold OTC without being prescribed by a healthcare professional. While most low sedating antihistamines have been available OTC for many years, including Zyrtec (cetirizine), Allegra (fexofenadine) and Claritin (loratadine), the only other medicated nasal sprays available OTC include topical nasal decongestants (such as Afrin) and NasalCrom (cromolyn).

Nasal Steroid Sprays for Allergies
Nasal steroids are a commonly used medication to treat the symptoms of allergic rhinitis (also called hay fever). These medications work by decreasing the allergic inflammation within the nasal passages, and treat symptoms such as sneezing, itchy nose, runny nose, congestion and post-nasal drip. Since steroids generally take many hours before they begin to work, nasal steroids do not work well on an "as-needed" basis, and therefore need to be used routinely for best effect.

Most studies show that nasal steroids are the single most effective medicine available for the treatment of nasal allergies. In fact, many studies show that nasal steroids are better at treating allergy symptoms than oral antihistaminesnasal antihistamine sprays or Singulair. Nasal steroids are also particularly good at treating symptoms of eye allergies.


Antihistamines for the Treatment of Allergic Rhinitis

Antihistamines are medications that block a receptor for histamine, thereby stopping the symptoms that histamine causes. Antihistamines are the most commonly used medications to treat allergic rhinitis. Older antihistamines, called first-generation antihistamines, include diphenhydramine (Benadryl), chlorpheniramine (Chlor-Trimeton), and hydroxyzine (Atarax/Vistaril). Because of the side effects of these medications, they are generally considered to be too sedating for routine daytime use. Newer antihistamines, called second-generation anthistamines, include cetirizine (Zyrtec), fexofenadine (Allegra, generics), desloratadine (Clarinex), and loratadine (Claritin, Alavert, various generics). These newer antihistamines tend to have fewer anticholinergic side effects, and therefore are termed “low-sedating” or “non-sedating”.

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Daniel More, MD
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