Allergy Treatment

It is the time of year that brings many people in with questions about allergies and the medications used to treat them.  Here is the rundown on available treatments for seasonal allergies:

1.  Daily antihistamines (brand names Claritin, Zyrtec, Allegra) - usually the first line treatment; all of these medications are available over the counter, can be given once a day, and usually do not cause sleepiness (unlike our old standby, Benadryl).  The exception to this is Zyrtec, which can cause sedation in some children.   I usually dose these medications in the evening before bed to minimize this side effect.
2.  Steroid nasal spray (brand names Fluticasone, Flonase, Nasonex) - anti-inflammatory medication that blocks the body's allergic response to environmental allergens; the first choice of many doctors due to their potency and the rapid onset of relief of symptoms.  I usually recommend these if patients have not gotten better with antihistamines or if parents want to avoid antihistamine side effects.  The major side effects of steroid nasal sprays are nasal membrane dryness and nosebleeds.   Steroid nasal sprays are prescription-only, so your child will need to be evaluated by his/her doctor to see if nasal spray would be beneficial.  Your child would have to be able to tolerate a nasal spray - this is a drawback for some kids. 
3.  Mucinex - mucolytic medication that thins nasal mucus to decrease postnasal drip; also helps with cough associated with postnasal drip.  I sometimes add this medicaiton for night-time cough associated with allergies. 
4.  Singulair/ class of medication called leukotriene inhibitors - originally developed as an asthma medication, decreases the inflammatory response in the airways to allergens.  These medications are sometimes used as an adjunct to the above allergy medications.  I find this most helpful for children who have BOTH allergies and asthma, since it treats both conditions.  As an allergy medication alone, it is not as powerful at controlling symptoms as steroid nasal spray or antihistamines.  These medications also have side effects including behavior/mood changes, so any use should be discussed with your child's pediatrician.

If allergy medications do not control the symptoms, consider making an appointment with an allergist for an evaluation and possible allergy testing.