How Can You Know Which Allergy Medicine Is Best?

by Kathi MacNaughton Health Professional

There are tons of allergy medicines available, both over the counter and by prescription. So, how can you know which one is best?

The answer to this question is not a simple one. First, it will be helpful to explore the main type of medicine used to treat allergies, which is an antihistamine. An antihistamine is a drug that blocks a receptor for histamine. Histamine is a chemical in your body that over-reacts to certain triggers, or allergens, such as pollen, mold, dust mites or pet dander and produces allergy symptoms. These symptoms can include sneezing, nasal stuffiness, sniffling, and itching. So, antihistamines help relieve or prevent those symptoms.

Let's look closer at the different choices you have for allergy medication:

  • First-generation antihistamines. These are the original medicines developed to treat allergy symptoms and are available over the counter. These medications are generally effective, but have some bothersome side effects, especially drowsiness, which makes it difficult to take them on a regular basis. Examples are Benadryl and Chlortrimeton.

  • Second-generation antihistmines. These medicines don't cause the same level of drowsiness as their predecessors, though some of them can still cause mild sedation in some people. However, they are all highly effective and can be taken on a regular basis with very few side effects. They also come in long-lasting versions, so you only need to take them once a day. Examples are Allegra, Zyrtec, and Claritin. Claritin has been sold over the counter for a couple of years, and also has a number of generic versions (loratidine).

  • Leukotriene modifiers. Singulair falls into this category and it is used for both allergies and asthma. It blocks leukotrienes, another body chemical that is involved in the allergic response.

  • Homeopathic medicines. This is an alternative treatment for allergies, whereby you take tiny amounts of allergens by mouth to slowly de-sensitize you over time to allergens (it's also known as sublingual immunotherapy).

So, which of these treatments are best for you?

Since the arrival of the second-generation, non-sedating antihistamines a decade or more ago, the first-generation drugs have fallen out of favor. Why take something that causes such bothersome side effects when you can take something just as effective that doesn't? Probably the main reason why anyone would take one of them now is the fact that you can buy them without a doctor's prescription and that they don't usually cost as much.

The jury is still out on whether homeopathic medicines are actually effective, though some people swear by them. They are definitely not proven through reliable research, however.

So, that leaves the second-generation antihistamines as the most common choice for treating allergies today. But among those, which is best? There are studies proving the effectiveness of one over the other in regards to various criteria, including length of action, quickness of action and level of relief. However, most of these studies were sponsored by the drug companies that make the medicines, so you have to look at those results with some caution and skepticism.

As an allergy sufferer who has tried all 3 of the second generation antihistmines, as well as most of the over the counter first-generation variety, I have to say I think it depends on the person. When I first saw an allergist as a young adult (prior to the existence of the newer allergy medicines), he prescribed a low dose of Benadryl twice daily. I took it regularly and never had any significant degree of sedation. When I take it these days, though, I do, so go figure.

On my second round of being treated by an allergist a decade later, I started trying the different second-generation drugs. Neither Claritin or Zyrtec were particularly helpful to me in relieving/preventing my allergy symptoms. It's not that they didn't work at all; they did, just not that well.

When I started taking Allegra, though, I got the best relief of my life. However, other people swear by Zyrtec or Claritin, so your experience may vary too.

My advice? Talk with your doctor about your particular set of symptoms, and then be willing to go through a trial and error period. Try one medicine for a few months, and if it isn't controlling your symptoms, ask if you can try a different one for a while.

Of course, the best way to prevent allergy symptoms is to avoid your triggers, but that's not always an easy task. Another option is to take allergy shots, which slowly de-sensitize you to your allergens over a period of months or years.

See also:

Medicines for Allergies

Medicines for Asthma

Symptoms of Allergies

Is Your Allergy Medicine Safe?

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.