Seasonal allergies plague more than 10 percent of the American population. A runny nose and difficulty breathing are symptoms 10 percent of us are all too familiar with. And who can forget the Itchy, red, and puffy eyes. Now there are two new over the counter medications available to help you seek relief, at least for the eyes; Zaditor and Alaway.

Both Zaditor and Alaway are brand names for a drug called ketotifen fumarate. Ketotifen is an antihistamine which means it is great for treating the itchy eyes, runny nose and other symptoms that are caused by the release of histamine in the body. It is also the first product to have antihistamine AND ‘mast cell stabilizer' action, sold without a prescription. Sounds fancy but what it really means is that it has the potential to attack allergies from many different angles, potentially providing more allergy relief than drugs that just act as antihistamines alone.

How Should I Treat My Allergies?

 Generally when treating any condition, we start small and work our way up. This is an important concept as it helps minimize the amount of medication used and, therefore, the side effects associated with those medications.

When treating red itchy eyes, the first step is to attempt to eliminate and avoid any offending allergens. Next, in  conjunction with your doctor or pharmacist, you may choose to try an over the counter, antihistamine and/or decongestant eye drop product (Naphcon-A, Opcon-A, Visine-A OTC, etc). These are relatively inexpensive and a great many people find relief with these products. Remember, these products are for short term use only as they can cause a rebound effect. This means that the itchiness and redness can come back even stronger if you continue to use it on a regular basis.

If this doesn't work for you, you and your doctor may decide to try a topical antihistamine or anti-inflammatory product (Emedine, Livostin, Acular, Acular PF). These are fast-working products that can be especially helpful if swelling is involved.

Plain, mast cell stabilizing medications are next (Cromolyn, Alomide, Alocril, Alamast). These are good for prophylactic use which means you can use them if you think you will encounter something that will set off your allergies. These are safe and effective for short or long term use, however, they do not work as fast as other medications.

If these still don't work, you may opt for a product that is both an antihistamine and mast cell stabilizer (Optivar, Elestat, Zaditor, Alaway, Patanol). These are nice because the antihistamine action works quickly, while the mast cell stabilizing part of the formula provides longer acting effects.

Corticosteroid eye drops would be next in line and are only reserved to control severe symptoms (dexamethasone, Alrex, Lotemax, HMS Liquifilm, prednisolone acetate, prednisolone sodium phosphate). Before using these, generally, an ophthalmologist is consulted. These are never used as the first treatment to try and should not be used long-term. Long-term use of these drugs have been associated with glaucoma, cataracts and infections.

Along with the above, patients who experience sneezing and runny nose are often prescribed antihistamines orally. It may be advisable to try a newer antihistamine (like Claritin) versus an older one (like Benadryl) as the newer ones tend to have less side effects and can be taken less often.

Conclusion

If you suffer from seasonal allergies, work closely with your doctor and pharmacist when selecting drug therapies. They will be able to help point you in the right direction and help you select the best medication for your symptoms.

Author: Christi Larson, Pharm. D.