Treatment strategies focus on impeding the function of the IgE antibodies, interruption of the release of antigen-induced autocoids (histamine and eicosanoids) and decreasing their effects at the receptor sites.

Environmental Interventions

Avoiding allergens is a useful but not an often practical way to reduce allergy symptoms. There are some environmental interventions that can help to reduce the presence of irritants in the environment:

• Keep windows closed and the air conditioner on in spring and autumn
• Use a HEPA (high-efficiency particulate air) filter to remove pollen, mold and dust
• Use a dehumidifier in damp areas like the basement
• Install wood, tile or vinyl floors rather than carpet that can trap allergens
• If you do have carpets, have someone else do the vacuuming or buy a machine designed to reduce dust emissions.
• Treat carpets with an anti-allergen spray or powder that kills dust mites (acaricide)
• Minimize clutter and books which collect dust and pollens
• Keep pets outside or bathe them regularly if they're indoors, and keep them off your bed
• Wash your hair every night before going to bed to rinse off dust and pollen
• Use mattress and pillow covers to create a barrier from dust mites
• Take shoes off at the door
• Wash clothing as soon as possible after being outside for extended periods
• Avoid use of stuffed toys for children

Oral Medications

Antihistamines have been available for over 50 years - they work by interfering with the effect of histamine. A major side effect of traditional antihistamines is drowsiness and some types produce more than others. Examples include:

• Diphenhydramine (Benadryl - available over the counter)
• Chlorpheniramine (Usually taken as an ingredient in over the counter combination products such as Alza-Seltzer Plus Cold Medicine, Chlor-Trimeton, and Comtrex)

Second-generation antihistamines are less sedating than other antihistamines. Examples include:

• Loratidine (Claritin) - available over the counter
• Cetirizine (Zyrtec)
• Fexofenadine (Allegra)
• Desloratidine (Clarinex)

Leukotriene-receptor antagonists (LTRAs) are non-steroidal oral medications that are available as a chewable tablet or in granules that can be dissolved in liquid or food. They may also be referred to as anti-inflammatory bronchoconstriction preventors. LTRAs work by blocking a chemical reaction that can lead to inflammation in the airways. Although not preferred first choice therapy, LTRAs can be tried when an inhaled steroid cannot be used or if the dose cannot be increased. Side effects include nausea and headache. Examples include:

• Montelukast (Singulair)
• Zafirlukast (Accolate)
• Zileuon (Zyflo)

In August 2009, the U.S. Food and Drug Administration (FDA) asked the manufacturers of leukotriene-modifying drugs to include a precaution in their labeling about the potential for neuropsychiatric events with these medications. The drugs include Accolate (zafirlukast), Zyflo (zileuton), and Zyflo CR (zileuton), which are used to treat asthma, and Singulair (montelukast), which is used to treat asthma and allergic rhinitis, and to prevent exercise-induced asthma.