SAN ANTONIO – As mountain cedar counts keep rising, patience keeps dropping for allergy sufferers.
Allergist Dr. Dennis Dilley with Dilley Allergy & Asthma helped us figure out which medications work for specific symptoms.
Three legs to allergic reactions
1. A histamine reaction that can be helped by allergy pills
2. Inflammation that can be helped by nasal sprays
3. Severe symptoms/asthma that can be helped by prescription medications, such as Singulair (generic called montelukast)
Over-the-counter pills
“Those are mostly given to people who have the histamine-type reactions: itchy watery eyes, sneezing, runny nose,” Dilley said.
For a stuffed-up nose, you can get decongestants, but Dilley said people with heart issues or high blood pressure should avoid those.
Can you take allergy pills twice a day?
“The studies show that you could take more when the need was there. So if cedar is really high and you’re on one pill of allergy medicine, as long as you don’t have any other complications in your health, yes, you can take a second dose if you need to. It’s very common for people to do that,” Dilley said.
Children’s allergy medicine
“Children’s Zyrtec, for example, in 2- to 6-year-old kids, can be dosed twice a day, so a split dose often works better because their body metabolizes the medicine faster. Allegra is twice a day for children as well,” Dilley said.
Dilley also explained when children are old enough to use the adult versions of medication, including nasal sprays.
“They can start using the adult medications usually between the ages of six and 12, depending on the size of the child. They can start using the nasal steroid sprays as young as two. Those we use a lot for the younger kids that are used to getting a lot of sinus infections. They tend to do better with those nasal sprays,” Dilley said.
Eye drop tip for kids
Many people with eye issues can take eye drops, but parents know getting kids to cooperate is tough.
“I generally tell the parents to have them lay on their on the bed on their back with their eyes closed. I put the drop on the corner of the eye and then let them open their eye, and it’ll go in there. Tell them what you’re going to do so they’re not confused,” Dilley said.
Nasal sprays
Steroid nasal sprays are brands like Flonase, but there are many different versions.
Antihistamine nasal sprays are brands like AstePro, which just became available over the counter.
Dilley said you can use both sprays if you have severe or mixed symptoms.
Solo headache symptoms
There are many people whose sole allergy symptom is headache.
“Those are what I call packers. Their allergies pack in their sinuses. So usually nasal rinses, then the nasal sprays are super effective. Sometimes they’ll need to do a nasal rinse with a steroid to get that steroid washed up in there,” Dilley said.
He said people with mainly headaches may want to avoid histamine pills like Zyrtec, Allegra, and Claritin.
“I generally tell them not to take antihistamines over the counter because that dries our sinuses further. Usually, that’s what they’re doing to try to counter it,” Dilley said.
If you mostly feel like your head’s packed, stick to a saline nasal rinse, followed by over-the-counter sprays. Typically, both steroid and antihistamine sprays work best together.
However, Dilley said Flonase contains alcohol, which can irritate some people’s noses or even cause a headache.
“If you have irritation, there are also more gentle sprays with the active name budesonide. Then also just direct the spray a little bit away from the middle to also help,” Dilley said.
A former brand of budesonide was called Rhinocort, but it was discontinued last year.
Can you take allergy medication every day?
“If you’re allergic to something all year round? Absolutely. The one downside to them over the long haul is that if you’re a person who works like on a computer screen, the antihistamine chronic use will tend to accelerate the development of dry eye, which is really annoying to people,” Dilley said.
Allergy shots
“By the time they get to us for shots, they usually have already tried the over-the-counter stuff, and they’ve been taking it consistently. They’ve usually been prescribed things by their doctors,” Dilley said.
Allergy shots contain the things that you’re allergic to. The dosing is slowly built up to what’s called a “maintenance dose.” Being on that maintenance dose over time makes you less and less allergic to that.
Some people are on shots year-round, whereas others take them seasonally depending on specific allergies.
Natural immunity does not build up over time
“I often get asked, ‘Well, how come it doesn’t work when I’m exposed to it naturally?’ Really, the reason why is because those levels vary too much,” Dilley said.
In fact, he said the allergy can actually get worse over time.
“The reason why is because the part of your immune system that causes allergy is your immune memory. The next year, they have memory for that, so it’s amplified even harder,” Dilley said.
Talk to your doctor
If you have persistent symptoms or any medical issues, Dilley said to make a doctor’s appointment.