3 Reasons to Choose OTC Antihistamines Over OTC Decongestants to Treat Your Allergy Symptoms

by Kathi MacNaughton Health Professional

Choosing the right types of medicines to treat the symptoms of your nasal allergies can be a tricky business. Most allergy medications today are available over the counter (OTC). While this makes them more accessible, it also means that the consumer — you — is often on your own in trying to choose the right medicine for you and your symptoms.

What Are the Symptoms of Nasal Allergies?

To review quickly what symptoms I am referring to, here are the things most people who have nasal allergies struggle with:

  • Nasal congestion

  • Runny nose

  • Sneezing

  • Itchy nose, throat, oral cavity, eyes, etc.

  • Watery eyes

There may be other symptoms too, but these are the most common.

What Types of Medicines Relieve These Allergy Symptoms?

The most commonly used medication type for allergies is an antihistamine. This type of medicine comes in oral form (pills or liquid), as eye drops, nasal sprays, and even in lotion form for skin allergies. Antihistamines are very effective in treating the itching, sneezing, runny nose and watery eyes.

Unfortunately, antihistamines don't relieve nasal congestion. For that reason, people often turn to decongestant medicines in order to get relief from this bothersome symptom.

Some antihistamines are available in a combination form with a decongestant. When you see a medicine such as Allegra-D, Claritin-D or Zyrtec-D, this means the antihistamine Allegra, Claritin or Zyrtec has been combined with some type of decongestant.

Decongestants also come in the form of nasal sprays, such as Afrin. NOTE: The newer nasal sprays such as Flonase and Nasacort are actually steroids, rather than decongestants. They work in different ways and don't carry the same risk.

So What Are the 3 Important Reasons to Use Caution with Decongestants?

Although decongestants can be quite effective at relieving nasal stuffiness, they are not usually an ideal choice for ongoing treatment. Here's why:

1. You can become dependent on decongestants. This happens especially when you use these medicines often, or all the time, over a number of months or years. It is not an addiction such as you might have with pain medicine. But your body does become dependent on having this medicine continuously in order for you to breathe easily. And it's never a good idea to be dependent on a foreign substance for quality of life

2. The decongestant's effectiveness can wear off over time. Unfortunately, even if the decongestant did a great job at first, over time it will probably stop working as well. So, you may be tempted to use it more often or maybe in larger doses. But in the end, this just results in your nasal congestion getting worse and worse.

3. When you stop taking a decongestant, you may find that your nasal congestion is worse than before you started. This is called a rebound effect, and it is especially common with decongestant nasal sprays.

In addition, I'll share my personal experience with decongestants: They keep me awake at night! Twice, I took an Allegra-D preparation and both times I didn't sleep for a few nights, until I realized the cause of my insomnia. Never again for me!

What CAN You Do to Treat Nasal Congestion?

This is a great topic of discussion to share with your allergy specialist. Some people will benefit from the short-term, controlled use of a decongestant, for especially severe allergy attacks, or when a common cold worsens allergy symptoms. But it is important to follow your doctor's instructions for taking and stopping the medicine.

You might also check into the new OTC nasal steroid sprays, such as Nasacort and Flonase. These can be very effective for some people in treating all of the symptoms of nasal and eye allergies. The plus is that these medicines are also safer than decongestants for long-term use.

Kathi  MacNaughton
Meet Our Writer
Kathi MacNaughton

Kathi is an experienced consumer health education writer, with a prior career in nursing that spanned more than 30 years — much of it in the field of home health care. Over the past 15 years, she's been an avid contributor for a number of consumer health websites, specializing in asthma, allergy, and COPD. She writes not only as a healthcare professional, but also as a lifelong sufferer of severe allergies and mild asthma, and as a caregiver for her mother with COPD.