Medicines for hay fever

Hay fever - Diagnosis and treatment

Diagnosis

Positive reaction to allergy test

Positive reaction to allergy test

A small area of swelling with surrounding redness (arrow) is typical of a positive skin prick test for allergy.

To diagnose hay fever, your health care provider typically does a physical exam and talks about your health, symptoms and possible triggers. Your provider may recommend one or both of these tests:

• Skin prick test. Small amounts of material that can trigger allergies are pricked into patches of skin on your arm or upper back. You're then watched for an allergic reaction. If you're allergic, you develop a raised bump (hive) at the site of that allergen. This typically takes about 15 to 20 minutes. Allergy specialists usually are best equipped to perform allergy skin tests.
• Allergy blood test. A blood sample is sent to a lab to measure your immune system's response to a specific allergen. This test measures the amount of allergy-causing antibodies in your bloodstream, known as immunoglobulin E (IgE) antibodies.

More Information

• Allergy skin tests

Treatment

Once you know what you're allergic to, you and your health care provider can develop a treatment plan to reduce or get rid of your hay fever symptoms.

It's best to limit your exposure to substances that cause your hay fever. If your hay fever isn't too severe, medications you can buy without a prescription may be enough to relieve symptoms. For worse symptoms, you may need prescription medications.

Many people get the best relief from a combination of allergy medications. You might need to try a few different options before you find what works best.

If your child has hay fever, talk with your child's health care provider about treatment. Not all medications are approved for use in children. Read labels carefully.

Treatments for hay fever may include medications, immunotherapy and nasal saline rinses.

Medications for hay fever

Nasal corticosteroids

These nasal sprays help prevent and treat the nasal stuffiness (congestion) and the itchy, runny nose caused by hay fever. For many people, nasal sprays are the most effective hay fever medications, and they're often the first type of medication recommended.

• Nonprescription nasal sprays include fluticasone (Flonase Allergy Relief), budesonide (Rhinocort Allergy), triamcinolone (Nasacort Allergy 24 Hour) and mometasone (Nasonex 24HR Allergy).
• Prescription nasal sprays that combine an antihistamine with a steroid include azelastine and fluticasone (Dymista) and mometasone and olopatadine (Ryaltris).

Nasal corticosteroids are a safe, long-term treatment for most people. Side effects can include an unpleasant smell or taste and nose irritation. Steroid side effects from a nasal spray are rare.

Antihistamines

Antihistamines work by blocking a symptom-causing chemical (histamine) released by your immune system during an allergic reaction. Antihistamines can help with itching, sneezing and a runny nose but have less of an effect on congestion. These preparations are usually given as pills (orally). However, there are also antihistamine nasal sprays that can relieve nasal symptoms. Antihistamine eye drops can help relieve eye itchiness and irritation.

• Oral antihistamines available without a prescription include loratadine (Claritin, Alavert), cetirizine (Zyrtec Allergy) and fexofenadine (Allegra Allergy).
• Nonprescription eye drops include olopatadine (Pataday) and ketotifen fumarate (Alaway, Zaditor).
• Nonprescription nasal sprays include azelastine (Astepro Allergy).
• Prescription nasal sprays include olopatadine (Patanase).

Common side effects of antihistamines are dry mouth, nose and eyes. Some oral antihistamines may make you sleepy. Other side effects of oral antihistamines can include restlessness, headaches, changes in appetite, trouble sleeping, and problems with blood pressure and urinating. Talk to your health care provider before taking antihistamines, especially if you're pregnant or breastfeeding, or have glaucoma or an enlarged prostate.

Decongestants

Decongestants reduce nasal stuffiness and pressure from swelling. Because they do not relieve other symptoms of hay fever, they're sometimes combined with other medications such as antihistamines.

Decongestants are available as liquids, tablets and nasal sprays. They are also available with and without a prescription.

• Oral decongestants include pseudoephedrine (Sudafed).
• Nasal decongestant sprays include phenylephrine hydrochloride (Neo-Synephrine) and oxymetazoline (Afrin).

Oral decongestants can cause a number of side effects, including increased blood pressure, insomnia, irritability and headache. Decongestants may cause problems urinating if you have an enlarged prostate. Check with your health care provider before taking decongestants if you have high blood pressure or heart disease or if you're pregnant.

Don't use a decongestant nasal spray for more than 2 to 3 days at a time because it can worsen symptoms when used continuously (rebound swelling).

Cromolyn sodium

Cromolyn sodium can help relieve hay fever symptoms by preventing the release of histamine. This medication is most effective if you start using it before you have symptoms. Cromolyn sodium is available as a nonprescription nasal spray that must be used several times a day. It's also available in eye drop form with a prescription. Cromolyn sodium doesn't have serious side effects.

Leukotriene modifier

Montelukast (Singulair) is a prescription tablet taken to block the action of leukotrienes. Leukotrienes are immune system chemicals that cause allergy symptoms, such as irritation in the nose and making too much mucus. It's especially effective in treating allergy-induced asthma. It's often used when nasal sprays can't be tolerated or for mild asthma.

Montelukast can cause headaches. In rare cases, it has been linked to psychological reactions such as insomnia, anxiety, depression and suicidal thinking. Get medical advice right away for any unusual psychological reaction.

Nasal ipratropium

Available in a prescription nasal spray, ipratropium helps relieve severe runny nose by preventing the glands in the nose from making too much mucus. It's not effective for treating congestion, itching or sneezing.

Mild side effects include dry nose, nosebleeds, dry and irritated eyes, and sore throat. Rarely, the medication can cause more-severe side effects, such as blurred vision, dizziness and trouble urinating. This drug is not recommended if you have glaucoma or an enlarged prostate.

Oral corticosteroids

Corticosteroid pills such as prednisone sometimes are used to relieve severe allergy symptoms. Because the long-term use of corticosteroids can cause serious side effects such as cataracts, osteoporosis and muscle weakness, they're usually prescribed for only short periods of time.

Immunotherapy for hay fever

Allergy shots

Also called immunotherapy or desensitization therapy, allergy shots change the way the immune system reacts to allergens. If medications don't relieve your hay fever symptoms or cause too many side effects, your health care provider may recommend allergy shots. Over 3 to 5 years, you'll get regular shots (injections) containing tiny amounts of allergens. The goal is to get your body used to the allergens that cause your symptoms and decrease your need for medications.

Immunotherapy might be especially effective if you're allergic to animal dander, dust mites or pollen produced by trees, grass or weeds. In children, immunotherapy may help prevent asthma.

Under-the-tongue (sublingual) allergy tablets

Rather than getting shots, you take tiny amounts of allergen in pill form that dissolves in your mouth. Pills are usually taken daily. Sublingual allergy tablets don't work for all allergens but can be helpful for grass and ragweed pollens and dust mites.

Nasal saline rinses for hay fever

Saline nasal spray

Saline nasal sprays can moisten dry nasal passages and thin nasal mucus. You don't need a prescription and you can use them as often as needed.

Nasal irrigation

Rinsing your nasal passages with saline (nasal irrigation) is a quick and effective way to relieve nasal congestion. Rinsing flushes out mucus and allergens from your nose. Saline irrigation is a water-based solution that contains a tiny amount of salt (sodium) and other ingredients.

Saline irrigation solutions can be purchased ready-made or as kits to add to water. You can also use a homemade solution. Look for a squeeze bottle or a neti pot — a small container with a spout designed for nose rinsing — at your pharmacy or health food store.

To make up the saline irrigation solution, do not use tap water, as it can contain organisms that could cause infection. Use water that's distilled or sterile. You can also use water that was boiled and cooled. Another option is using water that has been filtered using a filter with an absolute pore size of 1 micron or smaller.

To prevent infections, wash the bottle or pot with hot soapy water and rinse it after every use and leave it open to air-dry. Do not share a container with other people.

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Lifestyle and home remedies

It's not possible to avoid allergens completely, but you can reduce your symptoms by limiting your exposure to these substances. If you know what you're allergic to, you can avoid your triggers. Consider some of these tips.

Pollen or molds

Pollen and mold spores are fine dustlike particles that plants use in fertilization. They float in the wind and can get into your nose and eyes.

• Close doors and windows during pollen season.
• Don't hang laundry outside — pollen can stick to sheets and towels.
• Use air conditioning in your house and car.
• Use an allergy-grade filter in your home ventilation system and change it regularly.
• Avoid outdoor activity in the early morning, when pollen counts are highest, and also on high pollen-count days.
• Stay indoors on dry, windy days.
• Use a dehumidifier to reduce indoor humidity.
• Use a high-efficiency particulate air (HEPA) filter in your bedroom and other rooms where you spend a lot of time.
• Avoid mowing the lawn or raking leaves.
• Wear a dust mask when cleaning house or gardening.
• Wear glasses or sunglasses when outside to limit pollen getting in your eyes.

Dust mites

Dust mites are tiny, insect-like pests that are common in dust. They live in bedding, carpets, upholstery and stuffed animals. Dust mites prefer warm, humid spaces.

• Use allergy-proof covers on mattresses, box springs and pillows.
• Wash sheets, blankets and stuffed animals at least weekly in water heated to at least 130 F (54 C).
• Use a dehumidifier or air conditioner to reduce indoor humidity.
• Vacuum carpets weekly with a vacuum cleaner equipped with a small-particle or HEPA filter.
• Consider removing carpeting, especially where you sleep, if you're highly sensitive to dust mites.
• Use a damp mop and dust cloth to avoid stirring up dust.

Cockroaches

Cockroaches leave tiny droppings that can become airborne. Getting rid of the insects gets rid of their droppings.

• Block cracks and crevices where cockroaches can enter.
• Seal around and fix leaky faucets and pipes.
• Wash dishes and empty garbage and recyclables daily.
• Sweep food crumbs from counters and floors.
• Store food, including pet food, in sealed containers.
• Consider professional pest extermination.

Pet dander

Pet dander is tiny flecks of skin shed by cats, dogs, and other animals with fur or feathers. Pet urine and saliva may also contain allergens.

• Keep pets out of your home, if possible.
• Bathe dogs twice a week, if possible. The benefit of bathing cats hasn't been proved.
• Keep pets out of your bedroom and off furniture.
• Vacuum carpets often with a vacuum cleaner equipped with a small-particle or HEPA filter.
• Wash your hands after petting an animal.
• Wash clothes after contact with an animal.
• Ask a person without allergies to provide grooming and cleaning of pet areas.
• Consider removing carpeting, especially where you sleep, if you're highly sensitive to pet dander.
• Use a damp mop and dust cloth to avoid stirring up pet dander.

Alternative medicine

While there isn't much evidence about how well alternative treatments work, people sometimes try them for hay fever. Examples include:

• Herbal remedies and supplements. Extracts of the shrub butterbur may help prevent seasonal allergy symptoms. If you try butterbur, be sure to use a product that's labeled PA-free, which indicates that it's had potentially toxic substances removed.

  There's some limited evidence that spirulina and Tinospora cordifolia also may be effective. Though their benefits are unclear, other herbal remedies for seasonal allergies include capsicum, honey, vitamin C and fish oil.

  Herbal remedies and supplements are not evaluated by the U.S. Food and Drug Administration the way medications are. Discuss these products with your health care provider before using them.

• Acupuncture. Some people claim that acupuncture can help with seasonal allergy symptoms. There's limited evidence that these treatments work, but there's also little evidence of harm.

Preparing for your appointment

You're likely to start by seeing your primary care provider. However, in some cases when you call to set up an appointment, you may be referred to an allergist or other specialist.

Take a family member or friend along, if possible. Someone who accompanies you can help you remember information.

Here's some information to help you prepare for your appointment. Before your appointment, make a list of:

• Your symptoms, when they occur and what seems to trigger them. Include symptoms that might seem unrelated to hay fever.
• Recent life changes, such as a move to a new home or new part of the country.
• All medications you take, including vitamins, herbs and supplements, and their dosages.
• Questions for your health care provider.

For hay fever, questions to ask include:

• What is likely causing my symptoms?
• What tests do I need?
• Is my condition likely to go away on its own?
• What is the best course of action?
• What other treatments or ways to avoid triggers can you suggest?
• I have other health conditions. How can I best manage them together?
• Are there restrictions I should follow?
• Should I see a specialist?
• Are there brochures or other printed material that I can have? What websites do you recommend?

Don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your health care provider is likely to ask you a number of questions, including:

• When did your symptoms begin?
• Have your symptoms been continuous or occasional?
• How severe are your symptoms?
• What seems to trigger your symptoms?
• What, if anything, seems to improve your symptoms?
• Do any of your blood relatives, such as a parent or sibling, have hay fever or other allergies?
• Do your symptoms interfere with work, school or sleep?

What you can do in the meantime

While waiting for your appointment, remedies available without a prescription may help ease hay fever symptoms. They include pills, liquids, nasal sprays and eye drops. Also, try to reduce your exposure to possible triggers, if possible.

By Mayo Clinic Staff

Hay Fever Medications | AAAAI

Seasonal allergic rhinitis known as hay fever symptoms range from being mildly annoying to seriously impacting day-to-day life.  These symptoms can include sneezing, stuffiness, a runny nose or itchiness in your nose, roof of your mouth, throat, eyes or ears.

Hay fever symptoms are most often triggered by tree pollen in the early spring. Grasses are often the culprit during the late spring and early summer. Weeds are most often the cause of late summer and fall hay fever symptoms.

While avoiding the allergens that trigger symptoms is the best way to control hay fever, your allergist / immunologist may prescribe an allergy medication to manage your hay fever symptoms. These medications include nasal corticosteroid sprays, antihistamine pills, nasal antihistamine sprays or decongestant pills.

Antihistamines
If you have allergies, your allergist may prescribe an antihistamine. This medication treats hay fever and conditions such as hives. Antihistamines help prevent the effects of histamine, which is a chemical released by your body during an allergic reaction. By preventing the action of histamine, your allergy symptoms can be reduced. Antihistamines are available as a liquid, tablet or nasal spray.

Antihistamines are divided into:
•  “First generation, sedating,” which may cause drowsiness
• “Second generation, low-sedating or non-sedating,” which are much less likely to cause drowsiness

Potential side effects (usually associated with the “first generation” antihistamines):
• Dry mouth
•  Trouble urinating (especially in men with prostate problems)
• Constipation
• Drowsiness
• In some children: nightmares, unusual jumpiness, restlessness, irritability

Decongestants 
These medications may reduce your stuffy nose and other symptoms associated with allergies. Decongestants work by narrowing your blood vessels, which decreases the amount of fluid that leaks out into the lining of your nose. They are available as a liquid, tablet or nasal spray.

Potential side effects:
• Nervousness
• Sleeplessness
• Increased blood pressure or heart rate
• “Rebound rhinitis” can occur with the decongestant nasal spray if used for more than three or four days in a row. This rebound causes your stuffy nose to become more severe, which may lead you to become dependent upon the use of the medication.

Nasal Steroids  
The mainstay of treatment for allergic rhinitis, or hay fever, is nasal steroids. It is important to note that these are not like body-building, or anabolic, steroids. This type of steroids helps to control inflammation, in this case in the nose. For those with other than very mild and intermittent symptoms, nasal steroids are very helpful.

Nasal steroids take at least several days to become fully effective, so they should be used on a daily basis for the best relief of symptoms. In those with only seasonal  allergies, nasal steroids should be started a week or two before the anticipated start of pollen season. For those with perennial, or year-round allergies, nasal steroids should be used year-round. Nasal steroids are also used for nonallergic rhinitis and nasal polyps, and they can help decrease the frequency of sinus infection.

There are two types of nasal steroids, aqueous or wet, and powder or dry. The liquid nasal steroids include Nasonex, Nasacort AQ, Rhinocort AQ, Flonase Sensimist, Omnaris and Flonase. Several generic forms are also available. (Flonase, Flonase Sensimist, Nasacort and Rhinocort can now be bought over the counter.) The dry nasal steroids are Q-Nasl and Zetonna. Dymista is a combination of fluticasone and a nasal antihistamine.

Nasal steroids should be sprayed in the nose, pointed away from the septum, or midline of the nose. Potential side effects include dryness, burning, stinging and nosebleeds. If you experience these potential side effects, your doctor may prescribe an alternative nasal steroid for you.

The majority of allergy medications for hay fever work best if started before tree pollen is in the air and allergy symptoms develop. If you start taking allergy medications before you first come into contact with spring allergens, the medication can prevent the release of histamine and other chemicals. As a result, allergy symptoms may be much less severe.

Healthy Tips
• Avoid using a decongestant nasal spray for longer than three or four days in a row. It may cause your stuffy nose to become worse and cause you to become dependent upon the medication.
• See your allergist to find out which medication is right for you.

Other Resources
A complete list of medications used to treat allergies can be found in the AAAAI Drug Guide.

Monitoring pollen levels can help you avoid being outdoors during peak pollen times. The National Allergy Bureau^TM(NAB) provides the most accurate and reliable pollen and mold levels. The AAAAI also offers a mobile pollen app. Visit pollen.aaaai.org from your iPhone, iPad, BlackBerry or Android and add this app to your home screen.

For long-term relief of allergy symptoms, talk to your allergist / immunologist about Immunotherapy (allergy shots). This is a proven treatment approach that provides lasting benefits for many people suffering from allergic rhinitis. Allergy tablets are also available.

Reviewed: 9/28/20

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Respect! The symptom chart is for educational purposes only. Do not self-medicate; For all questions regarding the definition of the disease and how to treat it, contact your doctor. Our site is not responsible for the consequences caused by the use of the information posted on it. nine0005

Hay fever (hay fever) - signs, symptoms, causes, diagnosis and treatment of the disease

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Allergist-immunologist deals with the treatment of this disease

The information provided on this page should not be used for self-treatment or self-diagnosis. If you suspect a disease, you should seek help from a qualified specialist. Only your doctor can diagnose and prescribe treatment.

• Causes
• Symptoms
• Diagnostics
• Treatment
• Prevention

Hay fever (pollinosis, seasonal allergic rhinoconjunctivitis) is an allergic disease caused by plant pollen. It is seasonal, appearing in spring and summer during flowering.

Causes

The most common cause of hay fever is the seeds and pollen of wind pollinated plants. These small particles easily enter the respiratory tract and cause an allergic reaction. Aggravation, as a rule, happens on hot windy days when pollen soars in the air. nine0005

Other allergens can cause hay fever: dust, wool, cigarette smoke. In this case, the disease can make itself felt throughout the year.

Hay fever is more common in women and manifests itself at a young age. Also plays a role heredity.

Symptoms

Hay fever is characterized by the following symptoms:

• nasal congestion and mucus;
• swelling of the pale nasal mucosa;
nine0292 sneezing;
• breathing problems;
• itching in nose and throat;
• eye inflammation;
• rash.

Also hay fever may be accompanied by an attack of bronchial asthma.

Diagnosis

In the medical center "SM-Clinic" diagnosis is carried out on the basis of symptoms, as well as identified contacts with the allergen. As a rule, examination of the patient is sufficient to make a diagnosis. But to determine the allergen, additional tests are needed. For an accurate diagnosis, the doctor performs the following steps:

• Patient examination
• History taking
• Allergen testing. It is carried out by the method of skin or intradermal tests. Possible allergens are introduced into the body, after the injection, the reaction (redness and swelling) occurs within 20 minutes

Antihistamine (antiallergic) drugs, anti-inflammatory and vasoconstrictors are prescribed for the treatment of hay fever:

• The latest generation of antihistamines do not cause drowsiness and do not have other side effects that can adversely affect the patient's life.
• Anti-inflammatory drugs are applied topically to suppress the inflammatory response in the nose.
• Vasoconstrictor drugs relieve swelling, eliminating airway congestion.

For severe attacks of hay fever, the patient may also be prescribed immunotherapy, a series of treatments during which small doses of the allergen are injected into the body. In this case, the dose is gradually increased. Immunotherapy leads to a decrease in the reaction to the allergen in most cases. nine0005

SM-Clinic experts note that without proper treatment, pollinosis can provoke further weakening of the immune system and cause additional diseases (conjunctivitis, drug-induced rhinitis). Therefore, with symptoms of hay fever, it is recommended not to postpone going to the doctor.

Prevention

As in the case of any other allergy, it is necessary to avoid patient contact with the allergen. However, in the case of pollen, this is almost impossible. During flowering, the patient needs to filter the air in the room with an air conditioner and not open the windows to the street unless necessary. Also during this period, walks in the forest, park are not recommended. Upon returning home, be sure to change clothes and take a shower. nine0005

To make an appointment with an allergist in St. Petersburg, as well as to get answers to all your questions, call the SM Clinic at the number listed in the Contacts section.

Article published : 10/12/2016
Last updated : 11/04/2022

See also

Serum sickness

Exogenous allergic alveolitis

Allergic rhinitis

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