Dear Pharmacist, I have allergies and I’m not sure which medication to buy. Can you compare/contrast them? –
-M.T., Gainesville, Florida
Answer: The most common triggers include pollen, pet dander, dust mites, mold spores, cockroaches or foods (like mangos) or proteins in food. That last one about proteins (such as gluten in wheat, or casein in dairy) is extremely important because the “allergy” doesn’t look like your typical allergic sneezing fit. The allergy may be an underlying driving force that causes lifelong disorders such as asthma, diabetes, Rheumatoid, MS and so forth.
Your body has to defend itself against the perceived allergen. It utilizes military cells from your immune system which reside primarily in your gut. That’s why I’m always harping on you to eat well, take digestive enzymes, probiotics and avoid sugar. As your body struggles to remove the perceived invader, it creates chemicals -all with good intentions- that happen to trigger sneezing, itchy throat, irritated eyes, and runny nose. To relieve the misery of “allergic rhinitis” doctors prescribe antihistamines which dry you up. Makes sense right? We want to dry all those wet, sticky, runny mucus membranes. All of the following can cause dry mouth, dry eyes or constipation.
Diphenhydramine- Sold over-the-counter (OTC) as Benadryl. Causes extreme sedation so it’s perfect for nighttime use if you also have insomnia. If you take this, stay off the road!
Hydroxyzine- Known as “Vistaril” or “Atarax.” Doctors use it to treat allergies as well as anxiety, insomnia and skin rashes. It’s fallen out of favor, but it’s child (meaning, it’s metabolite) is a multi-million dollar business today.
Cetirizine- Known as Zyrtec, this is the child of hydroxyzine. It works well and can cause drowsiness, especially in older people; there’s debate, but I’d avoid citrus/grapefruit juice with this.
Levocetirizine- A relatively new drug called “Xyzal.” It’s the child of Zyrtec. Do you see a pattern with drug companies yet? They lose money when their drug goes generic, so they patent a metabolite from the first drug. It’s brilliant from a business standpoint but you can save money if you just buy the low cost generic that goes OTC, and let your body do the converting.
Loratadine- This is “Claritin” or “Alavert.” One pill works all day and I like it because it doesn’t make you sleep.%uFFFD There’s debate, but I’d avoid grapefruit juice with this.
Desloratadine- Sold as Clarinex, it’s the child of Claritin sold OTC. Works just as well, and with similar side effects but it’s prescription only and more expensive.
Nasonex- It’s a nose spray that doesn’t knock you out, or keep you up. Squirt once daily for 24 hour coverage.
Singulair- This drug squashes leukotrienes, not histamine. Some doctors prescribe it along with traditional antihistamines. Accolate is another drug in this class.
Pseudoephedrine- This is a decongestant used for a stuffy nose or sinus headache, it’s “Sudafed.”
Did You Know?
You can buy eye cups and soothing eye washes at any pharmacy. These help with red, puffy, itchy eyes.
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